Caring for People on the Margins: An Institutional Ethnographic Exploration of Community Palliative Care Work for People who are Precariously Housed

Petruik, Courtney Rae

Caring for People on the Margins: An Institutional Ethnographic Exploration of Community Palliative Care Work for People who are Precariously Housed

dc.contributor.advisor	Ducey, Ariel
dc.contributor.advisor	McCoy, Liza ( Associate Professor Emerita)
dc.contributor.author	Petruik, Courtney Rae
dc.contributor.committeemember	Milaney, Katrina
dc.contributor.committeemember	Tezli, Annette
dc.contributor.committeemember	Marshall, Zachary
dc.contributor.committeemember	Stajduhar, Kelli
dc.date	2023-11
dc.date.accessioned	2023-09-20T17:40:53Z
dc.date.available	2023-09-20T17:40:53Z
dc.date.issued	2023-09-15
dc.description.abstract	People experiencing homelessness have more barriers accessing healthcare than the general population. Challenges are worsened when people become ill and require end-of-life care (EOLC). Some barriers to EOLC for this population include discrimination, service providers who lack knowledge about homelessness, and fewer opportunities to voice care preferences. As part of a developing palliative equity movement, small teams have been created to provide better EOLC for people experiencing homelessness. While much research explores homelessness and healthcare, to date, none investigates the social organization of these teams amidst the mainstream system. This research addresses this gap by exploring how one of these small teams, the Community Allied Mobile Palliative Partnership (CAMPP), interacts with clients, structures their work, hooks into the mainstream healthcare system, and is institutionally accountable to a broader philanthropic funding structure in Calgary, Canada. This project uses institutional ethnography (IE) as its guiding mode of inquiry. From the standpoint of CAMPP clients, IE promotes understanding of how this team’s work is put together, produced, legitimized, and challenged while operating in the interstices of the mainstream healthcare system. With over 100 hours of observations, document reviews, and 21 client and service provider interviews, this research recasts the reader’s view from taken for granted medical models of palliative care toward the social realities of people at society’s margins and how the CAMPP team embeds these needs into their care model. Grounded in client accounts, this project illustrates how the mainstream system is structured to create challenges for people facing economic marginalization warranting a service like the CAMPP team. Paying close attention to language, this study shows how CAMPP is shaped by and reshapes the palliative care discourse to include social factors, mobilizing the widely recognized model of “harm reduction”. Lastly, this project describes how the CAMPP team is funded and their perceptions of the sustainability of their program. This study has implications for policymakers, community programs, researchers, and people experiencing homelessness by making visible how teams like CAMPP provide care “at the margins” of dissolution while caring for people “at the margins” of society.
dc.identifier.citation	Petruik, C. R. (2023). Caring for people on the margins: an institutional ethnographic exploration of community palliative care work for people who are precariously housed (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.uri	https://hdl.handle.net/1880/117124
dc.identifier.uri	https://doi.org/10.11575/PRISM/41966
dc.language.iso	en
dc.publisher.faculty	Graduate Studies
dc.publisher.institution	University of Calgary
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subject	institutional ethnography
dc.subject	palliative care
dc.subject	homelessness
dc.subject	houselessness
dc.subject	end-of-life care
dc.subject.classification	Public and Social Welfare
dc.subject.classification	Social Structure and Development
dc.title	Caring for People on the Margins: An Institutional Ethnographic Exploration of Community Palliative Care Work for People who are Precariously Housed
dc.type	doctoral thesis
thesis.degree.discipline	Sociology
thesis.degree.grantor	University of Calgary
thesis.degree.name	Doctor of Philosophy (PhD)
ucalgary.thesis.accesssetbystudent	I do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.