Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study

Background People experiencing homelessness (PEH) often die at a younger age than the general population. Advanced ill-health often occurs late in its trajectory (if at all), leaving many PEH to die without adequate support from hospital-based, hospice-based or community-based palliative care servic...

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Main Authors: Kate Flemming, Briony Hudson, Caroline Shulman, Emma Casey, Jodie Crooks, Mandy Pattinson, Gareth Davis
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e096990.full
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author Kate Flemming
Briony Hudson
Caroline Shulman
Emma Casey
Jodie Crooks
Mandy Pattinson
Gareth Davis
author_facet Kate Flemming
Briony Hudson
Caroline Shulman
Emma Casey
Jodie Crooks
Mandy Pattinson
Gareth Davis
author_sort Kate Flemming
collection DOAJ
description Background People experiencing homelessness (PEH) often die at a younger age than the general population. Advanced ill-health often occurs late in its trajectory (if at all), leaving many PEH to die without adequate support from hospital-based, hospice-based or community-based palliative care services. Despite the high rate of bereavement and exposure to death among PEH, there are rarely opportunities for them to reflect on their experiences, thoughts and preferences around death or receive bereavement support. Death cafés are a global social franchise, providing a space for people to participate in an open group discussion about death, dying and bereavement. They are free to attend and unstructured but facilitated.Objectives To explore the perspectives of PEH and the professionals that support them with regards to the potential acceptability, benefits and challenges of death cafes.Methods A qualitative study comprising of interviews with nine homelessness and/or palliative care professionals with experience of running death cafés for, or supporting PEH in other ways, and two focus groups with nine people with lived experience of homelessness. The research was co-produced with a lived experience co-researcher forming a core part of the research team. Reflexive thematic analysis was utilised to develop themes.Results Five themes were developed to highlight the perspectives and experiences of death cafés for PEH: choice; expertise in facilitation: recognising risk and the unstructured nature; promoting safety against potential risk; potential benefits and potential practical considerations. Themes highlight the need for a trauma-informed approach. Death cafés could be impactful, where done well, but they are not without risk.Conclusions Death cafés for PEH pose risks that require comprehensive consideration and trauma-informed, expert facilitation. However, this research highlighted that a low-pressure space to explore thoughts around death, dying and bereavement is currently an unmet need within this population.
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spelling doaj-art-512bdbb9476a42d9ba744981a5c6f7792025-08-20T02:30:50ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-096990Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative studyKate Flemming0Briony Hudson1Caroline Shulman2Emma Casey3Jodie Crooks4Mandy Pattinson5Gareth Davis6University of York, York, UKMarie Curie, London, UKPathway, London, UKGroundswell, London, UKMarie Curie, London, UKPathway, London, UKPathway, London, UKBackground People experiencing homelessness (PEH) often die at a younger age than the general population. Advanced ill-health often occurs late in its trajectory (if at all), leaving many PEH to die without adequate support from hospital-based, hospice-based or community-based palliative care services. Despite the high rate of bereavement and exposure to death among PEH, there are rarely opportunities for them to reflect on their experiences, thoughts and preferences around death or receive bereavement support. Death cafés are a global social franchise, providing a space for people to participate in an open group discussion about death, dying and bereavement. They are free to attend and unstructured but facilitated.Objectives To explore the perspectives of PEH and the professionals that support them with regards to the potential acceptability, benefits and challenges of death cafes.Methods A qualitative study comprising of interviews with nine homelessness and/or palliative care professionals with experience of running death cafés for, or supporting PEH in other ways, and two focus groups with nine people with lived experience of homelessness. The research was co-produced with a lived experience co-researcher forming a core part of the research team. Reflexive thematic analysis was utilised to develop themes.Results Five themes were developed to highlight the perspectives and experiences of death cafés for PEH: choice; expertise in facilitation: recognising risk and the unstructured nature; promoting safety against potential risk; potential benefits and potential practical considerations. Themes highlight the need for a trauma-informed approach. Death cafés could be impactful, where done well, but they are not without risk.Conclusions Death cafés for PEH pose risks that require comprehensive consideration and trauma-informed, expert facilitation. However, this research highlighted that a low-pressure space to explore thoughts around death, dying and bereavement is currently an unmet need within this population.https://bmjopen.bmj.com/content/15/6/e096990.full
spellingShingle Kate Flemming
Briony Hudson
Caroline Shulman
Emma Casey
Jodie Crooks
Mandy Pattinson
Gareth Davis
Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
BMJ Open
title Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
title_full Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
title_fullStr Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
title_full_unstemmed Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
title_short Exploring perspectives regarding death cafés for people experiencing homelessness: a qualitative study
title_sort exploring perspectives regarding death cafes for people experiencing homelessness a qualitative study
url https://bmjopen.bmj.com/content/15/6/e096990.full
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