# Creating Compassionate Spaces for End-of-Life Care for Older People Experiencing Homelessness: Protocol for an Environmental Assessment of Hospice Settings

## TL;DR

This study aims to improve end-of-life care for older homeless people by assessing hospice environments and suggesting design changes.

## Contribution

The paper introduces a new protocol for evaluating hospice environments tailored to older people experiencing homelessness.

## Key findings

- The Aging in the Right Place-Hospice Environmental Assessment Protocol (AIRP-HEAP) was developed to evaluate hospice environments.
- Adaptations to the protocol include reconceptualizing spiritual care and family accommodation for older homeless individuals.
- Data collection and analysis are planned to inform recommendations for hospice design improvements.

## Abstract

With current data supporting an increasing population of older people experiencing homelessness (OPEH) requiring unique spatial and placemaking considerations in end-of-life care, understanding the environmental factors that influence their well-being is crucial.

This protocol paper provides a comprehensive overview for evaluating hospice environments tailored to the needs of OPEH.

The Aging in the Right Place study aims to address this gap by developing and implementing the Aging in the Right Place-Hospice Environmental Assessment Protocol (AIRP-HEAP) and AIRP-HEAP secondary observation tools. The AIRP-HEAP tool evaluates the built and natural environment within hospice settings. Adaptations were made to ensure alignment with the unique needs of OPEH, such as reconceptualizing spiritual care and expanding the definition of family accommodation. Additionally, the AIRP-HEAP secondary observation tool supplements this by capturing contextual data on the surrounding neighborhood of the hospice site, providing a holistic understanding.

Data were collected at Maggie’s Lodge hospice between November and December 2024 using the AIRP-HEAP and AIRP-HEAP secondary observation tools. The dataset is currently being cleaned, with analysis planned between May and December 2025. The anticipated results will highlight the importance of considering environmental factors in hospice environments and inform recommendations to improve end-of-life care for OPEH.

Data collected using these audit tools can guide environmental modifications in hospice settings to facilitate aging and end-of-life care in the right place. Thus, this protocol paper aims to promote the adoption of best practices in hospice design to better support this marginalized population.

DERR1-10.2196/73356