{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:51:56Z","timestamp":1782301916398,"version":"3.54.5"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000155","name":"social sciences and humanities research council of canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Fifteen to thirty percent of Canadians have access to palliative care, with even fewer access opportunities for people with experiences of homelessness. Existing research identifies barriers to access but rarely shows how health and social institutions actively organize exclusion. Part of a larger study, this paper examines how health and social systems shape the need for community-based palliative and end-of-life care, using 3 stories from clients of the Community Allied Mobile Palliative Partnership (CAMPP). Using institutional ethnography, data were collected between Fall 2019 and Summer 2020. Sources included approximately 100\u2009h of observation of the CAMPP team\u2019s work, 3 in-depth client interviews, and supplementary provider interviews. Data were analyzed to trace institutional processes that shape everyday experiences of illness and care. Findings reveal systemic demands like renewing insurance for medical equipment, restrictive housing rules, and standardized hospital protocols that overwhelm capacities of many people with experiences of homelessness. Rowan\u2019s story illustrates how bureaucratic requirements jeopardized his oxygen supply. Harriet\u2019s story shows the harm of being separated from her caregiver in housing and hospital contexts compounding distress and reluctance to receive care. Chapa\u2019s story demonstrates how fear and stigma delayed critical cardiology care. Overall, the clients valued CAMPP\u2019s persistent, relational, non-judgmental, and flexible approach. The team\u2019s independence from the mainstream health system mandates enabled responsive care but relies on precarious funding, constraining sustainability. Community-based palliative teams like CAMPP fill critical gaps in mainstream services by tailoring care to complex social realities. Their model shows the value of equity-informed, relational approaches, yet structural exclusion and precarious funding threaten long-term viability. Policy integration must sustain such programs without eroding the autonomy that enables them to deliver meaningful palliative and end-of-life care for people with experiences of homelessness.<\/jats:p>","DOI":"10.1177\/00469580251390760","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:27:18Z","timestamp":1761989238000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rethinking Palliative Care Through Three Institutional Ethnographic Stories of People Living With Homelessness and Life-Limiting Illness"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8666-6385","authenticated-orcid":false,"given":"Courtney R.","family":"Petruik","sequence":"first","affiliation":[{"name":"University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4761-589X","authenticated-orcid":false,"given":"Katrina","family":"Milaney","sequence":"additional","affiliation":[{"name":"University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. 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