{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:53:01Z","timestamp":1792093981198,"version":"4.4.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:00:00Z","timestamp":1587945600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000026","name":"Institute of Aging","doi-asserted-by":"publisher","award":["MOP 133578"],"award-info":[{"award-number":["MOP 133578"]}],"id":[{"id":"10.13039\/501100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>People experiencing structural vulnerability (e.g. homelessness, poverty, racism, criminalization of illicit drug use and mental health stigma) face significant barriers to accessing care at the end-of-life. \u2018Family\u2019 caregivers have the potential to play critical roles in providing care to these populations, yet little is known regarding \u2018who\u2019 caregivers are in this context and what their experiences may be.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To describe family caregiving in the context of structural vulnerability, to understand who these caregivers are, and the unique challenges, burdens and barriers they face.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Critical ethnography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>Twenty-five family caregivers participated. Observational fieldnotes and semi-structured interviews were conducted in home, shelter, transitional housing, clinic, hospital, palliative care unit, community-based service centre and outdoor settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Family caregivers were found to be living within the constraints of structural vulnerability themselves, with almost half being street family or friends. The type of care provided varied greatly and included tasks associated with meeting the needs of basic survival (e.g. finding food and shelter). Thematic analysis revealed three core themes regarding experiences: Caregiving in the context of (1) poverty and substance use; (2) housing instability and (3) challenging relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Findings offer novel insight into the experiences of family caregiving in the context of structural vulnerability. Engaging with family caregivers emerged as a missing and necessary palliative care practice, confirming the need to re-evaluate palliative care models and acknowledge issues of trust to create culturally relevant approaches for successful interventions. More research examining how \u2018family\u2019 is defined in this context is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269216320917875","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T00:13:44Z","timestamp":1588032824000},"page":"946-953","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Caregiving at the margins: An ethnographic exploration of family caregivers experiences providing care for structurally vulnerable populations at the end-of-life"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-4712","authenticated-orcid":false,"given":"Kelli I","family":"Stajduhar","sequence":"first","affiliation":[{"name":"Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada"},{"name":"School of Nursing, University of Victoria, Victoria, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Giesbrecht","sequence":"additional","affiliation":[{"name":"Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Mollison","sequence":"additional","affiliation":[{"name":"Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naheed","family":"Dosani","sequence":"additional","affiliation":[{"name":"Inner City Health Associates, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"McNeil","sequence":"additional","affiliation":[{"name":"BC Centre on Substance Use, Vancouver, BC, Canada"},{"name":"Department of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,4,27]]},"reference":[{"key":"bibr1-0269216320917875","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2015.21.5.236"},{"key":"bibr2-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1177\/0269216311402713"},{"key":"bibr3-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0000000000000146"},{"key":"bibr4-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317717101"},{"key":"bibr5-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-019-0396-7"},{"key":"bibr6-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2018.06.005"},{"key":"bibr7-0269216320917875","doi-asserted-by":"publisher","DOI":"10.3747\/co.24.3129"},{"key":"bibr8-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-016-0168-6"},{"key":"bibr9-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-015-0059-2"},{"key":"bibr10-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2014.958629"},{"key":"bibr11-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0368-3"},{"key":"bibr12-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-006-0045-8"},{"key":"bibr13-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.04.008"},{"key":"bibr14-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1080\/01459740.2011.576725"},{"key":"bibr15-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001294"},{"key":"bibr16-0269216320917875","volume-title":"Palliative care services for people experiencing homelessness in Toronto: a preliminary needs assessment","author":"Centre for Urban Health Solutions Survey Research Unit","year":"2017"},{"key":"bibr17-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0075133"},{"key":"bibr18-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-11-14"},{"key":"bibr19-0269216320917875","volume-title":"Supporting informal caregivers \u2013 the heart of home care","author":"Canadian Institute for Health Information (CIHI)","year":"2012"},{"key":"bibr20-0269216320917875","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7273.1400"},{"key":"bibr21-0269216320917875","volume-title":"Critical ethnography: encyclopedia of social science research methods","author":"Thomas J.","year":"2003"},{"key":"bibr22-0269216320917875","first-page":"114","volume-title":"The SAGE encyclopedia of qualitative research methods","author":"Stern PN.","year":"2008"},{"key":"bibr23-0269216320917875","first-page":"867","volume-title":"The SAGE encyclopedia of qualitative research methods","author":"Ayres L.","year":"2008"},{"key":"bibr24-0269216320917875","unstructured":"International Alliance of Carer Organizations. 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