The Development and Operational Context of an Emergency Shelter–Based Hospice in Ottawa, Ontario: A Qualitative Study

In Canada and internationally, there is growing recognition that homelessness is a significant public health challenge (Hwang 2001), with homeless persons experiencing high levels of morbidity and mortality (Cheung and Hwang 2004; Hwang 2000; Garibaldi, Conde-Martel and O’Toole 2005). Over the past two decades, research has demonstrated that homeless persons experience high incidences of chronic and infectious diseases, such as hiv/aids (Culhane et al. 2001; Robertson et al. 2004), hepatitis C (Nyamathi, Dixon and Robbins 2002; Roy et al. 2001), respiratory diseases (Snyder and Eisner 2004) and diabetes (Hwang and Bugeja 2000). In addition to these challenges, homeless persons frequently