Table 4.

Qualitative Thematic Analysis: Quotes

Experiences of death and dyingI've watched a lot of people who were on the street and they're dying all around you out there anyway. It doesn't matter if they get cancer or they're dying of addictions, right. I'll call it drug addiction. (FG7RT)
We're actually talking about homeless people who are using and are dying out there on the street because of the lack of room. There's nowhere for anybody to go. (FG10RM)
Because dying outside is not fun. I've seen, and I've tripped over bodies and that. I have I've seen many people dying out there. (FG8R)
Well right now from what I understand if you're on assistance of any sort, be it even Old Age, and you have any insurance–you are, you know, the City of [X] will bury you in a mass grave with no markers. You don't know, it's pretty much you're a John Doe or a Jane Doe. (FG9F10)
Relationship with mortalityYou think about death consistently. [..] Because you don't want to be here anymore. What the hells this life going to be if you're just going to keep getting high and like letting these people just yell at you and work over you like they're a big hammer. (FG10RM5)
Oh it terrifies me because they're not going to give me pain meds. (FG7RD)
ABSOLUTELY. You nailed it. That's one of the biggest fears of people that are homeless dying, is that they're dying by themselves. (FG1I)
That would make for a pretty scary death out on the street. [..] And nobody is going to know that you passed away, nobody's gonna know, you start thinking things (FG1A)
I think we live in Hell and when we die, we don't leave this earth, we just go to another dimension and that's Heaven (FG9F10)
A good deathCompassion. Family. You know, surrounded by people who love you and you all know that you are somebody. You are part. You made- you know you touched our hearts. (FG1B)
When I'm gonna die, I'm gonna die like that [snaps his fingers] in the park with a beer and a joint in my hand. (FG1B)
Dying with friends and family around–yes. But are we all privy to that–no we're not. (FG9F10)
Experience and expectations of end of life care
    Dignity and RespectYeah. Who I am. Accept me. I'm different. I am who I am. Accept me for who I am and treat me like a HUMAN BEING (FG1B)
I was just another addict. And you know the quicker I died, or, and that was the attitude. The more that died, the less they had to worry about, because we were a nuisance to society. And ah yeah it just needs to change. The stigma needs to end. (FG7RT)
    FlexibilityIt seems simple but, if that's what I've done my whole life I think, in the last stages I should be able to. You know I don't eat breakfast until, you know, 11 o'clock in the morning. I shouldn't be served lunch at noon. I probably would want lunch a little later and then I probably going to would want my dinner a little later. They seem like simple things, but this is someone's life, so for the last part of it, I think the biggest thing here is I think autonomy, right. (FG7R)
Because the way you want to die may be completely different from the way I may want to die (FG7RD)
It doesn't matter where we are in life. We all deserve autonomy to make our own decisions and actually be able to say–this is actually what I want. It doesn't matter that you don't want that for me. You're not me and I get to make my own choices, right, so. It's, I mean even when people are dying, they still get to make their own decisions, right. (FG7RL)
    Substance UseIf somebody is dying of cancer, in extreme pain and um they're giving them pain meds and they want to inject those pain meds–they should be able to. They should be able to take their medication the way that they want to take it. You know if they want to snort it or shoot it or what have you. (FG7RD)
But if I'm on crystal meth and I'm dying of cancer and they've said to me that I'm dying anyways–I'm going to die. If I want to continue to use crystal meth in my last days, I absolutely should be able to. I make the decisions about what happens in my life not you, not you, not doctor whatever. If I made that decision I absolutely should be able to do that. Now if I made a decision to get sober, I absolutely should be able to do that too. (FG7RM)
But like if I'm using and I'm dying, I don't think I'm going to decide to get clean at that point, you know. If I'm clean–yeah I want to die a clean death, right. But if I'm using and I'm dying I'm going to say hey man get me some crack cocaine. (FG9M8)
Proposals for improving end of life careOther than sympathy training, I'd say rent control and guaranteed annual income would be a solution to this. (FG7RN)
But um if I was put in a facility where I could use and there was other people around me using, I would have ended up dying and using. So I think that you should have a facility that has separate parts, right. [..] So they have like transition beds and then they have rehab. Well they're putting people in transitions beds and putting them in with people in rehab. Well, you could trigger somebody so there has to be like section parts. (FG10RF4)
So if you had a regular crew hitting a regular neighbourhood, they would know whose ailments are what. If their focus was just on homeless people's health they'd be able to know Joe B is at this point. Connie is at that point. And they'd be able to do the follow-up, right. And then they would make arrangements because a homeless person's not going to do that. (FG9M3)
They need more people with lived experiences. (F7RL)
There are individual rooms but there is a foyer that people can meet in. A place that they can feel comfortable, maybe can have a coffee or their family there. That if someone needed to visit them, they would have a common room. (FG4 mol/L)