Reference no: EM133785658

Question: George is a 48-year-old Indigenous man with end stage liver disease. He was rphaned at eight years of age and had a difficult childhood. He has "lived rough" rom a young teen to now, is homeless and has alcohol addiction. He has two grown children with whom he has limited contact. He moves from shelters to friends to outside living situations, getting food from charitable kitchens and the food bank or from panhandling. He does not want to stay in hospital but die "at home;" home care typically cannot accept a referral when the client does not have a fixed address. A home care team is starting an initiative to provide palliative services for homeless or under-housed persons, and agree to work on this situation. A care coordinator is assigned to work with George and his care providers to find a way for him to be out of hospital and have some quality of life for his remaining time. Which interprofessional team members are most likely to be involved in the hospital discharge planning?