VICTORIA - A University of Victoria study that followed 25 dying homeless or marginally housed people in Victoria finds many received the best health care available only when they had reached death's door.

Kelli Stajduhar, a professor at the university's school of nursing and Institute on Aging and Lifelong Health, says 13 people died during the study and she doesn't know the status of the 12 who survived while the research was underway.

Stajduhar says the study recommends better training throughout the health-care system to inform providers about the barriers to care endured by homeless and marginalized people, including end-of-life support.

The study says 10 participants ended their lives in a palliative care unit where they reported they received the best care of their lives.

The study does not use the real names of those involved but includes details of interviews, where at least two of the participants said they went to a hospital suffering with pain, were diagnosed with cancer and then given only months to live.

Stajduhar says the study, “Too Little; Too Late,” finds that people living on the streets are in a world of unmet needs, multiple losses, persistent grief and trauma.