Improving end of life care for homeless people

by Chloe Longmore Service Design Manager end of life care for homeless people

From this week, front-line workers in shelters, projects and hostels will benefit from a ground-breaking new resource to help improve end of life care for homeless people.
The resource pack, called Homelessness and End of Life Care, is the first of its kind in the UK and was jointly developed by Marie Curie Cancer Care and St Mungo’s, as part of a long-running partnership project to improve end of life care for people who are homeless. Talking about death and dying does not come easily to most of us. For people experiencing homelessness there may be additional obstacles and barriers when it comes to planning their end of life care needs. Homeless people are more likely to have a combination of chronic physical and mental health issues and substance misuse problems. They are also less likely to access appropriate health and social services, or be willing to engage with healthcare professionals about their care needs. This new resource pack contains information as well as practical tools and templates useful for supporting the end of life care needs of people who are homeless. It is particularly relevant for supporting those living in homeless shelters, hostels and specialist projects accommodating homeless people with specific needs such as those with mental health problems. It acts as a guide for the various stages of support, from identifying someone who may be approaching the end of their life through to assessment, care planning and into bereavement. It also offers guidance on having difficult conversations about people’s end of life care preferences and wishes. Research shows that, on average, homeless people die at 47 years old - 30 years before the national average - and experience high rates of hospital admission, as well as significant distress in the last six months of life. It is not always easy to determine if, or when, someone is approaching the end of life, as signs can vary from person to person. This is why we are prompting front-line staff to consider: “Would I be surprised if this person died in the next six to 12 months?” If the answer is ‘no’, we believe it is a good idea to start thinking about having a conversation about their needs and wishes.