Improving 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.

It has been created by homelessness charity St Mungo’s and Marie Curie, the UK’s leading end of life care charity.

The pack pulls together tools, templates and relevant resources for staff working in homelessness organisations and with people who are homeless, enabling frontline staff to talk confidently about end of life issues with their service users as well as when working with health and social care professionals.

End of life care is vital as, according to research by Crisis in 2012, on average, homeless people die at 47 years old, 30 years before the national average of 77.

Feedback from a four week pilot confirmed that the material helped staff identify residents who are at risk of developing a terminal illness, such as advanced liver disease, and engage more confidently with residents who had already received a diagnosis.

The pack is the latest result of an award-winning five year partnership between St Mungo’s and Marie Curie.

It also follows from a research report by the Marie Curie Palliative Care Research Unit at University College London, which found:

• The majority of the deaths of people receiving care from St Mungo's each year are associated with liver failure.
• In this group there is a high rate of hospital admissions, as well as significant distress in the last six months of life.
• Currently, neither staff, nor healthcare professionals, nor residents find it easy to link the signs and behaviours of advanced liver disease with possibilities for palliative care interventions.

UCL academics studied the cases of 27 St Mungo's residents who died between January 2009 and April 2010. Their average age of death was 55.

Peter Kennedy, St Mungo's Palliative Care Service coordinator, said: "Hostel staff are best placed to recognise when a resident's condition is deteriorating. But end of life care is not an easy subject to broach, for many of us. This resource pack offers staff tools to help offer the best possible palliative care to a person, while also preparing friends, family and fellow staff.”

Dr Jane Collins, Chief Executive of Marie Curie, said: “Marie Curie hope that this resource pack will help improve access to, and the quality of, end of life care for people who are homeless. By working in partnership with St Mungo’s we have tried to deliver a thought-provoking and practical resource that supports the needs of front-line workers as they identify, and care for, clients at the end of life. We look forward to our continued partnership with St Mungo’s and others to improve our joint end of life care services.”

Charles Fraser, St Mungo's Chief Executive, said:"The aim is for this resource pack to become a must-have resource for every homelessness organisation nationwide. We are extremely pleased to be working with Marie Curie to help bridge the gaps which make it difficult for homeless people to get the healthcare they need.”

The Resource Pack is available to download online at www.mungos.org/endoflifecare. To ask about training email endoflifecare@mungos.org.

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