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Dying homeless receiving little palliative care, study finds

Homeless people are dying in unsupported and unacceptable situations with inadequate access to palliative care, according to a study which called for improved collaboration between services.

Homeless people are dying in unsupported and unacceptable situations with inadequate access to palliative care, according to a study which called for improved collaboration between services

homeless
Hostel staff often end up caring for unwell homeless people, a study found.
 Picture: Getty Images

Homeless people are dying in unsupported and unacceptable situations with inadequate access to palliative care services, a study has found.

Researchers from Marie Curie Palliative Care Research Department at University College London (UCL), Pathway, St Mungo’s and Coordinate My Care found many homeless people approaching the end of their lives are living in hostels.

Those with advanced ill health rarely receive adequate care and support in the community, and there is a lack of appropriate services, the study found. This results in repeated unplanned and emergency hospital admissions.

Almost 130 people including homeless people, health, social care and hostel staff from the London areas of Lambeth, Hackney and Westminster were recruited for the qualitative analysis, which the authors said was the largest of its kind. 

Realities of illness

It showed hostel staff often end up caring for some of the most unwell homeless people, despite not having the palliative care training or support to do so. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care, the study found.

Many homeless people die at a young age from conditions such as advanced liver disease, often complicated by mental health problems and drug and alcohol issues.

The research calls for improved collaboration between services and recommends a specialist health hostel with staff who can offer 24-hour support for people with serious illnesses, including those who are dying.


Shulman C et al (2017). End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care. Palliative Medicine. doi: 10.1177/0269216317717101

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