Homelessness and End of Life Care

Alison ColcloughHomelessness Project

Lead, St. Luke’s Hospice, Cheshire

Beginnings

Working together

A few harsh facts

•Homelessness Kills (Crisis 2013)

•The Unhealthy State of Homelessness – 2590 homeless people questioned 2012-2014 (Homeless Link 2014)

•The age of death for a man on the street is approximately 47

•The age of death for women on the street is approximately 43

More harsh facts

•73% of the homeless population reported physical heath problems and 41% reported suffering from a long term physical health problem (28% GP)

• 45% of the homeless population have been diagnosed with a mental heath problem (25% GP)

•80% of homeless people reported some form of mental heath issue

Local statistics

•Cheshire West supporting 317 homeless people at present

•In the past 37 months the hostel has had 883 people through its doors

• Of those 883 approximately 70% have needed support with MH issues

Where do homeless people WANT to die?

The DOH (2010a)suggests the way forward for EOL care for homeless people is within the hostel environment

National and local responses

Cheshire East

•Local YMCA introduced to the Hospital Discharge Team

•Links made between SLH and YMCA

•Befriending between SLH and S/A

•Lee’s Legacy (as yet unused)

•SLH and local housing provider links

•Invite local MHT to drop in once monthly

•Health Watch

Cheshire West

•Working with Homelessness commissioner

• GP service

•2 homeless hostels given EOL training

• 1 hostel has won funding for EOL bed

• Hospice to provide support

•Complex needs workers

•Very experienced counsellor

placed within designated GP

practice

What did I find?

•Hostel staff very compassionate

•Know their customers very well

•Best able to influence/support service user

•Need support with very distressing situations

•Need more information from medical team

•Can recognise physical deterioration but without training don’t always know what to do

•Need a link

Rising to the challenge

•Rough sleeping has increased by 37% since 2010

•NHS, social care, housing etc constantly struggling with fewer resources against increasing demand

•Working together across ALL boundaries using what we have

•Trusting our colleagues

•Recognising the need

Finally…….

Jason

John