New resource to help homeless people access vital care at the end of life

The information, available online for free, was informed by a study led by researchers from the Marie Curie Palliative Care Research department (UCL) in collaboration with Pathway, St Mungo's and Coordinate My Care.

A previous report published in Palliative Medicine from this group revealed that hostel staff often end up caring for homeless people with terminal conditions and complex needs, despite not having palliative care training. As a result, huge burdens are placed on staff who do their best to manage with minimal support and very limited resources.

In response to these findings, the team developed a two-day training course for hostel staff around supporting homeless people with palliative care needs - recently published in Nurse Education Today. The course was completed by frontline staff from two London homeless hostels, who later reported that the training had helped improve their confidence and knowledge.

One hostel staff member commented: "Before the training I didn't think people should die in a hostel. Training has changed my view. I've got a better idea of the support available."

The researchers have also created an online toolkit to ensure that staff can access the information at any time. Each section contains resources, tools and activities to help care professionals plan and provide person-centred care for homeless people.

However, as post-training evaluation indicated that one-off training wasn't enough to fully support hostel staff, the researchers are now undertaking further work to explore new models of training and support for people working with homeless people who have palliative care needs.

Dr Briony Hudson, Marie Curie Palliative Care Research Department at UCL, said: "The deaths of homeless people are often perceived as sudden, untimely and undignified. This can be very traumatic for everyone involved, especially hostel staff, as they are often left to support people who are very unwell, even when they have high care needs, due to a lack of suitable alternative places to live."

"One of the reasons homeless people are dying without support is that they are not recognised as having a terminal illness. Throughout this toolkit we suggest that concern about a client's deteriorating health should act as a trigger for action, rather than waiting for a palliative or terminal diagnosis. We hope this resource will be helpful in supporting homeless people."

Professor Bee Wee, Consultant in palliative medicine at Oxford University, commented: "I'm absolutely delighted to welcome this online resource, which supports staff working to support people who are homeless who are entering the last stages of their lives. It is a truly valuable contribution to our collective efforts to improve palliative and end of life care for all."

Simon Jones, Director of Policy and Public Affairs at Marie Curie, said: "Dying in familiar surroundings, in comfort, with dignity and with those we love and who love us is what we want for our own deaths and those close to us.  Sadly, very rarely is this something that someone who is homeless will experience. There is no reason why a homeless person should not have compassionate care at the end of their lives and a dignified death - this resource brings us one step closer to making this happen."

The research was funded by The Oak Foundation with support from Marie Curie, Pathway, St Mungo's and Coordinate My Care. The online toolkit was funded by a grant from UCL Innovation and Enterprise.

Links

• Online toolkit
• Marie Curie
• Pathway
• St Mungo's
• The Oak Foundation
• Palliative Medicine article
• Nurse Education Today
• Coordinate My Care
• UCL Innovation & Enterprise