End-of-life priorities within the UK homeless
From a study by Wendy Webb and others, University of Worcester
In the UK, people experiencing homelessness die, on average, 30 years younger than the general population. The average age of death for a homeless person is 47 years for a male and 43 years for a female, compared with general population statistics of 74 years for a male and 80 years for a female.
When homeless people die, it is often not as a direct result of homelessness, such as exposure in cold weather. It is most often because of advanced liver disease, respiratory and cardiac disease, blood-borne infections, such as HIV and hepatitis, and alcohol and drug-related complications.
They often die with no support from palliative care services.
Most people would prefer to die at home and research into End of Life (EoL) priorities of the general population reveals a number of common priorities, such as:
-
physical comfort and freedom from pain;
-
the presence of family and strengthening of family relationships;
-
peaceful acceptance of EoL and spiritual concerns being met;
-
relieving stress or burden on the family;
-
avoiding a prolonged period of dying;
-
achieving a sense of control at a time of great uncertainty.
Research into EoL priorities within the UK homeless found these different eight themes:
-
spiritual concerns;
-
practical concerns;
-
fear of needing care;
-
fear of being forgotten;
-
preference for dying suddenly;
-
preference for being somewhere comfortable where people know me;
-
prioritising autonomy and self-determination;
-
prioritising authenticity.
In the above, you can see the worries and fears of the homeless and note especially the spiritual concerns.
A trauma-informed, person-centred, collaborative 'compassionate community' approach to EoL care for the homeless needs to be developed.
Read the full study here.
Retweet about this article:
From a study by Wendy Webb and others, University , 12/05/2020