Homeless people often face chronic health problems and, on average, die younger than those who are not homeless. Research by the UK charity, Crisis, found that the average age of death of a homeless person is 47 years old (43 for women) compared to 77 for the general population, 74 for men and 80 for women.
The same research also showed that drug and alcohol abuse are particularly common causes of death among the homeless population, accounting for just over a third of all deaths. Smoking, alcohol and drugs use can also increase the risk of respiratory, cardiovascular disease and cancer, while poor sleep, diet, difficulty maintaining personal hygiene and treatment regimes can all contribute to poor health.
In 2007, Alpha Project in San Diego launched Hospice for the Homeless to provide assistance to veterans, homeless and indigent people who have six months or less to live. Alpha Project provides housing, support services and case management, and local hospice programs provide medical care, medications and hospice specific services. And the San Diego Rescue Mission provides recuperative care for homeless people who have been release from hospital but still require medical attention.
While in Ottawa, Canada, the Mission Hospice Program provides palliative care to terminally ill people who are homeless. The program is operated through a partnership between the Ottawa Mission, which provides all aspects of housing, transportation and spiritual care, and Ottawa Inner City Health, which provides palliative care. Clients who are homeless can be accepted for admission if they are living with a terminal illness which is progressing rapidly, need assistance in managing pain or other symptoms or are unable to access or benefit from ‘mainstream’ care services due to behaviour or lifestyle.
In the UK, St Mungo’s and Marie Curie Cancer Care have been working together for five years to improve support for homeless people at the end of life. They have developed a resource pack and training programme for those who work with homeless people to help them identify and support those who have terminal conditions.
Also in the UK, a number of hospices, such as St Richard’s Hospice and St Nicholas Hospice Care, are working with local hostels and charities which support homeless people, to improve end of life care and bereavement support.
These projects are just a few examples of the amazing work going on to help improve the last few months of life for homeless people, and highlight how partnerships can work to help reach those who are often seen as some of the hardest to reach.