Improving palliative care for homeless people in the UK

Photo by Andrzej Rembowski from Pixabay

“The deaths of homeless people are often perceived as sudden, untimely, and undignified. This can be very traumatic for everyone involved.” This was a major finding from research conducted in the UK, led by Dr Caroline Shulman and Dr Briony Hudson. The Marie Curie Palliative Care Research Department at University College London worked in collaboration with two homelessness charities – Pathway and St Mungos – on this research project.

The research showed that homeless people with complex needs often remain in homeless hostels or temporary accommodation as their health deteriorates, simply because they have nowhere else to go. As a result, hostel staff end up caring for people who are dying, with little or no training in palliative care, and limited access to support.

In response, the research team developed a two-day training course for hostel staff, focused on supporting homeless people with palliative care needs. Twenty-one staff from two London hostels completed the course. They reported that the training improved their confidence and knowledge, and reduced their perception of stress at work. However, post-training evaluation showed training alone was not enough for sustained impact, and there was a need for more support. The team then developed and launched a free online toolkit full of information and resources for professionals supporting homeless people with complex health needs who may be approaching the end of their life.

“We hope this new toolkit will help the many staff in services that work with homeless people to improve the quality of care and support they provide to people who have faced trauma and who often have shortened life spans,”

– Alex Bax, chief executive at Pathway.

St Mungo’s chief executive Howard Sinclair said,  “I hope this online toolkit is in itself a legacy to those who have died and to what we have learnt from them about improving our care for the future.”

Looking forward, in the next phase of their research, the team will facilitate training and support for hostel staff using this toolkit.  

In order to try to break down some of the barriers experienced by people experiencing homelessness when accessing healthcare, the study team also made the film above. This gives a platform to people with lived experience of homelessness and those that support them, highlighting their experience of barriers they encountered. The researchers hope that this film will raise awareness among healthcare professionals and provide useful insights into how to reduce inequity.

Marie Curie partners with Oak’s Special Interest Programme, which reflects the Trustees’ interest in making dynamic, diverse and challenging grants. Our Housing and Homelessness Programme (HHP) supports organisations, including Pathway and St Mungos, which are working to end homelessness in the UK.