Vulnerable homeless need palliative care
On any given night in Australia, there are more than 105,000 people who are homeless. These people face significant social and economic impacts, such as long term unemployment, exclusion from the community and chronic ill health. But, what happens when they are diagnosed with a terminal illness?
Yvonne Luxford, Palliative Care Australia (PCA) chief executive, says older people who are homeless have wishes and preferences for the end of life, just like anyone else.
According to Yvonne Luxford, Palliative Care Australia (PCA) chief executive, data demonstrates that if you do not have a carer, you are far more unlikely to be able to be cared for in the place of your choice at the end of your life.
The largest proportion of homeless people are younger Australians, with under 25s accounting for 46% of the homeless population. However, nearly one quarter are aged over 45 years, with a significant percentage having multiple or complex needs.
“A growing issue of concern is homeless mature women, who may have stayed at home to bring up children and find themselves alone due to the death of their partner or divorce,” Dr Luxford said.
“With no savings or superannuation and no recent workforce skills, they end up homeless. A large proportion of these may also be ‘hidden homeless’ as they often couch surf.”
Some of the common issues for people who are homeless and require palliative care relate to identifying their needs and finding an adequate place to care for them.
Having no fixed address makes it extremely difficult to make and keep appointments and manage health needs.
“This is a very vulnerable group of people. They face the daily stress of having no money or home, and making decisions about whether or not they eat or look after their healthcare,” Dr Luxford said.
“There are also often complex issues related to mental illness or drug and alcohol use, which makes comprehending health information and regularly taking medications for other needs more difficult. We live in a society that does not find it easy to talk about our end of life care needs.”
This situation, according to Dr Luxford, can be exacerbated for homeless people, who face complex health issues, are less likely to seek health advice early, are socially isolated and can be reluctant to engage with healthcare professionals.
People who are homeless have wishes and preferences for the end of life, just like anyone else, and they should be encouraged to talk about their choices.
“For people who are homeless, flexibility and coordination with service delivery is essential and we must encourage palliative care, homeless, health and community services to work together.
“Including palliative care services in homelessness programs will make conversations about end of life wishes for homeless people happen.”
