Foreword

 

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 full of practical tips and advice described with great clarity, and is one of the most user-friendly toolkits I have come across. The Ambitions for Palliative and End of L ife Care National Framework for Local Action states ‘each person has fair access to care’ as one of its six ambitions. Health and social care providers and their staff recognise the inequity in access and quality of palliative and end of life care often suffered by people who are homeless, but sometimes find it hard to know where and how to start to address this. This toolkit starts with identification, i.e. recognition of the client’s deteriorating health, because without that, key conversations, care and support planning and shared decision making, simply do not get started. It then goes on to provide really helpful practical advice online as well as resources and guides that can be downloaded and printed off for use with clients. It has been built on a combination of the experience of practitioners with extensive experience and evidence gathered through high quality research. It is a truly valuable contribution to our collective efforts to improve palliative and end of life care for all.

Professor Bee Wee

Consultant in Palliative Medicine, Sir Michael Sobell House, Oxford University Hospitals NHS Foundation Trust, and Nuffield Department of Medicine and Harris Manchester College, University of Oxford.

I’m delighted to introduce this on-line resource on palliative care and homelessness. The fact that such a resource is needed directly illustrates the physical harm that homelessness can cause. It also highlights that very often it is the staff working for homeless charities – hostels, day centres, supported housing services – that end up providing support to people as their lives come to an end. The toolkit helps services and staff think about how better to support their clients as health begins to seriously deteriorate. It doesn’t train frontline staff to be health care providers, rather it helps them recognise when and how to ask for more support. As well as providing health information it is also full of advice and guidance on how to talk about dying with our clients, how to elicit and respect people’s wishes and how staff can recognise and acknowledge their own feelings and emotions.  Thanks to everyone who put the toolkit together. It’s a great example of collaboration across sectors. The need for it is a sad comment on our society, especially when we know that political will and the right policy choices can prevent and end homelessness.

Jon Sparkes

Chief Executive of Crisis