A workshop was held in Westminster in early May, following a health needs assessment that Westminster City Council had commissioned to be carried out within its rough sleepers supported hostel pathway. One of the areas discussed at the workshop was palliative care.
The key points made included:
- Demand is increasing amongst this group.
- Palliative care works well for "normal", but former rough sleepers do not fit this mould - generally not having money, family or carers around them. They will often be ending their lives in a hostel environment, by choice. The staff in hostels are not carers, but support/key workers.
- Hospices were discussed very positively - Trinity Hospice was cited during the discussion. The pathway is linked in well with the hospice sector.
- The main challenges are around GPs, district nurses and carers understanding and knowledge of this client group. This covered practical issues around medication where service users are still using drugs, or at end of life due to alcohol use as well as the psycho-social side of things - providing trauma informed care to this very complex client group. One of the consequences of this is that support workers are left holding a lot more than is in their remit, and carrying vicarious trauma as a result.