One of the most shocking statistics about living as a homeless person is that it cuts your life expectancy quite literally in half.
That means that while most people living in the UK in the 2020s can expect to enjoy life well into their 80s, a homeless man or woman could be as young as just 46 when their life ends.
“These people are dying years too early and that is why we have been doing a lot of work to see what we can do to offer support,” says our Nurse Consultant Helen Smith.
As a Nurse Consultant, Helen is qualified to make independent decisions on medical issues and manage her own case load, both within our In Patient Centre and also as part of our Community team, which supports patients in their own homes.
And as part of that community remit, she has a particular interest in the needs and complex issues of people facing the end of life when they have no home in the way that most people would recognise.
Helen originally met with organisations like Sheffield’s homeless charity the Archer Project, exploring ways that palliative care could be offered to people living, for whatever reason, beyond the fringes of society.
“We were looking at what the barriers to receiving support were and that’s when I discovered that the average age of death for a homeless person is 46,” Helen says.
“What we were originally hoping was that we would be able to get funding to have two specialist palliative care beds within a hostel.
“The problem is that the general way of approaching palliative care might not work for them because it means taking them out of their environment, the place where they feel comfortable.”
That idea was halted by the pandemic but in recent months Helen has been part of a team exploring other ways of reaching out to the homeless and offering effective levels of palliative support.
“We are having a series of sessions looking at how we can improve knowledge of palliative care for homeless individuals,” she explains.
“We have hospitals involved, housing experts, nurses and district nurses and GPs, with the idea being that we will have a community practice offering better links.
“One of the big issues at the moment is that homeless services are quite fragmented and what we need is better recognition of how people can refer in, making sure there is a clear pathway into health care services and making sure we can adapt our practices to meet their needs because this is a very different client group but one that very much needs our support.
“I remember that probably the first homeless person I met was in his 40s and he did have cancer - and that’s what made me feel we should be doing it better.
“It’s challenging work and I think you have got to be fairly robust - and you have to have a thick skin!
“You have to accept too that this is how this person is living and this is where they are so you need some life experience and understanding that you are not going to be able to change the person but you are going to have to offer them support wherever they are and that can be difficult.
“Building trust is a big thing too and then all you can hope is that you will do your best for them, just as we would for any other patient.
“There is a real call for this sort of service but the real difficulty is that we don’t know how many people we are missing and how many people have died without the support we could have offered.”