This year World Homeless Day falls within Hospice Care Week and gives us an opportunity to speak about the work Royal Trinity Hospice has been doing to support people experiencing homelessness who are also living with a life-limiting illness.

This important work has been spearheaded and largely organised by a group of staff members from across the organisation who form the Trinity Homelessness Working Group. Through this group, we hope to have a coordinated, collaborative and creative approach to working with a group of people who so often have negative and difficult experiences of healthcare. 

We have been supporting people within hostels in Westminster, an area with particularly high levels of homelessness, to better understand the palliative needs of people experiencing homelessness. Palliative care for people in this setting differs from our traditional approach to care in a few ways.

Firstly, where we would usually see referrals come to us via traditional healthcare routes, Trinity’s clinical team has spent time proactively visiting hostels and attending meetings to spread the word about what we can offer and encouraging hostel staff to get in touch with us. Secondly, Trinity staff received further training and knowledge to offer patient-centred care for hostel residents.

Due to many hostel service users’ previous negative experiences of healthcare, it became clear that the nurses doing the front-line work needed to allocate more time and more visits to build trust and relationships with individuals which in turn would allow them to offer support and care when needed. 

This outreach approach involved partnering with a hostel to run a session with residents during Dying Matters Week earlier this year, to help promote healthy and open conversations about life, death and loss. This included hanging a ‘Before I Die’ wall up in the hostel for the entire week where residents could write their hopes and wishes for the future. 

A chalk board with things to do before i die on it

When it comes to symptom management and end of life care, many people who live in hostels may not wish to receive inpatient hospice care, and so this requires close working with hostel staff to put in-situ care in place in a safe, supported, and effective way. These adjustments are the same ideals that underpin our work with absolutely anyone who needs our support. All patients are treated with dignity and respect, with their needs and wishes central to the care we provide. 

Since starting our work with one hostel in particular, 100% of staff surveyed strongly agreed that they were more likely to refer a patient to Royal Trinity Hospice, and 100% either agreed or strongly agreed that the work we had done so far had had a positive impact on the delivery of palliative care. 

The palliative lead at the hostel said “prior to my involvement with Trinity, we were just ‘getting by’…Having a designated nurse creates a more feeling that we can provide the right support at the right time.” 

Looking to the future, we hope to take what we have learned from our experiences so far and work with more hostels and individuals who could benefit from our support. The issue of homelessness is a growing and pertinent one and supporting people experiencing homelessness is key to ensuring we can achieve our mission of being the hospice of choice for all those who need us. 

If you have any questions about the support we can provide patients and professionals please get in touch by emailing [email protected] or calling 020 7787 1000.

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