Homelessness, Ageing and Dying 19 homelessness aged in their 40’s and 50’s estimated that between 50% and 70% of residents had experienced institutional abuse, it is likely that the numbers could be high. This poses a very particular challenge for these individuals accessing care in all its forms. The Charity consulted as part of the Commission also identified the group of individuals who had had experiences of abuse as tending to be part of the longer term population of people who are homeless with mental health, alcohol abuse and challenging behaviour issues. This population is not typical of people who are homeless generally but is representative of a proportion of the population. Interestingly, while people who are homeless face significant barriers when accessing health care, research has found that they tend to use acute care services at higher rates than other vulnerable groups.53 The 2011 Simon National Health Snapshot found that 55% of respondents had used accident and emergency services in the previous month. (The London Pathways model, introduced to support people who are homeless through the hospital system, has demonstrated that, through a programme of early and sustained intervention, it is possible to significantly reduce the number and the length of admissions of people who are homeless. In the case of the London Pathways model they have managed to reduce the number of bed days by 1000, representing a saving in real terms of approximately STG £300,000 (approx. €360,868) a year54). 2.11 Dying and Death in Ireland Almost 30,000 people die each year in Ireland. The National Council of the Forum on End of Life estimate that 25% of people die at home, over 48% in acute hospitals, 4% in hospices, 3% in road traffic accidents, 3% die by suicide and 20% in long stay care (These figures are estimates based on the death statistics from 2004, 2006 and 2007, and are drawn from a variety of sources. Just over three quarters of deaths annually are drawn from those aged 65 years and over. Forty percent of these older deaths occur in acute hospital settings (See Table 2.1 for details). The most recent (2009) data available from the CSO suggest that a further 20% (4,000) older people die at home, while 15% die in private nursing homes, while the remaining 25% die in other settings, mainly public long-stay care facilities55” (O’Shea et. al, 2008: 29). Table 2.1: Total No of Deaths in Acute Hospitals for People Aged 65 Years and Over Age Group Total Deaths Deaths in Acute Hospitals 65-74 years 5,280 2,453 75-84 years 9,412 4,079 85+ years 7,382 2,286 Total 22,074 8,818 Source: National Audit of End-of-Life Care in Hospitals in Ireland Hospice Friendly Hospital Programme’s 2008/09 53 Larimer, Mary, E. PhD. et. al, Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons with Severe Alcohol Problems in Journal of American Medical Association, April 1, 2009. Vol. 301, No. 13, Pp. 1349-1357 54 Personal communication with Dr. Nigel Hewitt clinical lead for the homeless team at UCLH and Medical Director of the London Pathway on 15th February 2012 55 Public long-stay care facilities can include non-acute hospitals, convalescent homes or homes for people with physical/intellectual disabilities, long stay institutions, or community residences where nursing or medical care is provided.
Homelessness, Ageing and Dying
To see the actual publication please follow the link above