Homelessness, Ageing and Dying 33 DARA Dara ran away from home when she was 14. By the age of 18 she had two children, she is now 51. Dara married the father of her third child but it was a difficult relationship as he was violent. She eventually left him and moved to England where she had two more children. Dara’s children are now adults and live in and around Dublin. She does not currently have contact with them. On her return to Ireland Dara began a relationship with a man twenty years her senior. That relationship lasted for 21 years until his death from cancer. In the beginning they were both sleeping rough but a number of years before he died they had managed to get a flat and a dog together and life was better. Dara has slept rough for long periods much of which seems to have disappeared in a haze of alcohol, with large gaps in her memory. As her health disimproved she started to use various hostels. Dara had her first nervous breakdown after the birth of her second child. She has a number of others since. Dara also has serious arthritis (she believes this is as a result of sleeping rough). Dara was a heavy drinker and often combined her drinking with aspirin. Dara has not had a drink for three years. Dara suffers from low moods, and pains in her legs and chest. She has as yet not checked out what is the cause of these pains as going to hospital for her just takes too long with too much sitting around. Dara is often bored given that she spends a lot of time in her room as her mobility is restricted and she has collapsed on previous occasions, making her nervous about going out and about. Dara worries both that she will be moved to a nursing home and that she could be put out of the hostel. Dara lives from day to day and tries not to think that much about what lies ahead. She thinks about death at times and is afraid of dying. She would like to make her peace with her children before she dies. 3.2.5 Barriers to Accessing Health Care All of the interviewees had a GP that the vast majority got on well with. Physically getting to the GP outside of regular appointments appeared to be an issue for some interviewees (given that getting to their GP often involved significant organisation as the location of the clinic is often some distance away. It was also the case that some interviews were so unsteady on their feet that they needed a companion with them and that was not always easily organised). Some interviewees, particularly those with chronic conditions also had regular contact with a public health nurse. In some instances the nurse called to them to do regular checks ups on on-going chronic conditions and/or to administer injections. Worryingly, some interviewees spoke about having symptoms that they had as yet not presented to have assessed. The reasons given for not presenting for hospital appointments and/or A&E included long waiting time, a fear of being admitted to hospital and not being able to get alcohol and/or a fear of being admitted to hospital, getting bad news and being unable to return to their current accommodation and ‘worst of all’ having to move to a nursing home. Helping people who are homeless access health services must be a priority. The London Pathway project ‘based at University College Hospital in London’ is an example of a project established to support people who are homeless access enhanced levels of healthcare within the hospital system. The project, which is staffed by dedicated homelessness nurses and a GP, involves the identification of people who are homeless and accessing hospital services at an early stage. It involves regular GP lead ward rounds (three per week), weekly multiagency meetings and work with Care Navigators to develop care plans for and with people who are homeless to help them more easily navigate their way through the health care service. Anecdotally, the project has generated at lot of goodwill and good outcomes for people who are homeless, it has also improved the attitudes of staff working across the hospital. At a more practical level, the project has managed to reduce both the number of admissions and the length of admissions by a
Homelessness, Ageing and Dying
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