34 Simon Communities of Ireland thousand bed days. This represents a saving in real terms of approximately STG £300,000 (approx. €360,868)86 a year. This service is targeted at all aged groups of people who are homeless and is not specifically targeted at those requiring end of life care. Dublin based GP Austin O’Carroll87 has ‘for some time’ been making the case for the establishment of a dedicated intermediary health care service for people who are homeless in the capital. This service would target individuals who are too sick for hostels but not sick enough for hospitals. This service ‘were it to be developed’ could make a useful contribution to meeting the needs of people who are homeless and approaching end of life but who do not yet require intensive medical care. LEO Leo left school at 14 to work on the home farm and has lived in the family home since that time. Leo has always liked a drink and generally underplays his consumption levels to people who do not know him. Leo worked the family farm till a few years ago when it was sold. Since the farm was sold Leo has a lot less to do. Over time Leo’s home (which is on a country lane about a mile and a half from the main road), fell into very poor condition and was very damp, making Leo’s various health complaints worse. Leo was given the option to move into accommodation in the nearby town. He moved but within three or four months moved back to his original home. He said he preferred his original home where he could have a fire, neighbours who know him and were kind to him and he had more to do. Following Leo’s return to his family home, work has been done to make his home more comfortable, Leo spends a lot of time reading (he gets his books from the local library) watching videos and doing sticks for the fire. He is also currently fit enough to walk the 1.5 miles out to the road to get a lift or the bus into town. Despite all these activities Leo is not as busy and he would like. He says he would like to be doing more and speaks often and fondly of the satisfaction and the contacts he had made working on a local Community Employment (CE) scheme. Leo has lived alone for the majority of his life but for the last 14 years has shared his home with his dog. He worries that he would not be able to live alone without her. Leo has found getting old hard especially at Christmas when he can feel really down. Leo has a variety of alcohol related health issues as well as issues with his heart. He says he is generally a self-contained and contented person who tried to take every day as it comes. He tries not to think about dying and death and hopes he might slip away quietly in the night, he says he is lucky that he believes there is something on the other side and prays to his parents to ease his journey to the other side. Leo wants to die at home and hopes that this will be possible when his time comes. 3.3 Attitudes to Dying and Death 3.3.1 Experiences/attitudes towards dying and death Many interviewees attitudes to death were clearly coloured by the deaths (or in one case the thought of the death of a family member)88 of friends and families. Among the interviewees who had slept rough many spoke of having friends whom they lived with on the streets die ‘often suddenly’ and how hard that had been to deal with. These individuals were very pleased not to have to face the prospect of dying on the streets. Some interviewees had the experience of an unexpected death in a hostel they were staying 86 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 87 O’Carroll, A. O’Reilly, F. Corbett, M & Quinn, L (2006) Homelessness, Health and the case for an Intermediate Care Centre Report by Mountjoy Street Family Practice 88 Con was very upset at the thought of his mother dying. ‘I don’t really think about dying for myself but I think about it for my mum. She is 84 and I adore her, we meet every week and do her shopping and have a pint. I’m not sure what I would do without her’.
Homelessness, Ageing and Dying
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