48 Simon Communities of Ireland Recommendations in relation to end of life care 7. Raise awareness at policy, statutory and NGO level of the importance of end of life care for people who are homeless and provide staff working with people who are homeless with end of life care training Use the findings of this research to raise awareness of the issue and the need for particular provision to be made within the health sector for end of life care for older people who are homeless. Under the current system these individuals (aged 50 and over) are not eligible to avail of services for older people and generally have a history of non-engagement with services. Staff working in this sector needs to be more aware of role and purpose of end of life care and support (to include bereavement). They also need training and support in order to enable them to identify signals that the individuals need to be assessed in relation to the provision of end of life care. Two initiatives (developed by the Irish Hospice Foundation) offer very useful sources of training materials that could be adapted for use with staff working in the homeless sector. The ‘think ahead’ initiative promotes discussions on care planning (which would be beneficial for staff and ultimately for service users) while the ‘final journeys’ programmes is a model that could be adopted to raise awareness and improve staff members skills confidence in approaching ‘and ultimately discussing’ end of life care issues with service users. Another useful source of materials is the work done by Richard Lakeman in Dublin City University. Where staff are trained, sufficient time needs to be allocated within their schedules to engage with service users. As this research suggests staff currently working with people often have little time to spend in conversation. 8. Enhance access to end of life care for people who are homeless through the appointment of a Palliative Care Coordinator Palliative and end of life care are very sensitive areas that need careful handling. The appointment of a Palliative Care Co-ordinator (shared between different services and organisations) would ensure the necessary skills are available to support and train staff to be able to deal with the issues. 9. Ensure that Palliative Care beds are accessible to people who are homeless Palliative Care beds (Level 2) are available in a number of community hospitals around the country. Work needs to be done to determine to what extent these beds are currently accessible to people who are homeless and to identify what needs to be done to make these beds more accessible. Were an intermediate care centre/s to be developed (Recommendation 5), it would be important to ensure that some of the beds provided in the centre would be available for end of life care. The implementation of these recommendations would meet some of the policy objectives identified in the: • Various regional Homeless Action Plans which recognised the need for provision for people who are homeless. • The National Health Strategy which identifies a number of initiatives to improve the well-being of people who are homeless.
Homelessness, Ageing and Dying
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