Month: May 2018

    “There are no words”

    Tracey Jacob, St Mungo’s Housing Management and Lettings Coordinator, based in Westminster, shares her experience of working with people who are homeless and near the end of life.

    When a person has been diagnosed with a terminal illness, there are no words that can describe the emotions or feelings.

    When a client has no family, or has not been in contact with them, or wishes for them not to be informed of their illness. When a client makes a decision that he does not want to go to hospital or a hospice but wants to stay at home. This is when you realise they may see you as their family.

    Over the years, I have known and supported people who have been diagnosed with a terminal illness.

    There are guidelines, other colleagues, to help support and direct us as staff in that situation. But it’s those words – “I want my keyworker” – which cannot be substituted.

    With one of my clients, I had to start a conversation with him about being resuscitated. I didn’t know how.

    I called his GP who arrived the same evening to ask the questions and do the paperwork.

    I had to fight back the tears as I did not want the client to see me crying.

    The GP had a one to one with me after the meeting as well, to debrief me and make sure I was OK. These are the situations that don’t get seen, or talked about.

    On another occasion, I had to go through my client’s clothes to take some to the funeral parlour, wiping away the tears as I have never dressed a person who had passed away.

    My thoughts were, I want the client to look lovely, hoping that I chose a good outfit. I was given a cup of tea and they explained that I was not expected to do this, they would do it. These are the things that don’t get seen, or talked about.

    I have worked for St Mungo’s for many years. Any death is difficult. I have learnt that it’s ok to say “I need help and support” and to step back, take a few minutes to regroup your thoughts.

    For me, I take away that the person was not alone and I did the best I could do.

    It was Dying Matters last week . Please see our other blog by St Mungo’s Palliative Care Coordinator, Niamh Brophy, on the work being done to prevent people who are homeless dying on the streets.

    Hope from terrible tragedies

    Niamh Brophy is St Mungo’s Palliative Care Coordinator. We are the only homeless organisation to have such a person, supporting both clients and staff with ‘end of life’ experiences.

    For most of us, I hope Dying Matters Week is an opportunity to talk to our loved ones about death and the things that feel important to us: where we’d like to be cared for (for most of us it would be at ‘home’), and how we’d like to be remembered by our loved ones.

    But what if you don’t have a home? And what if you don’t have a family or support network to have these conversations with?

    This is the reality for the rising numbers of people experiencing homelessness. For many, their death will go ignored, not given the dignity or respect they are due, and with little planning given to their end of life wishes or preferences.

    This year’s Dying Matters Week (14-20 May) comes at a particularly poignant time. Recently, news that the number of deaths of people sleeping rough has more than doubled in the past five years shocked the public.

    These are individuals dying in car parks, on street corners and park benches, with no one around to support them as their lives draw to a close. This is desperately sad, and something most of us would think completely unacceptable in our society today.

    But from these terrible tragedies has sprung some hope. Campaigns have been launched to address and prevent these deaths from happening in future such as the #makethemcount campaign.

    Ed Davey MP has also proposed a new Homelessness End of Life Care Bill that aims to ensure people do not die homeless and alone on the streets, but have access to care and accommodation for the end of their life.

    At St Mungo’s we contributed to both of these initiatives. But more work is needed to ensure people get access to the care they need. That’s why we’re calling on the Government to ensure a review is carried out every time someone dies on the street, as part of their new rough sleeping strategy. This would ensure deaths no longer go ignored, and that lessons can be learnt to ensure such tragedies are not repeated.

    St Mungo’s were also involved in research published last year that explored the unique challenges in providing end of life care to people in hostels. What emerged was a picture of great complexity, but also plenty of opportunity to improve the experience of residents and staff when faced with such difficult situations.

    It’s now a decade since St Mungo’s first acknowledged the importance of providing end of life care to people who are homeless by establishing a Palliative Care role.

    In response to the increase in need of our residents, and the growing numbers of people dying on the streets, we will be expanding the service in 2018 and recruiting another member of staff to ensure all residents can be supported and cared for in the way that feels right for them.

    We continue to work every day to ensure our residents can access healthcare and be supported to approach the end of their life with dignity and respect. This Dying Matters week, we would encourage everyone to start a conversation on how we as a society can prevent the unnecessary deaths of people sleeping rough, as well as how we treat homeless individuals with dignity as they approach the end of their life.

Go back