Need for end of life care for older homeless, report finds

Provision should be made within the health service for end-of-life care for older homeless people, a new Irish study has recommended.

Homelessness, Ageing and Dying, commissioned by the Simon Communities of Ireland, found many older homeless people had a fear of dying on the streets or of dying alone and their body not being found for weeks.

The study was carried out for the Simon Communities by independent researcher Dr Kathy Walsh, who interviewed 16 homeless people over the age of 50. The average life expectancy of homeless people is 47 years for men and 43 years for women.

Dr Walsh found many, particularly those drinking heavily, just lived on a day-to-day basis. But some were kept awake at night by the thought of dying.

Only one, a former undertaker, had made preparations for his death.

“Interviewees generally wanted to die in their sleep, they did not want to die alone. For those who were estranged from their family, they wondered who would be there when they were dying,” said Dr Walsh.

“Most interviewees in this situation hoped they would ‘go to sleep and not wake up’. A particular concern for the interviewees who lived alone was that they would die alone and their body not be found for weeks.”

Speaking about death
Dr Walsh found the majority of interviewees – all of whom had an involvement with Simon – had not spoken about death to anyone.

Most expressed a strong desire to die where they were living and failing that, in hospital. Many feared dying in a nursing home – in some cases due to being in institutions when they were young.

Speaking at the publication of the report in Cork, Minister for State at the Department of Health Kathleen Lynch praised Simon for helping those "shunned by society".