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Dying in the cold; being homeless at the end of life in Scotland

  • Area of Work: The ALLIANCE
  • Type: News Item
  • Published: 19th May 2021
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A report coauthored by Marie Curie Scotland and Dr Joy Rafferty, Strathcarron Hospice.

Marie Curie and Dr Joy Rafferty, specialty doctor in palliative medicine at Strathcarron Hospice, have launched a new report Dying in the cold; being homeless at the end of life in Scotland (this link will take you away from our website) which calls for urgent reform of access and provision of palliative care for people experiencing homelessness with a terminal illness.

Scotland has the highest rate of homeless deaths per million population in the UK, almost three times that of England and more than three times that of Wales. Over 200 people die in Scotland each year while homeless, with an average age of death just 39 for women, and 43 for men. Despite people experiencing homelessness having significantly worse health than the general population, higher death rates and more complex health needs, they have poorer access to palliative and end of life care. Terminal conditions such as cancer and liver disease happen more frequently and at a younger age in people experiencing homelessness. Yet in many cases it is unknown what, if any, palliative care support they have received.

Challenges around providing palliative care for people experiencing homelessness can include;
o Frequently moving location
o Complex trauma and needs
o Co-existing mental health issues
o Problem substance and alcohol use
o A real lack of options for places of care at the end of life

The report gives eight recommendations in total. Summarised, they are:

  1. Scottish Government and Health and Social Care Partnerships to improve access and provision of palliative care for people experiencing homelessness
  2. Wider palliative care training should be rolled out for homelessness service staff to help them identify people who may benefit from palliative care much earlier
  3. More tailored bereavement support to be developed and delivered for both those experiencing homelessness, and those providing support

For the full report, visit mariecurie.org.uk (this link will take you away from our website).

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