Discussion centred around the following four topics: policy, principles and practice of palliative care; professional boundaries as a threat to holism and a hindrance to dignity; the social undesirability and invisibility of homeless people; 'community living' as a barrier to hostel-based palliative care and a new concept of family.

Background: People experiencing homelessness often die young and without adequate support. In the UK, they fail to access palliative care services and their end-of-life priorities remain poorly understood. Aims: To explore the end-of-life concerns, fears, preferences and priorities of a sample of people experiencing homelessness in the UK. Methods: This is an interpretive phenomenology. Data collected through semi-structured, audio-recorded, face-to-face interviews with 21 homeless participants in the UK were analysed iteratively using thematic analysis. Findings have been interpreted through the lens of Merleau-Ponty's philosophy. Results: Eight themes are reported: spiritual concerns; practical concerns; fear of needing care; fear of being forgotten; preference for dying suddenly; preference for being somewhere comfortable where people know me; prioritising autonomy and self-determination; and prioritising authenticity. Conclusion: A strengths-based, trauma-informed, person-centred, collaborative ‘compassionate community’ approach to care is recommended for people experiencing homelessness at end of life.

Homelessness is a complex and multidimensional issue often involving a combination of personal vulnerability, the limitations of social housing, and inadequacies in welfare support. Providing palliative and end-of-life care to people experiencing homelessness is challenging, both to individuals receiving care and nurses aiming to meet their complex needs. This article discusses what is understood by the concept of 'homelessness' and examines the barriers to accessing effective healthcare for people who are homeless and have life-limiting conditions. The authors review the research into end of life care for people experiencing homelessness and identify areas for further investigation, notably the lack of evidence regarding the end of life care priorities of these individuals. There is a focus on the availability of healthcare services for people who are homeless at the end of life, as well as the factors that should be considered if evidence-based healthcare services for this group of people are to be improved in the future.

BackgroundWith limited resources and no stable accommodation, people who are homeless arguably have greater need of palliative care support than the rest of society when they face the end of life. However, they consistently fail to access palliative care services (Care Quality Commission, 2016) and while there is much in the literature surrounding the barriers to appropriate health care (Hudson et al., 2016), their specific needs and wishes remain poorly understood by health care professionals (Care Quality Commission, 2016). This study aims to bridge the gap in knowledge.The Research QuestionThe central question of this study is therefore; ‘What matters most to homeless people in the UK as they consider end of life?’ Only when the answers to this important question are understood, will the problem of homeless people dying without adequate support and with very little dignity or choice begin to be addressed.Aim of StudyThe aim or purpose of this interpretive phenomenological study is therefore to explore the end of life priorities of a sample of homeless adults in the United Kingdom.MethodologyThis qualitative PhD project is a phenomenological study underpinned by the philosophy of French phenomenologist, Maurice Merleau-Ponty. Data are being collected through in-depth, semi-structured, audio-recorded 1:1 interviews with homeless adults across several UK counties. Interviews are taking place at staffed centres providing services for older homeless adults. Data are being analysed iteratively using thematic analysis.ResultsThis PhD is a work in progress. Early findings will be shared.ConclusionIt is not yet possible to draw full conclusions from preliminary data. However, it is hoped that a deeper understanding of preferences and priorities will assist commissioners and healthcare professionals to plan and provide relevant palliative care services that genuinely meet the needs of the dying homeless.The Florence Nightingale Foundation have part-funded this research.

Background: Spiritual care is a fundamental component of holistic end of life (EoL) care. Aim: To explore what is known about the spiritual concerns of people experiencing homelessness (PEH) towards the EoL.

Exploring the impact of providing seated chair massage to patients and staff at a forensic mental health and learning disability service. Mental Health Practice.

BackgroundThere are many complexities surrounding palliative and end of life care for homeless people (Help the Hospices 2012). Presently, the Department of Health (DoH 2010) is suggesting that hostel staff are the most appropriate key-workers for their dying homeless residents and that hostel based palliative care may be the best way forward. However, little is known about the views of hostel staff with regard to this.MethodsSemi-structured qualitative interviews of up to one hour were conducted with seven participants working in four hostels across three UK counties. A total of 37 specific case studies were shared by the seven participants. The case studies involved homeless residents with a wide range of life-limiting or palliative conditions.FindingsEight main themes emerged: understanding palliative care; working with limited medical information; taking responsibility; building rapport; upholding resident’s dignity; recognising physical deterioration; managing environmental challenges; role limitations and support needs of hostel staff.ConclusionDiscussion centred around the following four sub-headings: the policy, principles and practice of palliative care; professional boundaries as a threat to holism and a hindrance to dignity; the social undesirability and invisibility of homeless people; ‘community living’ as a barrier to hostel based palliative care and a new concept of family.

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