• District Nurse Helen Barnes explores health inequalities among the homeless population
• Journal publication sets out the importance of joint working between community services
• Recommendations to improve care include tailored care and honest conversations

A District Nurse at Bolton NHS Foundation Trust has shared her expertise in the British Journal of Community Nursing about how best to support homeless people with end-of-life care.

Titled ‘The challenges homeless people face when accessing end-of-life care: what district nurses need to know’, Helen Barnes explores the homeless community’s healthcare barriers and how Community Nurses are well-placed to provide person-centred care.

The article sets out how homeless people experience a backdrop of health inequalities and lower life expectancy because of risks such as substance misuse and poor nutrition and sanitation, which can increase pain at the end-of-life.

Helen identifies how joint working within community services, including Community Nurses, could provide more opportunities to meet the health needs of homeless people, including:

• Providing the right healthcare as soon as possible
• Using appropriate language and removing medical jargon which can act as a barrier to understanding health conditions
• Offer end-of-life care support to homeless shelters to make sure homeless people are being reached
• Educate and support hostel staff to recognise physical and behavioural changes

With end-of-life care being a key part of a Community Nurses’ role, the publication draws on recommendations to improve the offer to those experiencing homelessness:

• Use a tailored approach to provide pain relief
• Encourage honest and open conversations about alcohol consumption to make sure the most effective medication is prescribed
• Hold regular multi-disciplinary team meetings to improve communication about patients
• Offer end-of-life patients control and choice by using advanced care planning

Helen said:

It’s a privilege to be able to speak so frank and openly about some of the challenges our homeless people experience when trying to access services.

“Bolton has a wonderful Homeless and Vulnerable Adult Nursing team that work closely with Bolton Council and offer a range of services to support this vulnerable population.

Bolton NHS Foundation Trust has job opportunities available online to join the Community Nursing teams.