Access to palliative care for people without safe and secure housing 

 A homeless person can be described as someone who does not have safe and secure housing. There are homeless people that are visible on the streets and those that are not visible. This includes those who may stay with others temporarily, be subject to overcrowded accommodation or be staying in temporary accommodation such as caravan parks or crisis - accommodation. This can severely affect their access to health care including palliative care.

Why palliative care matters

Both alcohol and smoking are major risk factors for life-limiting conditions including cancer, cardiovascular disease, and COPD. There is a strong association between problematic alcohol drinking and homelessness. Information on smoking suggests many may be smokers. One in four people in Australia who had ever experienced homelessness rate their health as fair or poor. This is almost double that of those who have not experienced homelessness.

Common barriers and outcomes

Common barriers to accessing palliative care for people who are homeless include: 

  • lack of health records, 
  • lack of fixed residence to provide care, 
  • health services refusing to enter accommodation due to conditions, 
  • fear, and 
  • mistrust of health services. 

Homelessness also presents challenges for referrals and follow-up care. Homeless people are subject to negative stereotyping and discrimination. Many have faced multiple challenges in life and are more likely to have poorer health than the general population. As homelessness can affect people from many specific population groups, the crossover between groups can add to the complexity of their situation.

Overcoming the barriers

  • Homeless people may have a lack of trust in health care institutions and a fear of displacement from their current living situation. This may be due to rigid routines and restrictions such as bans on smoking and alcohol consumption. Collaboration between health services and homelessness services may assist in meeting the person’s needs.
  • Homeless people have poor attendance with primary health care services and often do not have a regular GP. A consequence of this is that GP’s have no access to previous medical records leaving many health needs unmet. Electronic health records such as My Health Record would enable any doctor involved in the care to see previous records if they were uploaded.

Learn more

To learn more about our homeless population, visit the ELDAC website and the Australian Government Department of Health Exploratory Analysis of Barriers to Palliative Care - Issues Report on People Experiencing Homelessness.

This information was drawn from the following resources:

Last updated 02 August 2021