Pathway Charity, London, UK.
Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.
Palliat Med. 2021 Jun;35(6):1202-1214. doi: 10.1177/02692163211006318. Epub 2021 Mar 29.
People residing in UK homeless hostels experience extremely high rates of multi-morbidity, frailty and age-related conditions at a young age. However, they seldom receive palliative care with the burden of support falling to hostel staff.
To evaluate a model embedding palliative specialists, trained as 'homelessness champions', into hostels for two half-days a month to provide support to staff and residents and facilitate a multidisciplinary approach to care.
An exploratory qualitative design.
SETTING/PARTICIPANTS: Four homeless hostels in London, UK, including nine hostel managers/support staff and seven palliative care specialists (five nurses and two social workers).
Benefits to introducing the model included: developing partnership working between hostel staff and palliative care specialists, developing a holistic palliative ethos within the hostels and improving how hostel staff seek support and connect with local external services. Challenges to implementation included limited time and resources, and barriers related to primary care.
This is the first evaluation of embedding palliative care specialists within homeless hostels. Inequity in health and social care access was highlighted with evidence of benefit of this additional support for both hostel staff and residents. Considering COVID-19, future research should explore remote ways of working including providing in-reach support to homelessness services from a range of services and organisations.
居住在英国无家可归者收容所的人在年轻时就经历着极高的多病共存率、脆弱性和与年龄相关的疾病。然而，他们很少接受姑息治疗，支持的负担落在收容所工作人员身上。
评估一种模式，即将接受过培训的姑息治疗专家（称为“无家可归问题专家”）嵌入收容所，每月提供两天半的服务，为工作人员和居民提供支持，并促进多学科的护理方法。
探索性定性设计。
设置/参与者：英国伦敦的四家无家可归者收容所，包括九名收容所经理/支持人员和七名姑息治疗专家（五名护士和两名社会工作者）。
引入该模式的好处包括：发展收容所工作人员和姑息治疗专家之间的伙伴关系，在收容所内培养整体姑息治疗精神，以及改善收容所工作人员寻求支持和与当地外部服务联系的方式。实施面临的挑战包括时间和资源有限，以及与初级保健相关的障碍。
这是首次评估将姑息治疗专家嵌入无家可归者收容所。卫生和社会保健服务获取方面的不平等问题凸显出来，表明这种额外支持对收容所工作人员和居民都有益。考虑到 COVID-19，未来的研究应探索远程工作方式，包括通过各种服务和组织为无家可归者服务提供内部支持。
