In Canada, we often think of good health and access to health care as basic rights, available to everyone. However, this is not true for the 150 000 to 300 000 people who are homeless or at risk of homelessness.
Chronic health conditions, like diabetes and high blood pressure, as well as life-limiting illnesses, like cancer, are a reality for people who are homeless. In fact, men who are homeless live, on average, to somewhere between 42 and 52 years old when for the general population life expectancy is near 80 years. Their rate of death is 3 to 4 times higher than the national average in Canada.
Not being able to access health care means that people who are homeless and face life-threatening and chronic conditions are not able to receive palliative care. The goal of palliative care is to help people with life-limiting illness be as comfortable as possible, to manage their pain and other symptoms well, and to help them maintain a good quality of life in four areas: physical, psychological, spiritual, and social.
Many workers take a harm reduction approach to care in order to build relationships with people who are homeless. They do this with the goal of building trust and trying to assist them in getting better access to care, including end-of-life care. However, this can be frustrating and daunting for workers when they may not have all of the skills and knowledge that they need in order to discuss dying and death, palliative care, and a palliative approach.
This resource was developed with and for workers across Canada who support people who are homeless. It is designed to provide useable and practical information about providing a palliative approach to care while building on the knowledge and expertise workers already have about harm reduction approach, relationship development, and meeting people where they are at.