‘They are the experts of their own lives - we’re just here to provide options’

Image of the Tāmaki Makaurau/Auckland skyline taken by Merryn Gott

We have been fortunate to partner with Te Tāpui Atawhai/Auckland City Mission to explore palliative care need within the homeless community. In our latest paper we highlight the central role that housing key workers play in this space. The ability to provide palliative care for people experiencing homelessness is dependent upon supporting engagement with mainstream health services. It is here that the key worker role is central, due to the complex and expert work they undertake to facilitate healthcare access for the street whānau they support.

Key workers often went ‘above and beyond’ to support their clients in engaging with mainstream health services, during outpatient appointments, hospital admissions and in emergency department settings. They felt clinicians in these settings did not recognise the knowledge they held about the person, or their skills in terms of providing trauma informed care. The inflexibility of current care provision, as well as people experiencing homelessness feeling stigmatised, and neither valued nor respected in these settings, also created barriers to receiving care.

Our key worker participants shared how they were left ‘traumatised’ by the unjust dying circumstances of their street whānau and all the ‘lives cut short’ they witnessed. Nevertheless, participants also talked about it being a ‘privilege’ and feeling ‘proud’ to support individuals through serious illness and dying.

We make recommendations for palliative care service providers, the most important of which is to work in partnership with social care providers to develop new models of palliative and end of life care for people experiencing homelessness and vulnerable housing.