Exploring the views of people experiencing homelessness regarding their health and housing support, and their perspectives on deteriorating health and end of life support: a qualitative analysis.

OBJECTIVES

To explore the views of people with lived experience of homelessness regarding health, housing and social care support and the support people with deteriorating health may need.

DESIGN, SETTINGS AND

PARTICIPANTS

14 qualitative interviews were undertaken with people experiencing homelessness who were in contact with services that had previously participated in a Community of Practice intervention. Participants resided in hostels (n=12) or supported housing (n=2). Interviews were conducted primarily face to face and were supported by a lived experience researcher. Data were analysed using reflexive thematic analysis and were used to inform the refinement of the Community of Practice intervention.

RESULTS

Four themes were identified: the impact of homelessness on health; structural and relational barriers to equitable healthcare; contribution of the hostel environment to poor health; views on how health and homelessness service staff could respond to deteriorating health. A high burden of health issues, psychological trauma and exposure to death were described. Health and social care services were perceived as absent or hard to access. Mental health support and adequate pain control were challenges. Stigmatising experiences in hospital, often related to addiction, were common. Interviewees supported more proactive conversations around deteriorating health.

CONCLUSION

The risks and reality of deteriorating health among people experiencing homelessness were widely recognised. Interviewees felt that sensitive conversations about this issue could be initiated by staff. However, healthier environments and improved access to health and care support were needed. Lived experience input was a vital component for the development of the Community of Practice programme.