HOMELESSNESS & PALLIATIVE CARE

A scoping study in regional, rural and remote NSW

By Emma Scott-Stevenson

Palliative Care NSW is completing a scoping study on Homelessness and Palliative Care in Regional, Rural and Remote areas of NSW. The aim of this study is to examine the availability and accessibility of Palliative Care services for individuals facing homelessness in these regions. This study follows the findings of PCNSW’s 2022 scoping study on Homelessness and Palliative Care in Metropolitan Sydney, conducted as part of Palliative Care Australia’s National Project. Prior to these studies, little was known about the services and policies which support homeless individuals who require Palliative Care across NSW.

PCNSW interviewed health workers from Regional, Rural and Remote Local Health Districts in NSW to better understand their experiences with Palliative Care patients facing homelessness. Chamberlain and Mackenzie’s cultural definition of homelessness was used in the study, which includes:

· Primary homelessness is experienced by people without conventional accommodation, for example sleeping rough or in improvised dwellings. Secondary homelessness is experienced by people who frequently move from one temporary shelter to another, for example emergency accommodation, youth refuges, ‘couch surfing’ or temporarily staying at the homes of friends, families or others.

Tertiary homelessness is experienced by people staying in accommodation that falls below minimum community standards, for example boarding housing and caravan parks.

Homelessness is a significant issue across NSW, and secondary and tertiary homelessness is especially prevalent in many Regional, Rural and Remote areas. These forms of homelessness are often referred to as ‘hidden homelessness’, as they are less visible than primary homelessness and can be harder to identify. The participants of the study described barriers they’ve faced while providing Palliative Care to homeless patients, and described changes they believe could improve the delivery and receival of Palliative Care services in Regional, Rural and Remote areas of NSW.

Some of the topics that will be explored in the study include:

The factors influencing homelessness in Regional, Rural and Remote areas of NSW, including natural disasters, COVID-19, rising costs of living and the limited number of properties available for rent or purchase at accessible prices.

· The availability and accessibility of Palliative Care services for homeless individuals in Regional, Rural and Remote areas of NSW.

The difficulties faced by health workers when trying to provide homeless patients with care.

The difficulties associated with patients maintaining their living arrangements after receiving a palliative care diagnosis and while living with a life-limiting illness.

· The barriers that can occur as a result of patients residing in rental, temporary or emergency accommodation while living with a life-limiting illness.

Ensuring the safety of community nurses and patients while providing and accessing care in varying environments. Meeting the psychosocial and cultural needs of patients living with a life-limiting illness while facing homelessness.

This study on Regional, Rural and Remote NSW is expected to be published in July 2023. You can access the first study on Metropolitan Sydney here