Table 3

Challenges to discussing palliative care with people experiencing homelessness

Attitude to death
  • Death and dying are taboo

  • Fear of discussing death

Recovery focus
  • Young age of people experiencing homelessness with advanced ill health

  • Most deaths seen as avoidable, pressure to never give up on someone

Fear of impact on person and staff
  • Fear of fragility

  • Concern regarding escalation of harmful behaviours

  • Concern about the removal of hope

  • Potential emotional impact on staff

  • Working with uncertainty, difficulty identifying who may be at risk of dying

  • How to talk about deteriorating health and future care preferences

  • Which professionals should or could be having these conversations

  • Lack of options to offer people who are homeless and are experiencing advanced ill health.