{"id":815641,"date":"2026-10-27T17:00:13","date_gmt":"2026-10-27T17:00:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/815641\/"},"modified":"2026-10-27T17:00:13","modified_gmt":"2026-10-27T17:00:13","slug":"what-does-a-good-death-look-like-when-you-dont-have-a-home-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/815641\/","title":{"rendered":"What does a \u2018good death\u2019 look like when you don\u2019t have a home? \u2013 The Irish Times"},"content":{"rendered":"

Research reveals time and time again that being homeless<\/a> is detrimental to your health.<\/p>\n

It also dramatically shortens your life.<\/p>\n

People who are homeless also have significantly greater rates of chronic disease, serious mental illness<\/a> and substance abuse<\/a> difficulties.<\/p>\n

And, despite having complex health needs, they are less likely to access healthcare<\/a> and much more likely to die at a younger age than the general population.<\/p>\n

When we reflect on a good death, many of us may picture being at home in a warm bed surrounded by our family and friends, or perhaps we may choose to die in the supportive care of an acute hospital, hospice or nursing home<\/a>.<\/p>\n

But what does a good death look like when your home is in long-term homeless accommodation, unsuited to meet complex medical needs, or you are vulnerably housed \u2013 that is, living in substandard, insecure rental accommodation?<\/p>\n

Research from the Health Research Board<\/a> in 2024 reported that there were 121 deaths among people who were homeless in 2020, equivalent to 10 deaths per month. The median age of those who died was 41 (42 years for men and 36.5 years for women).<\/p>\n

According to a 2021 report by P Dr Austin \u00d3 Carroll, there are several complex reasons why homeless people have a much higher mortality rate than the general population. These include a high rate of substance misuse, accidental and violent deaths, and a high prevalence of mental illness and suicidality<\/a>.<\/p>\n

\u00d3 Carroll\u2019s report also highlights that \u201cpeople experiencing homelessness generally come from areas of poverty which experience excess mortality and morbidity independently of homelessness\u201d, and \u201cthere is a much higher prevalence of severe physical illness among the homeless population\u201d.<\/p>\n

While people experiencing homelessness die from many of the same physical conditions as the housed population, such as cancer<\/a>, chronic obstructive pulmonary disease<\/a> (COPD) and cardiovascular disease<\/a>, the difference is that they die at a much younger age. More startling still is that young homeless people are dying from diseases that are wholly preventable and treatable.<\/p>\n

Ciara Cotter is a clinical nurse manager with Dublin Simon Community<\/a>\u2019s primary care nursing team. Her role involves caring for clients who are dying. Coupled with co-ordinating care with the local hospice, GPs, acute hospitals and palliative care teams, she works to ensure that patients receive the care they need in safe accommodation. <\/p>\n

Recalling a young woman patient who died at the age of just 41 from cervical cancer, Cotter says many people experiencing homelessness develop end-stage cancers at a young age because the transient nature of their lives means they are excluded from cancer screening programmes.<\/p>\n

How do you receive a letter inviting you to take part in a screening programme if you don\u2019t have an address?<\/p>\n

\u201cOften, our role with palliative care<\/a> is to do with having clients with end-stage cancers … often as a direct result of missed screening while they are younger, and they often present with end-stage cancers quite young,\u201d she says. <\/p>\n

Most of the patients who have been assessed as needing palliative care are in long-term homeless accommodation. Cotter says that since 2024, the Dublin Simon Community<\/a> has cared for seven such patients. Of these, six were under 65.<\/p>\n

[\u00a0Homeless numbers rise 9% in a year as latest figures show fresh increaseOpens in new window<\/a>\u00a0]<\/p>\n

Long-term homeless accommodation is home to people experiencing homelessness, and Cotter says most palliative care patients wish to remain in their accommodation for as long as possible. <\/p>\n

\u201cThe main role of the nurse is really an advocacy role … it\u2019s referring clients to the specialists, identifying any deterioration and just making sure that their symptoms are managed and their care is provided where they want to be, and oftentimes that is where they call home.\u201d<\/p>\n

While the building may not be suitable for someone who is dying, Cotter and her team do all they can to ensure patients\u2019 needs are met. This includes bringing in specialised medical beds and co-ordinating visits by nurses from the Irish Hospice Foundation<\/a> (IHF). <\/p>\n

The IHF\u2019s forum on End of Life 2026 took place in September at Croke Park. It explored the theme Every Death Matters: Dying, Death and Bereavement in a Changing Ireland \u2013 Emerging Narratives, and focused on under-represented voices, including the experiences of migrants and people experiencing homelessness.<\/p>\n

Unfortunately, long-term homeless accommodation is not set up to care for someone who is dying, and of the seven palliative care patients cared for since 2024, four died in a hospice and three in an acute hospital.<\/p>\n

Cotter says the Simon Community has identified the lack of palliative care beds as a gap in homeless health services; the charity would like to have one at its Usher\u2019s Island Health and Addiction Care facility in Dublin.<\/p>\n

When a client dies, Dublin Simon provides a funeral in the Church of Our Lady of Lourdes on Se\u00e1n McDermott Street in Dublin, attended by the charity\u2019s staff, some of whom would have cared for the person for many years. If, as is often the case, there is no family present, staff will lead the eulogy and prayers, and the charity also funds the burial in Glasnevin Cemetery<\/a>.<\/p>\n

According to the IHF, while almost three-quarters of people want a good death at home, only one-quarter actually die at home. The charity advocates for a good death wherever the patient may be \u2013 at home, in a hospice, a nursing home, or an acute hospital.<\/p>\n

When long-term homeless accommodation is your home and it is not set up to care for your needs, or if you are vulnerably housed \u2013 living in substandard, insecure rental accommodation \u2013 that choice of where you would like to die is taken away. <\/p>\n

Dr Aoibheann Conneely is a consultant in palliative medicine at St James\u2019s Hospital<\/a> and Our Lady\u2019s Hospice and Care Services Dublin. She has a special interest in inclusion health, an approach that aims to address the extreme health inequalities experienced by socially excluded people.<\/p>\n

St James\u2019s Hospital has pioneered inclusion health in Ireland thanks in no small part to the work of Dr Cl\u00edona N\u00ed Cheallaigh, consultant in infectious diseases and general medicine and clinical lead of the Inclusion Health Service at the hospital. <\/p>\n

As part of her job in palliative medicine, Conneely cares for patients with life-limiting conditions who are experiencing homelessness. She also liaises with colleagues in community palliative care or the hospice to ensure these patients receive the specialised care they need. <\/p>\n

[\u00a0Palliative care: We do death well in Ireland, but what about the lead-up period?Opens in new window<\/a>\u00a0]<\/p>\n

\u201cEach life is a person,\u201d says Conneely. \u201cNo one life is more important than the next. No one death is more precious than the next; each one is precious, and no one should suffer. We have to be careful not to have a punitive approach within health and social care, and focus on the person, their story, the adversity they have lived through, have an awareness of the trauma they have lived through, and treat them with dignity and respect both in living and in dying.\u201d<\/p>\n

According to Conneely, a good death is one where the person is cared for, feels safe, and is surrounded by the people they wish to be with. \u201cFor some people this is at home; for others it may be in long-term accommodation as long as their care needs are met … for some it may be hospital, for others hospice.<\/p>\n

\u201cI think what is hard for people is when that choice isn\u2019t there, when they don\u2019t have a choice to be at home because they don\u2019t have one. Or when they don\u2019t have a choice to be … in their accommodation if, for various reasons, that is just not possible due to limitations on resources within that accommodation despite best efforts.\u201d<\/p>\n

Conneely recalls a patient she cared for a number of years ago while working as a junior doctor in another hospital.<\/p>\n

Her patient was a man in his 60s who was living in long-term hostel accommodation. It was a wet hostel, where alcohol was allowed. He was admitted to hospital with a chest infection, and an X-ray revealed a mass on the lung. Lung cancer was one possible diagnosis, which would have required further appointments.<\/p>\n

When he missed his follow-up appointment due to a fear of attending the hospital, the respiratory consultant visited him at his hostel to encourage him to return. With the support of the consultant, hostel and hospital staff, he agreed to return, and sadly he was diagnosed with lung cancer. As he became weaker, Conneely was asked to see him; she organised a brain scan, which revealed that the cancer had spread to his brain and he was not strong enough to withstand treatment.<\/p>\n

The man was estranged from his daughter, but with his permission the hostel staff were able to contact her. He was transferred to the hospice for end-of-life care and was reunited with her. <\/p>\n

\u201cI was a young doctor at that time, but it showed me how staff across all services can be so compassionate and empathetic, trying to support that patient in their way, not being judgmental about the life he lived, not being judgmental about missed appointments, etc,\u201d says Conneely.<\/p>\n

Asked what one thing was needed to improve palliative care for the homeless in Ireland, Conneely says: \u201cEnd homelessness. In an ideal world, people wouldn\u2019t be dying in homelessness. I shouldn\u2019t have a specialist interest in this area because it shouldn\u2019t exist.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Research reveals time and time again that being homeless is detrimental to your health. It also dramatically shortens…\n","protected":false},"author":2,"featured_media":815642,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[847,267633,102,267631,2960,2750,165213,1906,49286,267632,157577,9728,56,54,55],"class_list":["post-815641","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-cancer","tag-glasnevin-cemetery","tag-health","tag-health-research-board-hrb","tag-healthcare","tag-heart-disease","tag-homeless-crisis","tag-mental-health","tag-nursing-homes","tag-simon-community","tag-st-jamess-hospital","tag-suicide","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/815641","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=815641"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/815641\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/815642"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=815641"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=815641"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=815641"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}