Denigration or Decline: Reflections on Offering Staff Consultation Focussing on End-of-Life Care In a Homeless Hostel

People experiencing homelessness are subject to entrenched health inequalities and obstacles to accessing care. Numerous studies have highlighted that structural and organisational obstacles result in people experiencing homelessness living with unmet healthcare needs. Over time, this is associated with a reduced life expectancy compared with the national average in the UK. Although combating health inequalities has become a mandate for many healthcare providers, attempts to improve parity and access for people experiencing homelessness has stalled. This article utilises a case study method to highlight instances of psycho-social exclusion that homeless patients can be subject to and examples where healthcare staff can collude in this exclusion. The article concludes with highlighting the benefits of psychologically informed staff consultation, which creates reflective spaces to gain a better understanding of people experiencing multiple disadvantage and exclusion. In addition, staff consultation allows space to process feelings that are stoked in professionals who struggle to comprehend why it is difficult for some people to accept offers of care.