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April – May 2024 : Compassion READ ONLINE

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September 01 2019
The writers (l-r): Andrew Knee, Palliative Care Coordinator, St Mungo’s; Dr Caroline Shulman who works in homeless health with Pathway Charity, University College London & King’s and Julian Daley, who has been homeless, and is now a Care Navigator, Pathway. © AK The writers (l-r): Andrew Knee, Palliative Care Coordinator, St Mungo’s; Dr Caroline Shulman who works in homeless health with Pathway Charity, University College London & King’s and Julian Daley, who has been homeless, and is now a Care Navigator, Pathway. © AK

Talking about death can be helpful and help you live well. That’s why we’ve devoted this issue of the Pavement to the big taboo. 

Though death happens to everyone, many of us have not spoken to anyone about our concerns, fears or wishes. This may be because we don’t want to. Or it may be that we haven’t thought about discussing it before. Or we don’t know who we could talk to. It may be that we prefer to just focus on the here and now, or we have suffered so much that we cannot face talking about it. Most of us are not alone in having fears and concerns about death.

Discussing these fears and concerns may enable us to deal with them, and get support from others.

It’s important that we don’t feel pressurised to talk. Many people who are homeless often have fears and concerns that they would like to share with someone – but for many reasons may not feel able to do this.

Sasha told us: “I used to carry a list and a diary around with me when I was on the street, because it had things about who I was. I wanted people to know me as a person. I’d written down what I wanted to happen to me. And it had important information like who my family were, stuff like that. I was afraid of dying alone. I had friends on the street for a while who I talked to, but when we all went our separate ways, I never told anyone else of these fears.”

Instead of fear, maybe we could focus on what we want? For example, what would living well look like? If we ended up unwell and in hospital what would we like to say to a health care provider about what we would (or wouldn’t) want them to do to us?

Many people experiencing homelessness have a long-term health condition, which can make it difficult to know what the future holds. This can be particularly complicated for people who are using substances. For example, even specialist doctors often do not know how long someone with severe liver disease might live for. Perhaps it would help all of us to think about what we would like to happen here and now; what living well means to us now and what we would like to happen if our health were to get worse.


In a nutshell

  • Death happens to everyone.
  • Focus on what you might want should your health deteriorate, and what living well means to you.
  • This is a chance to hope for the best, but plan for the worst.
    See how on p12.


What is...

  • Palliative Care is the treatment, care and support for people with a long-term condition and advanced ill health. Palliative care is to help us to have a good quality of life. This includes being as well and active as possible in the time we have left.
  • End of Life Care (EOL) involves treatment, care and support for people who are nearing the end of their life. It involves managing physical symptoms, pain relief, and emotional support to us and those close to us. 



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April – May 2024 : Compassion

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