Case study:

06 December 2010

Care of a homeless woman with learning difficulties

Key points

Mary was a 44-year-old woman with learning difficulties living at a local authority hostel in Leicester when she attended the Homeless Healthcare’s weekly GP service to have a cervical smear. The results were severely abnormal and an advanced cancer of the cervix was diagnosed, which required treatment with chemotherapy and radiotherapy.

Mary had no family contact but with her consent and with her input, her needs were met by co-ordinating all aspects of her care between the local authority, the local hospice and Homeless Healthcare. A member from the Homeless Healthcare team attended every hospital clinic appointment and all appointments for treatment with her to ensure she wasn’t alone and unsupported.

During treatment Mary was often unable to completely self manage and the local authority facilitated a transfer from the self-catering women’s hostel where she was staying to a self-contained en suite flat within the multi-agency Dawn Centre, a 44-bed hostel and YMCA drop-in centre which also accommodates the Homeless Healthcare health suite.

During this time her application for a bungalow reached the top of the housing list but rather than moving her out quickly as was usual practice, the local authority liaised closely with Mary and partner agencies and ensured her treatment was complete and that she would be able to manage before she moved on. Social services arranged for a package of care to be delivered daily and members of all four agencies, (that is, GP service, hospice, local authority, social services) worked collaboratively to ensure a high standard of care was consistently delivered and that all her needs were holistically met.

When her condition deteriorated and she needed admission to the oncology unit, a multi-agency case conference was arranged with both Mary and the above agencies present. She chose not to return to her bungalow with an increased package of care or to the local hospice but instead chose to move to a nursing home.

Following an accompanied visit by a member of the Inclusion Healthcare team she selected a bed in a local nursing home experienced in delivering palliative care and where she eventually died. On one of the team’s routine visit she said how happy she was there.