When it comes to end-of-life care, options for Halifax's homeless are few

More options are needed to ensure homeless people in Halifax can die in a safe and comfortable environment, advocates say, and a hospice is a good place to start.

It's unrealistic for shelters to hire staff to assist with end-of-life care, said Patti Melanson, executive director of Mobile Outreach Street Health, which provides primary health care to those who are homeless or street-involved.

This means the hospital is usually the only option for a homeless person who is dying, even if it's not the place where they want to spend their final days.

A hospice for the homeless in Halifax — a home designed to provide residential care for the terminally ill — would be "really, really helpful," said Melanson.

Claudia Jahn, program director for the Affordable Housing Association of Nova Scotia, said a Halifax charity called Hope Cottage — which provides free meals out of its location at 2435 Brunswick St. — purchased the parking lot next to the cottage in recent years. Its goal was to build a facility that would include residential palliative care.

Those plans stalled when the executive director, Michael Burke, died in November 2016, Jahn said.

Gordon Neal, the CEO of Hospice Halifax, said its building — currently under construction at 618 and 620 Francklyn St. in Halifax — might be an option for the homeless when it opens in the fall of 2018. 

The 10-bed facility aims to be Nova Scotia's first stand-alone facility for end-of-life care, providing a free service for patients.

"One of our founding principles is compassion," Neal said. "We recognize that it's important to offer service to people who are precariously housed or street-involved."

Neal said he's working with other community agencies to ensure the new facility is accessed by a broad range of people. 

Even then, he said the new hospice will only be a third the size of what is considered adequate for a city like Halifax.

Jahn, who helped compile a report on the health status of Halifax's homeless population in 2012, said the final days for a homeless person with a terminal illness can be especially difficult.

The report found that many people refused treatment outright, she said, because they knew they wouldn't have anywhere to recuperate, and they couldn't handle the side effects while living in a shelter or on the street.

"They just refused and really resigned themselves to this diagnosis," Jahn said.

Even managing pain is difficult for the homeless if they aren't in a safe place, she said, because they're at risk of being robbed for their medications.

Some physicians are also reluctant to prescribe appropriate pain medications to those living with opioid addictions, Melanson said, when they aren't living in a supervised environment.