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Practice comment

'Better epilepsy care is needed for people who are homeless'

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David Parker-Radford calls on community nurses to take action in order to improve epilepsy care for the homeless

Over half a million people in the UK are diagnosed with epilepsy. But did you know that if you live in one of the most deprived areas of the country you are twice as likely to have epilepsy than if you live in one of the most affluent areas? Or that the rate of epilepsy in people who are homeless is as much as eight times higher than in the general population.

Not all people experiencing homelessness are well served by healthcare services. According to a survey of over 2,500 people in this group, over 17% were not receiving help for their mental health problems and 15% were not receiving help for their physical health problems. This is deeply concerning for patients who may be living with epilepsy and either on the streets or in insecure housing.  Poorly managed epilepsy can lead to uncontrolled seizures and can even heighten the risks of sudden unexpected death.

Nurses have a significant role to play in considering and identifying epilepsy when working with patients who are homeless. As such, they should consider a wide range of issues when working with this group of individuals, including whether the seizures or similar symptoms are unexplained and whether an individual is in need of immediate or regular neurological review or assessment.

Other relevant issues include whether the individual has any support from friends, family or other organisations, and whether those people would offer help by accompanying them to appointments. Another issue is whether the homeless person can pick up prescriptions and store anti-epileptic drugs safely and securely.

It is important for nurses to continue to update their knowledge on the barriers to diagnosis and treatment of epilepsy, along with the importance of routine treatment through anti-epileptic drugs. By linking effectively with local epilepsy services, nurses can play a valuable role in ensuring their patients get the specialist care that they need.   

The Queen’s Nursing Institute has worked with epilepsy specialist nurses and homeless health nurses to develop guidance for healthcare staff: Working with Epilepsy and Homelessness: Guidance for Community Nurses covers seizure types, first aid, treatment options, living with epilepsy and links to further information. It aims to help nurses improve their understanding and knowledge about epilepsy and the specific additional risks associated with being homeless and living with the condition.

Community nurses have a key responsibility to take action that helps to reduce health inequalities and improve the health of the public more widely. In identifying potential epilepsy among patients who are homeless and supporting people to access appropriate care and treatment, they play a critical role in helping people to manage the most common neurological long-term condition.

David Parker-Radford is homeless health project manager, Queen’s Nursing Institute

  • Click here to download a print-friendly PDF of this article
  • The guidance Working with Epilepsy and Homelessness is available here


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