Archive for May, 2008

The following is a guest post from Michael, author of the SLO Homeless blog.  Michael was once homeless himself and provides his perspective on homeless medical needs, recovery, etc. below.  Be sure to visit Michael’s blog as well!


There is no cure for the common cold. That’s just the reality of life. The best a person can hope to do is go to the local pharmacy and buy one of the many over the counter remedies – which only make it easier to cope with the symptoms at best. If the symptoms are a bit more severe, the person may take a day or two off from work and “sleep it off.”


For the millions of American’s who just happen to be a part of this nation’s homeless population, even the common cold can make an already stressful life all the more harsh.


According to the National Coalition for the Homeless fact sheet, Health Care and Homelessness,


“Poor health is closely associated with homelessness. For families struggling to pay the rent, a serious illness or disability can start a downward spiral into homelessness, beginning with a lost job, depletion of savings to pay for care, and eventual eviction.”


However, for those who are homeless, health care issues do not stop there.


While many communities offer some form of government sponsored indigent health care services for their local homeless, lack of adequate funding severely limits the quality of medical services available to the homeless – particularly for those who have chronic health issues. For those who have on-going medical needs for such conditions as diabetes, respiratory or cardiac diseases, addiction disorders, and mental heath issues, the lack of stable housing makes it a near impossibility to keep their conditions from worsening.


Additionally, a lack of accessibility to proper nutrition, regular hygiene care and even sleep, often times means that the homeless have a less robust auto-immune system. This places them at risk of contracting numerous bacterial and viral infections.


Among those homeless who utilize local homeless shelters, the incidence of upper respiratory infections is higher than those of their non-homeless counterparts. Since most homeless shelters utilize a dormitory style methodology for providing shelter, this forces the clientele into close proximity with others. Consequently, if one or two of the homeless have an upper respiratory infection, there is a high probability that the majority of the clientele will also develop the infection. It is not unusual for many homeless to develop “shelter cough.”


There is a higher price to be paid by the community when there is a lack of proper medical services for the area’s homeless.


Although most of a community’s homeless are aware of the availability of medical services, many of them do not utilize these services immediately upon becoming sick. This is often times a result of the distances that must be traveled to obtain these services. In some communities, the homeless support services agencies are located in a more remote or industrialized section of the municipality while medical services may perhaps be located on the “other side of town.”


As a result, a medical condition – which had it been treated at the onset – worsens until the person finds themselves with no other option but a visit to the emergency room. In the long term, these emergency room visits cost the community more in taxpayer dollars than it would to fund preventative and supportive medical services.


Moreover, since the homeless are unable to pay for emergency room visits, the hospital is required to “write off” the costs. This writing off of costs isn’t completely dismissed however. They are ultimately passed on to the rest of the community as hospitals are required to increase their prices to cover their operational expenses.


With the ubiquity of prepaid services these days, it might be wise for us as a society to take that approach when it comes to providing adequate medical services to our nations’ homeless.


It’s up to us. We can choose to take the more cost effective route and “pre-pay” for those services; or we can choose to pay after the fact. But, have no doubt about it – the invoice will have to be paid for one way or another.


It’s been my experience that it’s less expensive to get it right the first time, than it is to have pay the extra costs the second time around.


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Last Saturday, a great group of volunteers from the Crossroads Community Church GO Cincinnati project came to Respite to help us with some much needed chores.  They painted our front doors, porch door, installed a walking path, flower beds, and even a brought a new hose!  Appearance isn’t everything, but it gives our clients and staff a lift to see our building looking so much better. 

GO Cincinnati is an annual, community-wide project that Crossroads coordinates, sending out thousands of volunteers into the Cincinnati area to help nonprofits like Respite make much-needed changes.  Agencies submit project proposals which are then delegated to smaller groups.  Neighborhood leaders oversee several small groups, making sure the projects go smoothly.  I couldn’t be more pleased with the results!

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May 6 – May 12 was nurse’s appreciation week, so it seems only fitting that I take a moment here to appreciate the Center for Respite Care nursing staff.  Now, we all know that nurses are pretty special folks.  They take care of us when we’re very sick (and cranky) and, in the case of Respite clients, work to resolve homelessness as well.

Not only do our LPNs help clients learn to self-administer medications, they provide dressing changes, help coordinate appointments, take referrals, evaluate clients, keep track of loads of paperwork, and millions of other tasks that probably would make me feel a bit sick!  Patient care assistants and unlicensed assistants must run miles a day helping with some of the tasks above and more!  Plus, they keep us staffed through the night, making sure our clients are safe and healthy 24 hours a day.

Along the way, these wonderful people provide the moral support necessary to encourage our clients – to convince them that homelessness is a situation, not an identity.  That’s a pretty tall order to fill, but they do it every day.

Our clients are hardly typical, and they don’t exactly have standard hospital surroundings.  They share a common television and split living space with 2-3 other clients, all of whom are too sick to be in the hospital, but not well enough to care for themselves.  They are definitely not well enough to return to the streets! 

Special clients require a special nursing staff.  Ours is a group that is willing to deal with their nursing duties as well as the normal “living together”-type issues that arise.   They know how to support a person that needs help without enabling someone that needs to learn independence.  They balance medical and social needs, appointments, meetings, referrals, phone calls, and many other issues that arise throughout the day.

To all the hardworking, loving nurses out there – thank you!  And a special thanks to my amazing coworkers for the work that they do. 

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