Pathway teams work to support homeless people in hospital, trying to find every patient a safe place to go when are discharged. These homeless patient stories show just a few of the thousands of people Pathway teams have helped, who have kindly agreed to share their experiences (some details have been changed to protect identity).
Vince was a self employed electrician for 40 years. Aged 59, he had no family and moved around regularly to find work, usually staying in local B&Bs. When work took a downturn he couldn’t find another contract, and couldn’t pay for his B&B room. In debt and desperate, he took an overdose and was hospitalised. During his treatment staff found out that Vince was diabetic.
The Pathway team went to see Vince, a Care Navigator who had been through a similar situation shared his own story and they went to the housing office together when Vince was discharged. The Care Navigator helped Vince negotiate a return to his B&B with backdated housing benefit to pay his arrears and an application for benefits until he could get back to work.
Vince’s benefits were delayed and he returned to hospital a week later at breaking point. The Pathway team helped him apply for a crisis loan and gave him a Dignity in Care package to buy food to stabilise his blood sugar. This simple support prevented another overdose or diabetes related admission.
Eddy was 40, living in a hostel, but struggling with health problems. He had prolonged treatment in intensive care for alcoholic cardiomyopathy, liver and renal failure.
He stopped drinking alcohol and using drugs during his hospital stay. Like many people, he didn’t want to start again, but found it hard to be abstinent because most other residents in his hostel were using these substances.
The Pathway team negotiated Eddy a placement at a “dry” hostel for people recovering from dependency. Over the next few months he came back to hospital regularly for a programme of planned admissions to treat ascites. Each time the Pathway team visited him during his hospital stay.
Eddy no longer uses drink and drugs, and has re-established a relationship with his father.
Dave, 54, was admitted to hospital for surgical drainage of his dangerously infected leg and hand. He was alcohol dependent and had been prescribed methadone, but was still using intravenous drugs. Dave finds it hard to engage with community services, and had no GP, his health had spiralled.
During treatment he was in a great deal of pain. The hospital painkillers were ineffective because of his high opiate tolerance, caused by years of drug use. This caused friction with ward staff, some of whom assumed he was ‘drug seeking’. The Pathway team acted as liaison between Dave, the ward staff, the pain team and the drug treatment team to ensure adequate pain relief.
Once his pain was under control, Dave stopped using street drugs and alcohol. With his permission, Pathway invited a community drug worker into hospital to meet with him and discuss a possible rehabilitation space.
Dave eventually decided against rehab because he was afraid of bringing up bad memories. Instead, Pathway helped him to register with a local GP for future healthcare and he retained links to the community drug worker he had met. When he left hospital the Pathway team arranged for him to collect his methadone and analgesia daily, from a location near his hostel, to minimise the risk of him relapsing.
Although Dave still struggles, he remained out of hospital for a year after discharge.
Paramedics were called to Jim, 48, after he was found in the lounge of his hostel, lying in urine and faeces. He had been there for two days, unable to move or climb the stairs to his room, and was suffering from alcohol withdrawal seizures and malnutrition.
Jim was too ill to communicate, but his records showed that over the past decade he had attended hospital 155 times, been admitted 11 times and had spent 62 days as an inpatient. Most treatment had been related to self-harm or alcohol, and both had worsened when he lost his home, seven years earlier.
Despite his horrific situation, Jim had not been given ongoing support, because his mental and physical health problems were considered alcohol-related. Doctors found that he had alcoholic fatty degeneration of liver, cerebral atrophy and symptoms of cerebellar ataxia and peripheral neuropathy, caused by brain and nerve damage. He was covered in scars from self-harm.
The new Pathway team stepped in, and the specialist homeless GP produced a report about the impact of Jim’s homelessness on his health and well-being. The local council finally agreed to house Jim and the Pathway team worked with them to find a placement in a supportive residential care unit.
When the Pathway team met Sue, she was adamant that she wasn’t staying in hospital, despite a chronic leg ulcer and bleeding duodenal ulcer. At age 33, she had a severe alcohol and heroin dependency, was injecting into her groin, and had frequent emergency hospital admissions, but each time she discharged herself.
The Pathway nurse asked Sue what she would like her life to be like, if there were no barriers. Sue said that she couldn’t cope alone in England any more, and just wanted to go home to her family. The nurse agreed to try and make this happen whilst she was in hospital.
Sue stayed in hospital, stabilising on methadone, completing alcohol detoxification and seeing improvements in her leg ulcer. The Pathway team located Sue’s family, and identified a means of funding the move home. They liaised with local drug treatment agencies and arranged for Sue’s GP to transfer her methadone script.
After a mammoth journey, Sue arrived home. She is well supported by her family, remains drug and alcohol free, and has started visiting a dentist to get her smile restored.