Aleksandr was a 42-year-old Lithuanian man experiencing homelessness who came to the attention of the Hull Pathway Team having attended Hull A&E 12 times previously with alcohol intoxification, seizures and stomach issues. On this occasion he was admitted to the Hull Royal Infirmary Acute Admissions ward with a leg infection. Liver function tests showed he had early signs of alcohol related liver disease.

Aleksandr was unemployed, but with a history of prior employment. He had previously lived with his partner and young son, but his relationships had broken down on account of his drinking, leading to street homelessness. His English was limited, and he was not engaged with any support services prior to that admission. He had been referred for support, but had never made it there. When the team first met him, he was distressed, tearful, and in a low mental health state, and desperately wanted not to return to drinking alcohol for his health and future.

The team built a relationship with him, and developed rapport, taking time to fully explain things as necessary, and taking small treats etc. He gradually saw them as advocates who he could trust, and started working positively with them.
As part of his treatment on the ward Aleksandr completed a 4-day detox. The immediate option for Aleksandr by the Local Authority was to be discharged to an emergency bed.

However, both he and the Pathway team felt this was inappropriate because it would bring him into contact with other drinkers, and there was limited support available. The team advocated for him to be kept in, and other options to be considered. He was then found a placement at an Emmaus community where he was discharged to 2 weeks later, after his health had also had a chance to considerably improve. Emmaus projects provide supported accommodation people for people in recovery who are able to volunteer in the Emmaus second hand furniture and restoration shops – thus giving a training and a sense of purpose.

Between us as a team we did so well to convince the hospital to keep him in, but it has made such a difference to his health and his future.

Clinical Lead Nurse Anna Darwood

The day of discharge was his birthday, and the team arranged for a cake and cards to be at Emmaus when he arrived. Aleksandr settled at Emmaus and started volunteering. He also engaged with his GP for follow up care. One of the workers from the team saw him once a week, and he was discharged at 6 weeks.