In from the Streets

by Cathy Finn

Every day at Duffy, before the first patient comes in, we hold a short huddle of all the staff to align ourselves with our patients’ needs for the day. We review a number of things, including hospital discharges from the day before. We know that sometimes a patient who is “discharged to home” and in need of respite has no home to go to. When this is said in huddle it is often followed by a moment of silence. What is there to say? We have said it before: How will they live (literally)? How can we keep them healthy when their home is a tent or even a doorway? How will their wounds heal? There’s no such thing as a sterile dressing in a campsite or bed rest in a sleeping bag on the ground.

And when there’s a winter storm on the way, the silence gets even deeper. And longer.

New staff will come to me and say “What can we do for them?” Our old timers will look into a patient’s eyes and say “Will you be safe?” “Safe” means different things to different people. Sometimes we are reassured by the patient that he will go into the shelter for the duration; the shelter will open to people in need in any way they can during a weather emergency.

Sometimes the answer is “Don’t worry, I have a lot of blankets.” That doesn’t put a caregiver’s mind to rest. When the wind picks up and the snow starts to fall, I will guarantee that that a Duffy staff person won’t be admiring the majesty of nature in its extremes; her mind will be in a small tent that is being buffeted about by gale force winds, with someone inside who’s sense of “bravery” has perhaps been augmented by drugs or alcohol, thinking survival can be ensured by a count of blankets.

I will never forget when I heard the blanket count from a patient, and tried, unsuccessfully, to intervene. There were fatal consequences; he didn’t make it through that winter. He had made choices from addiction and possibly mental health issues. Perhaps no one could have saved him, but it still makes the winter winds a lot colder for me.

There’s not a person in Duffy who would not go to the ends of the earth to try to guide a person to safety and health. Sometimes the hardest thing is for us to admit it can be beyond our ability to do just that at that moment in time. We dream of a future when we have some respite beds to offer to the medically fragile, so that a release to “home” could mean a warm, comfortable bed for few days or a few weeks, medically supervised and safe. Sometimes it seems that’s the only way our patients could recover, and right now, due to expense, it is beyond our reach.

A respite facility wouldn’t solve all our problems. I imagine we will always look out on cold winter landscapes and think of those out in the elements. I imagine we will continue to say, as I have heard coworkers say, “It was hard for me to be in a comfortable home last night.” “Have you heard from __ yet?” We look forward to the day when we can gather the resources to put together a 24/7 respite program for the medically frail homeless. At least when we announce another of our patients has been discharged to the street, the silence will be filled up with someone asking “How long will they need a respite bed?”

That’s when wind will fly more gently around the corners of Duffy Health Center. Although the calm will not come until the there is a bed for everyone, at least the chill will be off that wind for a few people in need.

If you’d like to become part of the solution, please consider donating to our Inn from the Streets program. In from the Streets began in 2005 as a community-based response to homelessness. When the program expanded to become a regional initiative, Duffy Health Center was asked to administer this program, which has assisted hundreds of individuals since its inception. This program offers temporary motel subsidies, and multi-agency case management to persons experiencing homelessness. People who are in need of medical respite, temporary housing until a voucher kicks in, and emergency situations are examples of where In from the Streets funding is used. Click here to learn more and donate today.