Discharged To The Street: A Shortcut to Readmission?

Homelessness and illness go hand in hand. Generally, the longer a person lives without a home, outside or in a shelter, the sicker they are, both in the number and severity of their illnesses. Hospital stays are routine in the lives of homeless people, and recovering from an acute illness is fraught with discomfort and risk. As an Online Community Building and Heatlh Fellow, I'm going to be examining the dilemma of hospital discharges of homeless people in Santa Barbara, and posting reports on my blog, homelessinsb.org.

A few cities, like Boston, have well funded respite care centers for their homeless residents. In that city, when a homeless person is discharged from an acute care center, they're not relegated to the quirks of weather and occupancy rates at shelters. They're admitted to a step-down center with round the clock nursing and allowed to recover fully before resuming the hardships of street existence. People who are discharged directly to "the streets," with limited access to nutritious food and an inability to rest, recuperate inadequately. Many times, they have to be readmitted for the very same illness.

In Santa Barbara, I recently saw a homeless person discharged from the hospital while still suffering the effects of pneumonia. The hospital was fully aware the individual would be camping and that rain was forecast for the weekend. It was not an isolated incident.

In my fellowship project, I'm going to follow a number of individuals and observe the trajectory of their condition. I hope to get one or two of them on video, speaking directly about their symptoms and their plans for taking care of themselves. I hope to impress upon the community how inefficient and inhumane it is to release sick, impoverished people to the sidewalk, and then bemoan their readmission weeks or months later for the very same condition.