LHF supports the work of the London Network of Nurses and Midwives in Homelessness. Last week Samantha Dorney-Smith told us how health services have enabled many people experiencing homelessness brought into hotels during the Covi-19 pandemic to stay in.
This week Samantha provides a case study of care. Petra’s name and details have been changed to preserve anonymity.
After a difficult upbringing, Petra struggled with alcohol and drugs from an early age, despite a successful career as a musician. However, heroin addiction led to a downward spiral, and her only child was taken into care. Petra’s partner died in early 2019 after a drug overdose and she moved to London to forget her past life, and reconnect with friends. When the Covid-19 pandemic hit, Petra had been living on the streets in London for around two months, after abandoning a night shelter due to her drug addiction.
Many people are caught temporarily in homelessness in London due to a lack of a local connection that would entitle them to services. Such people have generally felt compelled to move to London for a variety of reasons; to find work, to access better services, to escape a traumatic event, or on account of mental health or addiction. When they arrive, if they have no local connection to London, they are ineligible for housing support. Despite this many still choose to stay, and often deteriorate on the streets. The Covid-19 ‘Everyone In’ programme has enabled all people to receive emergency accommodation, at least on a temporary basis.
When Covid-19 hit Petra was already well known to the outreach team, and was identified quickly as being of concern. She had a background of severe asthma, dry skin, and mental health difficulties, as well as being a heroin user, heavy drinker and smoker. Petra was quickly triaged on the streets by nurses who identified her as someone needing to be taken in for her own protection from Covid-19. She was offered a hotel bed with in-reach health support and escorted there on the same day. She was then registered with the GP practice in-reaching into the hotel, and given immediate prescriptions of inhalers and creams.
Work then started to refer her to relevant services who could rapidly prescribe Methadone, help her control her drinking, and support her mental health; an addictions worker, addictions Consultant, nurse, GP and mental health social worker all became quickly involved. Luckily Petra wanted help, so this all went pretty well; until Petra developed Covid-19 symptoms.
She was transferred to another hotel with daily on-sight health support, to monitor her symptoms, and continue her addictions and mental health support whilst being supported to self-isolate. Daily trips by staff were made to pick up her Methadone, and Petra was provided with e cigarettes to reduce her desire to smoke. Three meals a day and daily mental health support was also provided. Onsite health staff conducted regular physical checks, and provided medications to manage her fever and cough symptoms.
Petra is one of the lucky ones. She had Covid-19, but survived, and is now considerably more stable on account of having stopped drinking, and being stable on a Methadone script. Her asthma is better managed and she is engaging with mental health support, and appreciative of the hotel accommodation and support she has had during Covid-19. Accommodation options are actively being sought locally, as she does not want to return to Manchester. Many health care professionals have been involved in Petra’s care, but she has been brought back from the brink, and feels and looks well.
Petra’s case is clearly an interesting as well as successful one. Care like this would not have been provided in pre-Covid-19 times, and yet it clearly works. A hotel room, food, a bit of respect and kindness, and rapidly responding health services have enabled Petra the space and time to start her recovery.
The challenge to the sector is clear: how do we provide this care once the pandemic is over?
The LHF supported, first LNNMH symposium will enable nurses and other professionals to take a look at the changes that have occurred within health care during Covid-19, and will help them to consider which changes we might want to take forward for the future.
If you would like to be part of this event tickets are available here