March 9, 2001

Helping the homeless – Collaborative program provides needed service

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Nurse practitioner Kei Berg helps apply a clean bandage to Respite Care Program patient Ralph Ozbun’s foot. Ozbun was being treated at the program after surgery. (photo by Dana Johnson)

Helping the homeless –
Collaborative program provides needed service

When patients are discharged from the hospital, it is usually with the instruction to finish recuperating at home. But for members of Nashville’s homeless population that presents a real challenge.

Home is usually the street.

The Campus for Human Development, aided by Vanderbilt University School of Nursing, is offering an improved solution to that problem – an expanded and relocated respite bed program, designed for Nashville’s homeless population who have been hospitalized but are not ready to return to the streets. The program’s new location, at Vine Hill Towers, was dedicated on Monday.

The respite care program, previously located at the Campus for Human Development on Eighth Avenue, has been expanded from nine beds to 24. It is the only program of its kind in Nashville. The Vine Hill property is being leased to the Campus by the Metropolitan Development and Housing Agency. The respite program is designed to help the homeless recover more fully – a task that would be difficult if protection, medical attention, rest and proper nutrition were not available.

Father Charles Strobel, director of the Campus for Human Development, said about 400 members of the homeless community are expected to be helped each year by the expanded facility.

“We are here to help patients who have been discharged from the hospital who don’t have the luxury of going to a home where they can completely recover. These are people with special medical needs; people who have nowhere to go.

“The homeless are confronted with the difficulty of finding assistance and shelter when recovering from acute medical problems, unmanaged chronic health problems, mental health problems and detoxification from chemical substances,” Strobel said. “Medication alone will not totally cure most illnesses or heal injuries. Appropriate nutrition, rest, and fluid intake are vital to the human body’s healing ability. Even though there is access to primary health care at the Metro Health Department’s Downtown Clinic for the Homeless, the care may not be complete if a homeless person has nowhere to convalesce,” he said.

Medical complications and longer periods of ill health can result if a homeless patient is discharged from the hospital and returns to the street. And the likelihood of re-hospitalization is significantly increased, he said.

The new Campus for Human Development respite care program is being dedicated in honor of Dr. Lewis B. Lefkowitz Jr., professor of Preventive Medicine at Vanderbilt University Medical Center. He has been the medical consultant of the current program since 1999 and has been involved in training Vanderbilt medical and nursing students to care for economically disadvantaged populations, including Nashville’s homeless community, since the late 1970s.

“Lewis Lefkowitz is a pioneer in the field of public health,” Strobel said. “He showed up here without my having to look for anybody. Had he not brought his students to us and continued to pursue his work here, we wouldn’t be where we are today.”

The respite care program receives patients with acute/chronic illnesses such as bronchitis, pneumonia, hepatitis, HIV/AIDS, diabetes, cancer and heart disease. Many have skin conditions and wounds that won’t heal properly, ulcers, cellulitis, exposure and frostbite – conditions brought on by living on the street. Many are victims of violence or are recovering from surgery.

Another Vanderbilt connection is Kei Berg, a nurse practitioner and health care coordinator. Berg, a 1999 graduate of the Vanderbilt University School of Nursing, is a new VUSN faculty member and has been with the Campus for Human Development since she began as a volunteer in 1999. She was introduced to the Campus in the summer of 1998 when she was part of an outreach program made up of Vanderbilt medical and nursing school students.

Aided by a $100,000 grant from the Memorial Foundation, the Campus for Human Development has been able to hire additional staff to assist Berg – an additional registered nurse and social worker to help care for the patients in the expanded program.

“We would not be able to make this improvement without the support of the Memorial Foundation,” Strobel said.

“We will be able to provide quality, well-rounded comprehensive care to our clients,” Berg said. “We don’t want our clients returning to the street after they are dismissed from the hospital. Our main goal is to assist in medical recovery by making sure our patients are treated holistically. There are not only physical needs, but there are social needs too. There may be secondary diagnoses that need attention. They also need education about their medications and their illnesses, how to use the health care system to decrease their emergency room visits, and how to care for themselves.”

Bonnie N. Pilon, DSN, senior associate dean for practice at the Vanderbilt University School of Nursing, said that Vanderbilt’s association with the Campus for Human Development is a win-win situation.

“The Campus population benefits from the placement of a highly-skilled nurse practitioner at the respite program. And the nursing school will benefit because this opens up another community training site for our pre-specialty students to learn about an economically disadvantaged population. The nursing school has been involved with the Vine Hill community for the past 11 years. We see this as a natural extension of what we do.”

Strobel said there are only a handful of respite programs in the country – in Savannah, Ga., Chicago, Washington, D.C., Boston and Denver.