Saturday 17 March 2018

A&E copes with huge numbers of homeless

Lynne Kelleher

Homelessness and hypothermia have been linked to nearly 3,000 hospital stays in the last decade, according to new figures.

HSE figures show a person is discharged from an Irish hospital without any home to go to almost every day of the year - with 2,627 hospital stays by patients with "no fixed abode" from 2009 to 2016.

The Healthcare Pricing Office shows there were 335 discharges of homeless people in 2016 but the highest number was logged in 2014 when there were 448 discharges in the year.

Dr Chris Luke, consultant in emergency medicine at Cork University Hospital, said homeless people living on the streets are admitted with a litany of conditions.

"They get TB, pneumonia, skin ulcers, skin infections, dermatitis, scabies, hepatitis, fractures from falling."

He also said the violent attacks on homeless people who come to the hospital are shocking. He said: "They are regularly attacked, the violence is shocking. They are victims of accidents, they're victims of being thrown into the river, of being beaten up, of being stabbed.

"They have any trauma injury you can think of. There is also malnutrition."

While the figures, which do not include ER or out-patient visits, give an indication of the number of hospital stays by homeless people, they are not thought to give a full picture as not all homeless admissions may be logged for various reasons.

Dr Luke said homeless people are seen in the ER daily as the chronic housing situation has spiralled in recent years.

"Every emergency department sees a steady flow of the homeless. It is very unusual for me not to see two or three homeless people on a trolley or on a chair more or less every day.

"Homeless people define the purpose of the emergency department. They are the sick, the poor, the needy.

"The homelessness situation is worse than it ever was. You've got globalisation, rampant capitalisation and rampant addiction issues and all of those come together to make (people) homeless often very unexpectedly."

He praised charities like the Simon Community for their "remarkable work" but said their "hostels are bursting at the seams".

He said: "The stuff that is going on is wonderful really but at the same time it's a bit like the health service, we're struggling to keep up with the workload, it's just so enormous."

He said some homeless people are in terrible health because of the ravages of drink and drugs. "Amongst the homeless now you have every conceivable type of drug. First of all you have the drink, then you have the tobacco.

"They are drinking cheap hooch, smoking counterfeit tobacco which gives them emphysema and bronchitis and pneumonia, and then they are taking the likes of opiate, Fentanyl, Solpadeine, Panadol, benzos, the head shop…"

And while the patients used to be predominately middle-aged males, there are now a lot of young men and young women. He said homeless people use the ER far more than the average population.

"They are chaotic, they're in and out, unfortunately they tend not to keep appointments. They tend to use the emergency department a multiple of three times as often as the average population.

"The emergency department ultimately is a sanctuary for the homeless, the needy and the desperate.

"Many are them are in dozens of times in the year and they will spend six or 10 or 12 hours a day on a trolley being kept warm and looked after by our absolutely magnificent nurses.

"They are incredibly kind to the homeless," he said.

Sunday Independent

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