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New London - Having a quiet, safe place to rest after being hospitalized for a mild stroke has given Paul Sawicki both a chance to recover and to start making a better future for himself.
"Without this service I don't know where I'd be," said Sawicki, straightening the covers on the single bed where he'd just spent three days recuperating after he was discharged from Lawrence + Memorial Hospital, not letting lingering right-side weakness deter him. "This is a good place for people who don't have a place to go."
The 59-year-old Air Force veteran is one of 45 homeless people who've made use of the nine-bed respite center at the New London Homeless Hospitality Center, a unique space within the shelter set aside for those recovering from illnesses. Sawicki, who lost his job two years ago and became homeless after his unemployment benefits ran out, has made use of the respite area twice - the first time when an infection set in after his big toe was amputated, and the second last week after the stroke. During his recent stay, he's been working with shelter staff to get into an apartment through a program for homeless veterans.
"It's quiet here, and you have staff and visiting nurses who can keep an eye on things," he said.
The respite center, equipped simply with single beds and chairs set off with office dividers, opened in November, a month after the shelter moved from St. James Episcopal Church to its new quarters at the renovated former Sts. Peter & Paul Polish National Church. In addition to regular shelter staff, the respite center also has a part-time nursing coordinator and regular visits from nurses with the VNA of Southeastern Connecticut.
"Our target population is the subacute population, who aren't ready to be on the street," said Dana Dixon, director of health services at the shelter. "I can't emphasize enough how important it is to meet people's needs where they are."
Cathy Zall, executive director of the shelter, said the respite center was incorporated into the $1.2 million shelter project from the start. Only one other homeless shelter in the state offers a similar service, she said.
"When we first started this, we recognized that there are special problems for people who are homeless and sick," she said.
After an overnight stay at the shelter, people must leave their beds at 7 a.m., often spending the day walking to the community meal center on Montauk Avenue, the library and other locations around the city. For someone recovering from surgery or sick with the flu, Zall said, that is not only inhumane, it doesn't make sense from a public health perspective. At the respite center, people are allowed to stay around-the-clock, with easy access to showers, bathrooms, meals and care of nurses who can change dressings, monitor vital signs and help obtain medications. Shelter staff work to reconnect respite guests with family members and find housing.
"We're not a medical facility, we're a substitute for home support," Zall said.
Dr. Robert Linden, director of the Center for Innovation at L+M, said the hospital became a partner with the shelter in creating the respite center because it, too, recognized that everyone would be better off - the hospital, the homeless recovering from illnesses and the entire community. The Center for Innovation, he explained, is charged with developing "out of the box" solutions to complex health care problems.
When a homeless person ends up in the emergency room, or hospitalized and needing surgery, oftentimes they would end up with long inpatient stays that swell the hospital's uncompensated care accounts because there was no alternative. Alternatively, he said, someone would be discharged only to be readmitted within a short time because they relapsed from trying to recover while homeless.
"This improves care and decreases readmission rates, so we could make an argument to the hospital for funding," he said.
Linden said he's working to get the word out to doctors and other health care providers throughout southeastern Connecticut so they know the respite center is available.
The respite center is being funded this year as a trial program, with $50,000 coming from L+M and a $50,000 grant from the Connecticut Health & Educational Facilities Authority. Examples of the people who've used the center in the 5½ months it's been open provide ample evidence that it should become permanent, Zall and others said.
Tina Belmont, a nurse with the Visiting Nurse Association of Southeastern Connecticut, has been providing care at the respite center seven to eight hours per week.
"We make follow-up appointments, make sure they have transportation to the appointments," she said. "So many of these things would fall through the cracks."
She told of one young woman who came to the respite center with a nephrostomy tube and catheter due to kidney failure, and was also struggling with mental illness.
"We got her here and calmed her down, and got the medications she needed and changed her dressings," Belmont said. "She couldn't go to the meal center because of the risk of infection. She needed lots and lots of rest."
She's also cared for those with congestive heart failure, broken jaws, diabetes complications, frostbite and a man who had been staying at the bus shelter in Norwich after lung surgery.
"He slept and slept and slept when he came here," she said. "We monitored his vital signs, and he was able to go back home. We prevented a rehospitalization."
Several people have stayed in the respite center after hospitalization for a psychiatric episode, Zall said.
"The transition from inpatient to outpatient can be really problematic," she said. Any progress made in the hospital can quickly unravel without the medication monitoring, transportation to appointments and other services available at the respite center, she added.
Zall said she believes the respite center is a wise long-term investment, not only improving health care for the homeless but also the entire community by easing the load on hospitals.
"My hope is that we can convince the hospitals that this will save them money on length of stay for uncompensated care, and unburden the emergency rooms of people who can't be released," she said.