Care Critical for Homeless

Vaughn Bell's kidney disease led to the loss of his job and his home. Homeless people with chronic diseases have difficulty getting care.
Vaughn Bell's kidney disease led to the loss of his job and his home. Homeless people with chronic diseases have difficulty getting care. (By Katherine Frey -- The Washington Post)
By Mary Otto
Washington Post Staff Writer
Monday, October 22, 2007

Vaughn Bell had a job, a good job, working at a rehab center for teens.

He had an apartment, nice clothes, a good life in New York.

Not bad for a guy who, after a difficult youth, lost a few years to drug addiction and prison. The climb back was rough, but he had finally won the struggle.

Then sickness stripped it all away. Everything.

Bell fell ill with kidney disease. Because he was sick, he couldn't work and lost the job. Because he lost the job, he lost his apartment and had to go to a homeless shelter. Because he lived in a homeless shelter, he had to take two trains and a bus to get to dialysis treatments. He fell behind, stopped caring for himself, then just stopped caring.

Late last year, his brother, Amen Ryals, who lived in Walkersville, heard about his plight and brought him home with him. By the time Bell arrived at the dialysis center in Frederick, his feet were so swollen with the fluids his damaged kidneys could no longer process, he could not wear his shoes.

His situation could have become worse: The No. 1 cause of death among the homeless is untreated chronic illness.

Chronic illness does not often, by itself, cause homelessness, experts say, but it's an ingredient in the mix of crushing problems, which often includes troubled personal history or economic trauma. And homelessness has a way of magnifying even a common cold. Without a place to wash, skin lesions fester. Without a safe place to store medicine, diabetes and HIV progress.

"This could happen to anyone very quickly," said Carole Elliott, a licensed clinical social worker at Frederick Dialysis. If health benefits or family supports are shaky or missing, "what do you do?"

The life expectancy for a homeless person ranges between 42 and 52 years, according to Health Care for the Homeless, a national organization that provides free medical attention to the indigent. At 49, Bell is pushing the outer edge.

"Homeless folks tend to live half as long as folks who have homes," said Jeff Singer, president and chief executive of Health Care for the Homeless Maryland. "It's not always because they freeze to death. The major cause is untreated chronic disease."

Research shows an estimated 750,000 people are homeless on any given day in the United States. One-third to one-half of the homeless have a chronic illness, and more than half don't have insurance.


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