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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)

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Treatment regimens can be difficult to maintain without transportation or a regular source of food, as Bell found out. "I was sick as a dog," he said.

"He was a train wreck when he came to us," said Kate Seymour, a dietician at Frederick Dialysis. Bell was so discouraged that he was ready to let go. But working with government agencies and local charities, Elliott was able to help Bell get benefits, including medical assistance. And during his three-hour visits to the dialysis center three times a week, the staff worked to get him to start eating right and taking the proper medications.

Most important, Bell said, they convinced him that his life was worth saving.

"It was nothing but love," Bell said. "They talked me back to good health."

That emotional support -- of "bolstering the patient's wounded self-concept"-- is key in helping homeless patients meet the challenges of caring for themselves, concluded a team from the University of Virginia Health Systems Dialysis Program.

The team published a research paper on managing homeless dialysis patients last year after realizing that six of its patients -- or 5 percent of its rural caseload -- were homeless, staying in shelters or their cars.

"If there's a problem, we try to address it. If all of a sudden we have six patients who are homeless, it's hard to ignore," said Thessa Obrero, a dietitian who worked with the local Salvation Army shelter to try to ensure that patients ate food that would not overburden their failing kidneys.

Staying with his brother in Walkersville, Bell found it far easier to eat right and keep up with his dialysis treatments. But then late in the summer, Ryals lost his home to foreclosure. He decided to head out West and begged Bell to come along.

But Bell decided to stay, clinging to his dialysis and his supportive community at the center.

"I didn't want to go nowhere else and risk it."

At Frederick Dialysis, Bell's social worker tapped into local homeless resources and emergency National Kidney Foundation housing funds to get Bell quarters in a motel until space became available in a shelter.

Agencies across the region are trying to help those with chronic illnesses bridge the gap between their homelessness and their medical needs. Montgomery County's main emergency shelter for men in Rockville will begin to remain open during the day starting in January. In addition, the facility is being enlarged to include a medical clinic.

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