When Worlds Collide: Healthcare & Homeless Ministry

12790452674_e7bff6f3d5_oLast night and this morning I was faced with a very frustrating situation in our attempt to help the unsheltered homeless in South Bend.  It’s one thing to write about how fantastic it is trying to do the things Jesus told us to do in Matthew 25 ( For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in,  I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’), but the reality is that not every interaction ends in joy and celebration.

Last night at our Weather Amnesty shelter an individual arrived who was medically challenged.  I’ll leave off the details to protect privacy, but the individual was in a skilled nursing facility in another town prior to refusing treatment and walking away from that facility and getting a bus ride to South Bend.  Now This isn’t unique to South Bend as it happens all over the country. The individual grew up in South Bend, however no longer has relatives close and no family support system to lean on.  It was the city he knew.  He wanted to be free and to have independence.  He didn’t come to “mooch off the services of the  city”, rather in a passionate move to gain freedom from being constantly cared for, he left his primary care facility to do something he wanted to do.  He refused treatment.

Since being in the city for just a few days he has spent time in the hospital as well as time in our weather amnesty facility.  He is incredibly polite, respectful and has no mental issues that I could determine in the short amount of time that I met with him.  He has a deep desire to have freedom and be more self supportive.  But based on what I saw, that is going to be challenging at best.   I feel like the canary in the coal mine.  I’ve had a conversation with the local hospital and other homeless facilities in town in an effort to coordinate a plan.  I cannot imagine working on situations like this without a coordinated effort. I am beyond blessed to have worked 20 years in healthcare locally and have a fantastic relationship with the other homeless agencies in town, however I’m concerned….

As I recall my time in healthcare administration our guest is likely at risk for being a frequent visitor to expensive emergency hospital care. You cannot make someone receive treatment.  You cannot force a solution on someone who still has the capability to make choices for themselves.  This ends up being incredibly expense and frustrating. You can find countless articles about the expense to a hospital (and community) related to homeless medical expenses. (Here is an example) This was one reason six years ago we starting Project WARM (www.projectwarmsb.org) to keep the unsheltered homeless in a safe location outside of the local hospital emergency room.  Our goal was to develop a relationship with the unsheltered homeless, share the love of Jesus with them and get them to a next step in their life.  Over the last six years we have seen incredible stories of success, but today’s example is a heartbreaking reality when someone refuses help.

The reality is our guest this morning needed something deeper.  He desperately desires “meaning” in his life and “independence”.  Two things that even in a skilled nursing facility someone can find, but seemingly were not provided to him.  When he gets placed again (hopefully soon) in a skilled facility, without someone addressing a basic desire of “What’s the meaning of my life” he likely will not be content and could refuse treatment again.

From a ministry standpoint he needs to have a relationship with Jesus.  He needs to know what “love” is – he’s never experienced it in a meaningful way.  He can find meaning in who God made him to be, but that can take time. It is difficult to convey and show the love of Jesus when someone refuses treatment, refuses good advice and is in a emergent homeless situation.

I was able to pray for him this morning and suggest a next step….. But I’m still frustrated….

That frustration reminded me this morning of Matthew 26:11 where Jesus pointed out that  “The poor you will always have with you…”.  Likely this was a reference to Deuteronomy 15:11 “There will always be poor people in the land. Therefore I command you to be openhanded toward your fellow Israelites who are poor and needy in your land”.

So while I’m frustrated, I’m not giving up.  We are commanded to be openhanded toward the poor.  We are not commanded to be openhanded until you get frustrated and then give up and walk away.  The reality is for every individual who refuses a healthy next step, there are more who take steps to recovery and health.  As I write this I’m reminded of the individual listening to everything going on this morning at our shelter who said that he was looking for a job today and was ready to get off the streets.  I’m reminded of the gentleman last week who told us that he stopped drinking two weeks ago and had been sober longer than he had been in years.   I’m pressing on….

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