Housing First turning on lights for patients

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Alfred Borden, one of the fifty patients participating in our Housing First pilot program, was recently featured in South Jersey Magazine as an example of the life-changing power of housing for people experiencing both homelessness and serious chronic illness. Before getting his own apartment in Collingswood, Alfred was in hospice care for his uncontrolled congestive heart failure. Once he was housed, his health improved dramatically: he was deemed no longer eligible for hospice care and has only visited the emergency room once in the six months since moving in.

Alfred is a trained cook from Atlantic County, New Jersey who hit hard times and lost his apartment. He eventually landed in Camden, where he first came up on our dashboard of frequently-hospitalized patients in 2014.

Without a stable home he was unable to manage his multiple, complex chronic conditions, and ended up in the emergency department thirty-nine times in eight different hospitals over a four year period. When he wasn’t in the hospital, he would find a bed in a shelter, or sleep as long as he could in the city’s transportation center.

As with many of our patients experiencing homelessness, without housing Alfred was unable to make much progress through our care management intervention. As Dr. Jeffrey Brenner, our Executive Director, says in the SJ Magazine article, “Nothing we do works if [our patients] don’t have stable housing. It’s hard to take your medicine, take care of your body and move your life forward if you’re sleeping on a bench, in a tent or on a cot in a shelter.”

Now Alfred regularly sees a primary care doctor at Project H.O.P.E. in Camden, has a cardiologist, has a nurse who does regular home visits, and attends a medical day program. He likes to sit in the armchair by the window in his ninth floor, one bedroom apartment, watching the planes take off and land at the Philadelphia International Airport. In the kitchen he can prepare healthy meals and sometimes his favorite dish, spaghetti and meatballs.

Camden Coalition social worker Latonya Oliver says that the most important thing to Alfred when he first moved in in January wasn’t the TV, the armchair, the window, or even the kitchen. It was a small table lamp. She was confused at first by his excitement over the lamp, then she realized that “when you’re in the shelter, they turn the lights off for you. It’s lights out at 9pm. So it was really big for him to have his own lights, so that he could control that.”

“Now the focus of my day is my health,” Alfred says. “I take my medications, check my weight, and prepare my own food. I have neighbors. I can talk to people and make new friends.” And, “I have a lamp that I can turn on and off, like a grown man.”

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