Creating the right places

Yesterday we spent the afternoon filtering another 4,000 bottles of wine at The Oaks, for the Managed Alcohol Program. I learn a lot there, and it’s not just about winemaking. One of the managers is the chief winemaker while the original chief winemaker travels the world. Since filtering wine involves about 20 minutes of waiting for every 10 minutes of actual work, there’s plenty of time for conversation. We talk about addictions and harm reduction, and the various challenges of working with the population that lives at The Oaks. They have 55 residents, many of whom live with multiple physical or mental illnesses and chronic alcoholism.

We emerged from the winemaking room for a break, a glass of juice, and a chance to watch the place in action for awhile. Some of the residents appear to be barely able to function, even in this supported-housing environment. I don’t know how some of them ever survived on the street while coping with a brutal combination like addiction, diabetes, depression and Alzheimers. It sounds harder than anything I’ve ever done. Some of them, when they were living on the street, were in ambulances 300 times per year. They were in and out of jails, emergency rooms and shelters all the time. Until The Oaks opened, nobody knew what to do with them.

There are lots of people in this city that nobody knows what to do with. I have a friend whose adult daughter is paralyzed and needs assistance for things like using the bathroom. On the other hand, she can get around town on her own, especially in the summertime when her motorized wheelchair is less vulnerable to weather-related breakdowns.

She lived for about five years in a hospital because there was nowhere else for her to go. Approximately 16% of Ontario hospital beds are being used by people who don’t need to be hospitalized, but who do need some degree of assistance if they’re not hospitalized. Unfortunately, there just aren’t enough spaces in alternate care facilities, so the hospitals can’t transfer them to more appropriate places. My friend’s daughter was on a waiting list for years, but she kept getting bumped because she already had a place: the hospital. Her circumstances were always deemed to be less dire than somebody else’s. Meanwhile, people who needed hospital care were getting bumped because there were no hospital beds available.

Recently she was moved to a long-term care facility. It’s far from ideal for many reasons, not least of which is because she’s young and everybody else is elderly and frail and most have dementia. She’d be better off in supportive housing, but there seems to be very little of that, and a very long waiting list for what little there is.

I think the reason they don’t provide more such housing is because it’s costly. But surely providing hospital care to people who don’t need it is much more expensive. Wouldn’t it make more sense – both economically and socially – to create adequate supplies of supported housing?

Maybe it’s because the housing money is in a different pot than the health care money. So even though it would make sense economically to provide more supported housing, some of the people who administer the various pots of money might not be so willing to see it reallocated.

All I know is that this young woman should have an opportunity to share a home with other young adults and a staff member or two, rather than living in an institution and sharing a room with an elderly, bedridden, demented woman.