For a few lucky seniors, happy endings in living situations
9th March 2015 · 0 Comments
By Elizabeth Simpson
Contributing Writer
Part II
VIRGINIA BEACH, Va.—Ruby Howard takes a while to warm up to describing past episodes of her life.
The 58-year-old Virginia Beach woman traveled a path through emergency rooms, psychiatric units and homeless shelters for a year before coming to an apartment complex where she’s now seated with a case manager.
“I could see whole episodes go on that weren’t really happening,” Howard said. “I could come in here and not see this table. Or I could see something that is there and it ain’t there. I was schizophrenic. My psychiatrist knew, but I didn’t know. I didn’t know what was wrong with me. I thought I was all right but I was totally messed up.”
She paused.
“I don’t like to talk about it, because I don’t like to think about it.”
Home for People at Risk
But she does because she feels strongly about the Cloverleaf apartment complex she moved into five years ago. It’s run by Virginia Supportive Housing, a nonprofit that opened a complex in Norfolk a decade ago and has since opened 60-unit complexes in Virginia Beach, Portsmouth and Chesapeake.
It’s just one example of a model that helps people at risk of being homeless because of finances or disability live in the community with onsite help.
A growing mix of people – the frail and elderly, the mentally ill, people confused by dementia, those without money or family – often fly under the radar.
But the old and frail often wind up together with the young and disabled in long-term-care facilities and adult homes. Some of the sites have staff well trained to blend the populations using therapeutic approaches, and give people space they need.
Others fall short, putting people at risk of injury.
Some housing options are available, but they’re in short supply.
Not Enough Support
The problem? There’s not enough to go around.
Mira Signer, executive director of the Virginia chapter of the National Alliance on Mental Illness, said: “Generally, it’s the same old story — state policy and funding that are not aligned with the needs of the disabled population. It’s a very marginalized population, so the needs aren’t known.”
For instance, there have been bills before the General Assembly for years to expand the auxiliary grant program, which funds care for low-income, disabled people in assisted-living facilities and adult homes. Advocates want to increase the grant amount, which is so low now that many homes won’t accept it, and expand it to other types of programs such as supportive independent living.
The legislation is continually tabled: “All they see are dollar signs, and they don’t want to pay for it,” Signer said.
But for those who support the idea, the dollar signs are in their favor.
Tracey Clark directs support services for the Virginia Supportive Housing complexes in Hampton Roads. She said a homeless person typically costs the public $50,000 a year in hospitals, jails and ER treatment, compared with $15,000 to $20,000 per person in one of their complexes.
“That’s not to say everyone becomes the perfect community citizen and never goes to jail or the hospital,” she said. “But the likelihood is less.”
Howard, for one, has lessened her hospital time.
One day earlier this month she sat in an office at Cloverleaf apartments, where she comes to visit with case managers. On this day, it was Danielle Jeffries.
Another resident in the hallway was loudly complaining about someone who failed to show up. He spoke so angrily that Howard stopped talking and put her hand to her forehead.
“He’s not always this way,” said Jeffries. Soon the tenant settled down and Howard returned to her story.
Helping Tenants Get Themselves Together
Howard said she left an abusive relationship about six years ago. For a year, she was in and out of the hospital, in shelters and housing that never lasted.
Volunteers of America, which provides services to the local homeless, hooked her up with Virginia Supportive Services. She received help signing up for disability payments and getting psychiatric care. She could reach out to case managers on site from 8:30 a.m. to 5 p.m., and others who were on-call around the clock.
At first, she had trouble keeping up her apartment and managing her money. A case manager stepped in to help.
“They are here to help you get yourself together,” said Howard, dressed neatly in a black dress with red flowers. “They have a staff that watches your progress. They deal with you by not treating you nasty and by not saying ‘You should have known better.’ They are open-minded.”
Her psychiatrist recently signed off on Howard handling her own finances. She cleans her own apartment, which is neatly decorated. She proudly showed off an item she brought from her former life: a gold mirror.
It’s only now that she looks back at her past behavior to see how off track she’d gone. She remembers getting into an argument with someone she thought had taken a love seat. Only the love seat wasn’t really gone.
“I was sick, walking around with the same thing on for a whole month, looking like rag doll dragging along. I was like a zombie. I still have my problems, but I take my meds, and I am fine.”
The supportive housing is funded by federal Housing and Urban Development grants, state and local funding, donations, and rent residents pay mainly through disability payments.
The residents range in age from 20s to 80s. Their prior addresses include shelters, jail, state hospitals, assisted-living facilities, family homes and the street.
Seventy percent have a mental health disability; 40 percent have a physical disability or chronic health problem.
All have been homeless. A complex scheduled to open later this year in Virginia Beach will also include units for people who can’t afford a place to live.
“Part of what helps is folks have their own space,” Clark said. “They’re not forced to interact.”
Also, the services are voluntary: “It’s about engagement and relationship. We offer assistance with the hope that our offer and genuine compassion shines through, and they are willing to work on issues that cause them to be homeless.”
Safe Options Underfunded
Susan Potter, who has provided legal representation for elderly people in the past, said safe options are severely underfunded. She gets frustrated at the spotty approach state officials have taken with hit-or-miss demonstration projects.
“They pick and choose the cute, happy people for a limited number of spaces,” she said.
Meanwhile, a wide swath of people has nowhere to go.
“The scary person you can’t take care of shouldn’t be sitting in a senior home next to someone who uses a walker,” Potter said.
Ali Policay, a social worker for the behavioral health unit at Sentara Virginia Beach General, spends a lot of time on the phone trying to find an assisted-living or nursing home for someone who is ready to be discharged from the 24-unit psych center that opened there in December 2013.
Sixteen of the beds are specifically for older patients because that population is on the increase. In the three years before the unit opened, the number of people with psychiatric issues who turned up in Beach General’s emergency room rose from 1,800 to 2,500.
But once patients are stabilized on the geriatric psych unit, it’s often difficult to find a place that will accept them if they have a behavioral issue.
If they can’t afford the monthly cost of assisted living, which averages about $4,000, the search is harder.
“Families want the best for their loved ones, but there are not enough options out there,” Policay said.
Sometimes the person doesn’t have family or friends to help out. In those cases, social workers turn to the public guardianship program, which adds weeks of courtroom work.
Meanwhile, the person lingers in the hospital.
A More Stable Life
Ruby Howard has had her share of hospital experience, and she feels relieved to have found a more stable life. She still struggles with health issues — not just mental ones but also diabetes — but she feels better equipped to handle them with a roof over her head and onsite help.
“I had to come back physically and mentally,” she said. “I was able to have a plan to stay here so I wasn’t running from pillar to post.”
This article originally published in the March 9, 2015 print edition of The Louisiana Weekly newspaper.
