How much good can a small red pouch, zip tie and sheet of paper do for someone living on the streets? Turns out, a lot.

The Vial of Life contains medical information that can help homeless people in case of emergency. Credit: Courtesy of the Downtown Chapel

Downtown Chapel is pioneering an innovative, potentially life-saving programme for medically vulnerable people experiencing homelessness called the Vial of Life programme. It’s actually an adaptation of a nationally established programme used by people who have homes, applied now to those who do not.

Homeless participants can fill out a one-page sheet listing medical illnesses, prescriptions, emergency contacts, allergies and blood type, stuff it into a red plastic pouch no bigger than an index card, and attach it to their backpack. The “vial” provides an easily identifiable, relatively reliable record to emergency personnel, and Downtown Chapel keeps a copy in case the original is lost.

Since June, around 40 homeless individuals have participated in the Vial of Life programme at Downtown Chapel, meeting one-on-one for a few minutes with volunteer nursing students from the University of Portland who help them fill out medical information and even call pharmacies if there are questions about prescriptions.

Reviews by participants have been “over the moon”, says Andrew Noethe, pastoral associate at Downtown Chapel who is overseeing the implementation of the Vial of Life programme in collaboration with parish nurse Sharon Christenson.

Participant Michelle says she recommends it to other friends on the street who have seizures or diabetes and thinks there should be “a lot more awareness” about the Vial of Life programme.

So far, people seem eager to sign up for the programme. “When you’re vulnerable and sick, you know it,” says Michelle.

Diabetes, seizures and cognitive disabilities are at the top of the list of health issues that the Vial of Life programme hopes to track. The health record may be largely self-reported, but the volunteer nursing students at Downtown Chapel “help ask the right questions in a safe place,” says Noethe.

“Sometimes a participant will just open their bag and show a nurse all the pills they’ve been taking, and that’s helpful if EMTs pick that person up,” he says.

Piloted with Northwest Parish Nurse Ministries and Providence Health Systems, the Vial of Life programme is an enormous boon for homeless health care in Portland.

People who are homeless are often mobile, without health insurance, especially vulnerable to injuries and illness, and prime candidates for reduced recollection, often the result of past trauma or head injuries.

Emergency personnel, including EMTs, police and Central City Concern’s CHIERS staff, are frequently forced to rely on guesswork when it comes to helping sick people on the streets.

For instance, last year more than 8,400 inebriated people were picked up off the streets and taken to Hooper Sobering Center on NE Burnside and MLK. “One of the first questions asked is, ‘do you have any medical conditions,'” says manager Steve Mattsson. But he admits that the homeless folks who come in are notoriously poor historians of medical history. Plus, alcohol can mask many serious medical issues.

“I meet first responders who wonder, ‘did I make the right choice?'” says Noethe, who hopes the Vial of Life programme will change that.

“The bottom line is we need to make sure those in need – however that is defined – get the right help in an emergency,” says Jean Marks with Providence Health & Service’s Public Relations office.

“Emergency responders seem to be excited about this programme because it makes their job easier. They don’t have to guess about their patients’ allergies and prescriptions,” says Marks. “It serves the poor and vulnerable, but it also helps everyone do a better job.”

Bruce Strade, executive director of Northwest Parish Nurse Ministries, says they are just getting a feel for how successful the programme is, but thinks adapting the programme for other agencies is “not out of our reach”.

Downtown Chapel’s idea for the Vial of Life programme originated from Northwest Parish Nurse Ministries’ and Providence Health Systems’ Vial of L.I.F.E. (Lifesaving Information for Emergencies) programme – a traditional method of storing medical information of isolated elders’ in readily identifiable pill bottles in refrigerators.

Early this year, parish nurse Sharon Christenson asked, ‘why not do this in the homeless community?’ and approached Noethe with the idea of implementing the Vial of Life programme at Downtown Chapel. Noethe says he immediately took to the idea, remembering times when homeless guests passed out mysteriously in Downtown Chapel’s lobby.

He is especially hopeful that the programme will help guests with trauma history, including traumatic brain injuries, who cannot recall medical history.

“They don’t always keep everything in mind,” says Michelle, who is borderline diabetic combined with other medical issues. “And if (medics) don’t know about it, that’s a problem.”

Noethe agrees. “It is essential that first responders, especially in Old Town, are able to identify the Vial of Life pouches and make use of them,” says Noethe.

His plan forward is to replicate the Vial of Life programme among other Portland service agencies. Noethe has even created a manual for other organisations to implement and evaluate the programme.

“I have no doubt this is going to benefit someone,” says Noethe. “With Vial of Life, we’re not doing case work where we follow people over time, and we won’t always get to see the outcomes.

“But I know this will improve lives.”

*Published under an agreement with Street News Service.

People in the U.S. are becoming more and more open towards homosexuality, in part due to the trendy Hollywood culture that conveys the image of young, hip and good looking gay men and women. But the situation changes when it comes to the elderly.

Bob Rupar, Jo Hamilton, Sharon Messerschmidt and Bruce Meisner, Gay & Grey PDX members. Credit: Jennifer Jansons/Street News Service

For a while, Bruce Meisner and Bob Rupar were attending a funeral a week. The two energetic, grey-haired men in their 70s, partners for 40 years, recall the Reagan era, in the USA, as a dark time when male friends were quietly dying, childless and spouseless, from an epidemic no one acknowledged: AIDS.

Today, Meisner, Rupar and other gay seniors of their generation still live in the shadows. There are an estimated 10,000 gay seniors in the U.S. city of Portland, and around thre million nationwide, according to the most conservative estimates. Many are battling a double dose of vulnerability that wreaks havoc on their finances, health and emotions.

Portland’s own gay elder advocacy group, Gay & Grey PDX, is on the frontlines of fighting that vulnerability. Supported by the community nonprofit Friendly House in Northwest Portland, the team of about 20 advocates and allies organises benefit events and conducts educational workshops in nursing homes to raise awareness about discrimination that many don’t even realise exists.

The group is a rarity – Gay-Straight Alliances and United Sexuality clubs are becoming common in schools, but gay senior support groups are virtually nonexistent. Consider the last time you heard of an LGBTQ group at your grandma’s nursing home, or similarly elder statesmen at the Pride Parade.

Double dose of vulnerability

LGBTQ seniors are more likely to live alone and five times less likely to access senior services than their heterosexual peers, according to Services & Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE). Gay seniors are also more likely to lack adequate support networks, especially since many do not have children to care for them as they age, according to SAGE.

More than 1,000 federal marriage benefits are denied to gay couples, many hitting gay seniors the hardest, including medical decision-making power and hospital visitation rights, Social Security survivor benefits, Medicare spousal benefits, inheritance of a spouse’s estate, and financial decision-making power on a spouse’s behalf.

When Rupar was hospitalized in Arizona, nurses would not let long-term partner Meisner see him because he wasn’t a family member. They would not tell Meisner about Rupar’s condition or even if Rupar was still receiving care. In other states, hospitals recognize domestic partnership certificates, but an individual nurse or administrator can still “make it difficult in a difficult time,” says Gay & Grey PDX member Sharon Messerschmidt, who dreads what would happen if her partner of 26 years, Jo Hamilton, should enter the hospital.

“If one of us were to become widowed,” speculates Hamilton, “how would we grieve? People would say, ‘I’m so sorry about your husband,’ but I would be mourning Sharon.”

Whereas a heterosexual older couple wouldn’t think twice about moving into a nursing home together, many same-sex senior couples hesitate to divulge their sexual orientation to health and housing providers because they fear prejudice, and struggle with the idea of coming out anew in retirement.

“Until I started coming to Friendly House,” says Messerschmidt, “I referred to Jo as ‘my partner’ purposefully, as a cover.” Rupar laughs, saying he frequently refers to Meisner as his partner only to get the response, “what business are you in?” Both Messerschmidt and Rupar say they did not always correct people.

Martha Wright, Marketing and Communications Coordinator for Friendly House, weighs concerning questions: “In nursing home facilities where care workers come from a conservative religious background, are they delivering care to gay seniors with compassion? Are [gay senior couples] free to be in the same apartment? Will they be separated from their loved ones? The bottom line is there are policies that are flat-out unfriendly toward gay seniors.”

Changing for the better

In response to gay seniors’ worries about discrimination, gay retirement centers are springing up nationwide. The Palms of Manasota in Palmetto, Florida, Triangle Square in Hollywood, California, and RainbowVision in Santa Fe, New Mexico are just a few that cater specifically to LGBTQ elders.

“They offer a place for people who might want to watch musicals, not football,” says Meisner. Rupar and Meisner moved to Portland from Oakland to live at Rainbow Vista, “an active LGBT senior residence,” in Gresham; however, even there, Rupar and Meisner say they witnessed “psychological abuse” that made them move out.

Even the Department of Housing & Urban Development (HUD) is making changes. Earlier this month, HUD launched a new, yearlong campaign called “Live Free,” designed to draw national attention to housing discrimination against minorities, including the LGBTQ community.

Although there is no national assessment of LGBT housing discrimination (HUD is currently working on one based on the last census), several state and local studies that have indicated evidence of bias. A 2007 report by Michigan’s Fair Housing Centers showed that nearly 30 percent of same-sex couples were treated differently when attempting to buy or rent a home, facing burdens from higher rental rates and application fees to borderline sexual harassment.

Oregon is one of seventeen states that ban housing discrimination based on sexual orientation. Nevertheless, the Portland nonprofit Senior Housing and Retirement Enterprises (SHARE) was established in 2001 to address the lack of local affordable housing for gay seniors.

SHARE’s raison d’etre is to offer “safety (from the) fear of mistreatment by care-givers and other residents…socialisation that is inclusive…(education for) staff and other residents regarding LGBT seniors’ sensibilities and fears” and to combat the “reluctance of LGBT seniors to reveal their sexual identity to health providers and care providers.” Last year, SHARE was incorporated into Gay & Grey PDX, which is in the midst of forming a subcommittee on housing.

Paving the way

There’s no denying that the gay rights movement has come a long way. Gay & Grey PDX members vividly remember a time, only forty years ago, when being gay was defined as a mental illness and gay-friendly bars would flash lights to warn patrons that police were coming.

“Youngsters today are so fortunate that we’ve come before them and paved the way,” says Messerschmidt.

Even so, gay youth coming out today continue to face rough odds – LGBTQ teens are bullied two to three times as much as straight single teens and are more than four times as likely to attempt suicide, according to the It Gets Better Project, started by media pundit Dan Savage.

“The thing is, it doesn’t get better at our age,” says Gay & Grey PDX member John Behrens. “As we get older, we get more vulnerable…but we don’t want to go back into the closet.”

“Friendly House has changed our lives,” says Hamilton. “It’s given us friends and allies.”

* Published under an agreement with Street News Service