Compassionate caring returns as small upside to Covid-19

Holding hands of the sick and homeless had been winnowed out of health system

Time to treat people properly is the one thing that was increasingly difficult to justify in a business-as-usual healthcare system governed by performance indicators, benchmarks and outcomes.

Time to treat people properly is the one thing that was increasingly difficult to justify in a business-as-usual healthcare system governed by performance indicators, benchmarks and outcomes.

 

It’s quieter in our reception area these days. We have reopened the doors of the Alice Leahy Trust on Dublin’s Bride Road with new practices for Covid times. We take temperatures, wear visors and ask everyone to wash their hands after they come in our basement door.

The first person back to us when we reopened hadn’t had a shower since we closed in March. He said he had been washing in streams or public toilets whenever he could. We were the only place where he felt he could have a shower or soak his feet. So he went without.

We have been campaigning for public toilets and showers since 2006. It has taken a pandemic to jolt people into action.

The pandemic has also exposed the holes in our social fabric: cutbacks over the decades in our caring network; fewer supports for vulnerable children at home and in schools; less support for older people wishing to remain in their homes, people living with disability and important roles like caretakers in flat complexes.

Alice Leahy. Photograph: Nick Bradshaw
Alice Leahy is founder director of the Alice Leahy Trust which has been caring for homeless people in Dublin for 45 years. Her memoir The Stars Are Our Only Warmth was published by O’Brien Press in 2018. Photograph: Nick Bradshaw

Cutbacks have resulted in the offloading of State services to the NGO sector making it now virtually impossible to differentiate between the two.

Instructions to stay at home in the severest stage of lockdown led to a scramble to find “homes” for people. The pandemic has lowered the number of people on the housing list.

Overcrowded accommodation

Some of those people have gone back to overcrowded accommodation while a number remain on the streets. A lot of empty commercial properties like B&Bs, Airbnbs and hotels have been used to house people. This temporary solution will unravel when and if tourists return.

I left nursing to start working with homeless people when our service was just one doctor and myself

Writing my memoir gave me time to reflect on my decades as a frontline worker before the pandemic brought attention to that great profession. I left nursing to start working with homeless people when our service was just one doctor and myself.

We cycled around the hostels, providing an outreach medical service, always aware that you can’t look at homelessness in isolation from community. We were naively certain homelessness would be solved within a year. Nearly half a century later we’re still here.

The importance of spending time with people, of holding someone’s hand, is something our health system has winnowed out of the working day of most health professionals. Time to treat people properly is the one thing that was increasingly difficult to justify in a business-as-usual healthcare system governed by performance indicators, benchmarks and outcomes.

Respect for compassionate caring seems to have resurfaced. This might be a small upside to the many downsides of Covid.

When I trained as a nurse in the late 1950s, my training was based on an apprenticeship system. Student nurses in Baggot Street Hospital cleaned floors and toilets, pulled out beds to clean underneath them, learning while doing.

Academic nursing

I welcome nursing becoming an academic discipline while not forgetting that one of the benefits in the old system was having somebody to turn to when the going got heavy. Having a mentor can be a vital lifeline.

The words of the late Tony Gill, street poet, who used our service for many years and rests in our plot in Glasnevin, capture the isolation many of us felt during lockdown and continue to as we struggle together through these strange and lonely times:

“Today I spoke to no one,

And nobody spoke to me.

Am I dead?”

For those early weeks of lockdown, the value of compassion snapped into sharper focus.

An important part of our work is connecting the messy realities and needs of those who find themselves 'homeless'

An important part of our work in the Alice Leahy Trust is to build connections and one of the most important of those is connecting the messy realities and basic needs of people who find themselves “homeless”: the need for hot showers, regular basic healthcare, warm clean clothes, a cup of tea and someone to whom they can talk if they wish, and respect for their right to not engage.

It would be nice to believe an appreciation for that kind of practical frontline approach could be a lasting legacy of tough times.

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