Nova Scotia homeless man's plight exposes gaps in system: advocate

The founder of an outreach centre in Kentville, N.S., says the plight of a homeless man with mental and physical health issues exposes gaps in the province's health-care system that need to be addressed.

John Andrew of the Open Arms Resource Centre said his staff have struggled over the past year to support the man in his late 60s, cleaning him when he defecates himself and changing bandages following multiple injuries.

He has become a target on the streets, having been robbed and assaulted multiple times. 

He regularly puts non-food items in his mouth, such as garbage or Vicks VapoRub — "things that would make most of us vomit," said Andrew.

The man's condition, which Andrew equated to that of a person in their 90s, extends far beyond the non-profit organization's mandate, which is to provide emergency shelter and help community members create a self-directed action plan. 

But mostly every time the man has been taken to Valley Regional Hospital for treatment or care, he would eventually be turned back to the centre. 

If Open Arms refused to take him in, Andrew is clear about what would become of this man: "He would die."

"There's no question in my mind that he would die if he were left outside any one of these nights that we've had lately," said Andrew, adding that during the summer, the man turned up at the centre with severe sunburns.

"His condition, both mentally and physically, is beyond a level of care that a shelter would typically provide. But you feel that if you didn't provide this care, he would have no care."

Earlier this week, the man was taken to hospital and delivered back to the centre three times in one day, even after Andrew told hospital staff there was a COVID-19 outbreak at the shelter.

The man now has COVID-19 and is isolating with the rest of the staff and guests at the shelter.

Passing the buck

Andrew said he has resorted in the past to begging hospital staff to deem him incapacitated so he would be taken into the care of the province.

He said health-care officials have appeared reluctant to make that call and have continuously "passed the buck," even as the man has no available family or anyone to advocate on his behalf. 

It wasn't until after Andrew reached out to CBC News that he was contacted by provincial officials to discuss the man's case.

Andrew said the man's family doctor has now deemed him incapacitated, a designation that Andrew had hoped would land the man in long-term care.

But a prior assessment by a psychiatrist deemed him to have capacity to make decisions for himself, and Andrew has been told that assessment takes precedence.

"I'm not sure how a man who eats spoonfuls of Vicks VapoRub can be deemed to have capacity," he said.

"There's the frustration and the burnout and ... it's very hard to see a situation where for months on end, you seemingly are not making any progress."

Advocate remains hopeful

A conference call was held on Friday with staff at Open Arms, representatives of the Valley Regional Hospital, representatives from Public Health, the town's police chief and Adult Protection Services.

Andrew said following that call, he's hopeful there will be a resolution. He said the man's case is at least now on everyone's radar, adding that his physical health is rapidly deteriorating.

He said although the man's situation is rare, it does happen, and he deserves to be treated with dignity. He said the system needs to change so that people who do not have someone to advocate for them don't fall through the cracks.

"When we are advocating for them and getting nowhere, that's really discouraging," said Andrew. 

"We are the service centre for this region of the province and we have a pretty amazing network of organizations and supports, so the fact that we couldn't find solutions for this one man lets me know that we have a lot of work to do."

Public Health cannot comment

Nova Scotia Health said it could not comment on any specific person's circumstances for privacy reasons.

Alyson Lamb, executive director of health services for Western Zone, said that "in complex situations, Nova Scotia Health regularly works with community-based agencies and organizations to determine what options are available for individuals in need of support."

"We value the partnerships we have with many community-based organizations and understand the role they play in advocating for individuals who need support," Lamb said. "We share the concerns of our community partners and are committed to working with others to help make sure everyone who needs support receives safe care in the most appropriate setting."

Andrew conceded that one person or institution is not to blame for the man's plight: he has been failed by the broader system.

He said he is optimistic that speaking out will draw attention to the wider issues at play and help the man get the help he so desperately needs.

"We hope that this has all the signs of being a story that ends well," said Andrew.