Page 7 - HealthcareNews May/June 2021

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Homeless
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foot, and socks — a large bag of them.
“Foot care is a big issue for this population,” she
said, putting extra emphasis on that word ‘big.’ “They can’t keep their feet dry, and that leads to a lot of
“It’s hard to track the homeless because they come in and out, and they’re very transient. They don’t have an address; they don’t have a fixed location.”
problems, especially athlete’s foot.”
Helping the homeless with such issues is just part of
the daily and weekly regimen for Bossie, who brings, as noted, high energy and a considerable amount of passion to her work, which involves caring for the homeless population in what would be considered the I-91 corridor, a stretch from Springfield to Turners Falls.
When asked how big that population is, Bossie said it’s difficult to give a specific number, but she estimated it to be at least 2,000 people, a number that obviously fluctuates and has certainly increased given
the financial difficulties many found themselves in due to COVID-19.
“It’s hard to track the homeless because they come in and out, and they’re very transient. They don’t have an address; they don’t have a fixed location,” she explained. “But the huge benefit of our organization is that we cross county lines and city lines. We’ll see
a patient in Springfield one month, and when they move up to this area, we’ll follow them up here, and they’ll never lose their healthcare.”
As she cares for this population, Bossie splits up her week, with Mondays and Wednesdays in Springfield at a health center inside the 240-bed Friends of the Homeless facility on Worthington Street. Tuesdays and Thursdays are spent in Northampton, at the ServiceNet resource center and also in other locations like the Craig’s Doors shelter in Amherst. Fridays are generally devoted to large amounts of paperwork and planning.
When the shelters in Amherst and Northamton are closed, she undertakes street outreach in her recently purchased minivan, loaded with supplies.
“We treat burns, abscesses, tick bites ... anything;
I treated three patients recently for hepatitis C while they lived in a camp,” she said, adding that she has a map of these camps; a new one is created each spring.
On the Tuesday HCN visited, Bossie was working with the Northampton Health Department to deliver COVID vaccines to homeless patients, after what she described as a “really tough” morning during which she saw seven people. A quick recap of that morning provides some real insight into her work — and the dedication she brings to the job each day.
First, she saw the patient mentioned at the top, who
was in mental-health crisis. The woman arrived so frightened of a delusion that she was planning to flee the state and had come to say goodbye. Fleeing would have left her without healthcare and without the sup- port services she needed. Bossie’s team was successful at “talking the patient down” and getting her to agree to go to the emergency room for evaluation with the intention of placing her in “safe place” for several days.
Next, Bossie saw a recovering alcoholic, an indi- vidual who has been placed in housing, but still needs a significant amount of “hand holding.” Bossie said she sees her once a month to help keep her on the track to sobriety.
“She just completed detox and was making a run at staying sober,” she said. “That’s really hard after 45 years of using alcohol, and we’re totally down to support her.”
Subsequent visitors, most with a scheduled ap- pointment, had a variety of different needs, including an untreated broken arm, various types of addictions, and a patient on oxygen with advanced lung disease. Bossie generally spends 20 minutes to a half-hour with each patient, which is generous compared to what some practices can do in an age when patient volume is critical to the bottom line, but often not nearly enough.
“You’re not sure when you’re going to see these people again,” she explained. “So you have to do everything you can in one visit.”
Bringing Order to Chaos
Bossie noted that many of the patients she treats in her Northampton facility sleep outdoors (the shelter