Michel Savoie uses a walker to shuffle between his lifelines in downtown Hamilton.

He’s recovering from spinal surgery at Hamilton General after developing a serious infection while sleeping outside.

The 52-year-old praises the care he received but is bitter about how the hospital discharged him after nearly a month.

“They gave me the boot and that was it,” he recently said over a cup of coffee after visiting a medical clinic downtown.

He was served dinner and told to leave the hospital that evening, Savoie said.

No details of a plan to send him in a taxi to a men’s shelter had been shared until that moment, he said. “If they had told me a day in advance, that would have been OK.”

But the “side-swipe” left him mentally unprepared to stay in a shelter, which can be replete with drug use, aggression and filth. Savoie said he was about to exit the hospital with a walker packed with his bags when he was told he had to leave the device behind.

So he hobbled on cane into a taxi that snowy December night. “I felt like just a dirtbag.”

He headed to a Tim Hortons on Barton Street East to take stock of his situation. The pain was bad. “You know what was worse? Feeling like I was being ostracized and rejected.”

Savoie later acquired a walker from someone he knows for $60. He still owes that money.

This isn’t how a person with nowhere to go should be discharged, but it isn’t an uncommon scenario, says a local doctor who treats patients who are homeless.

“Often the result is that people, they don’t get better. And to me, it’s not a surprise that they don’t get better,” said Dr. Tim O’Shea, medical director of the Hamilton Social Medicine Response Team.

O’Shea said patients should have a say in their discharge plan. Housing, food security, medication and mobility to make it to appointments need to be considered.

Hospitals aren’t necessarily well-equipped to address poverty and homelessness, while shelters can’t handle medical issues, he said. “I think that’s where people tend to fall into the cracks.”

This is an “unacceptable gap” in our system, said Katherine Kalinowski, Good Shepherd Centre’s chief operating officer.

“The problem of someone who does not have a safe, stable home to go to after hospitalization is a really significant issue.”

Good Shepherd and Shelter Health Network are developing a provincially funded pilot to help address the problem.

The pilot at Good Shepherd men’s shelter on Mary Street will involve 10 transitional beds for vulnerable patients leaving hospital. It will be staffed by medical professionals. Help with housing and other support services will be offered, too.

Kalinowski hopes the partners can start the pilot in coming weeks. “We truly believe it will result in improved health status for vulnerable individuals, but it will also reduce rehospitalization or repeated visits to the emergency room.”

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She said the pilot won’t be suitable for everyone and emphasized the community as a whole must continue reducing system barriers.

When asked about Savoie’s discharge, Hamilton Health Sciences said it couldn’t comment on a specific case but noted it has “well-established” practices for homeless patients.

“We ensure a supportive discharge plan is in place before discharging a patient, for example, with the patient’s consent, our team partners with the patient to locate and secure supportive housing and this may be a shelter bed,” spokesperson Patrice Cloutier wrote in an email.

Patients who need walkers after discharge are referred to the Local Health Integration Network Home and Community Care, Cloutier added.

Before surgery, Savoie had been homeless after losing his room at a residential care facility in the fall. After years of living on the street, he’d found a stability at Burris Lodge before it closed in a spiral of financial problems.

“My security was there in a sense,” said Savoie, who receives a disability pension. “I had a place to go and rest and not worry about anybody bothering me.”

Since he left the General, he has stayed at the workplace of a former boss and outside. “It was in underground parking; it was in stairwells.”

When the cold was too much for his ailing body, Savoie went to the Salvation Army on York Boulevard. There, he struggled to get in and out of his cot and worried about robbery.

Kalinowski said there’s a “tremendous tension” with hospitals under pressure to free up beds for patients with the most acute needs.

But in recent years hospitals and the homeless-serving agencies have made strides in closing the discharge gap, she said. The local Hospitals-Shelters Working Group meets regularly to discuss system barriers.

“Being poor and homeless makes you sick; being poor and homeless makes you likely to remain sick or get sick again, and re-enter the system repeatedly,” Kalinowski said.

Savoie hopes to find a place of his own where he can spend time with his 19-year-old daughter. “We can sit there and watch a movie together.”