The ill of homeless elders

Waltham's Anna Bissonnette greets Susan Jones, a nurse, outside the Bishop Street building that was Hearth's first permanent housing site. (Suzanne Kreiter/Globe Staff)

'It takes an average of two weeks for a person to be totally demoralized and institutionalized into homelessness," said Anna Bissonnette, who spent nearly two decades as a nurse at Boston University Medical Center.

Bissonnette, 76, of Waltham, was first exposed to what she sees as a common precursor to homelessness in the 1950s while working at the Little Company of Mary Hospital in East Cambridge, which cared for patients with chronic diseases, until it closed in 1959. Bissonnette said she and the staff regularly encountered people who arrived with no hope to live and watched them convalesce. But when it came time to leave, Bissonnette said, the steep hospital fees had emptied their savings, leaving them unable to afford a home.

"In order to be admitted into a chronic care hospital, you had to lower your assets, which often meant giving up your home," said Bissonnette. "We didn't have Medicare or Medicaid back then, so you had to use your Social Security."

Disgusted and determined, Bissonnette decided to pursue a graduate degree in public health in the hope of enabling elders, and those with disabilities, to remain at home.

She graduated after six years of night classes at Boston University and was asked to stay on to teach gerontology and public health.

During her years teaching in the medical school, Bissonnette coordinated nursing students to work with the medical students from Boston City Hospital and University Hospital (which later merged to form the Boston Medical Center) to make house calls in the South End, a program that still exists. It was during these house calls in the 1980s, she said, that an additional root of homelessness became apparent to her.

"The medical students were finding their patients in the throes of eviction," said Bissonnette. "They were being told by their landlords that they had to move because the houses were being bought up by the young professionals who wanted to live in the South End."

Bissonnette became a catalyst in founding a transitional housing program at Boston University called Elders Living at Home. It began in 1986 with a three-year grant from approximately 13 national and local organizations.

"We got apartments from the Boston Housing Authority that weren't being rented, took care of the patients medically, got them onto disability, and began looking for permanent housing," said Bissonnette.

During the past two decades, the Elders Living at Home program has provided temporary housing through agencies such as the Boston Housing Authority and Jewish Community Housing for the Elderly. Based at the BU Medical Center, the program has expanded to 28 units in four sites.

During a 1990 conference sponsored by the program, an appeal was made to attendees to come up with a more permanent solution to the problem. That day, seven people, including Bissonnette, raised their hands. A year later the Committee to End Elder Homelessness opened Bishop Street, the first of six residences, which houses 130 elders. One of the residences, in the heart of Boston's South End, is named the Anna Bissonnette House, and provides permanent housing for 40 formerly homeless elders. A seventh house is slated to be opened by the organization, now called Hearth, in Dorchester in 2010.

Bissonnette said care workers are learning to intervene before a person loses his or her home, to be aware of such scenarios when an elder is in the hospital, for example.

"If they can't pay their rent, or if their caregiver is no longer able, they'll wind up in a shelter," said Bissonnette. "There should be a plan set in place" for those in need to be relocated, she said.

Bissonnette was first exposed to homelessness as a child while helping her grandmother, who ran a boarding house for transients in Kankakee, Ill.

Even though many boarders took off without paying a nickel, said Bissonnette, her grandmother's dedication to help others stayed with her.

After high school, Bissonnette studied to become a nun, but three months before taking her vows she decided to leave.

"I had entered religious life without full awareness of my sexual orientation," said Bissonnette, who's now quite clear, and open, about being gay, "and subsequently realized that I could not observe the required vow of chastity." Soon after, she enrolled in nursing school.

She met her wife, Marion Kenneally, a retired public school teacher, through friends in 1980. They've been together ever since, and married four years ago.

"If something were to have happened to me" before the two were married, "like chronic hospitalization, the property that I own could have been sold," said Bissonnette. "We would have had no rights; I'm also protected because she was a schoolteacher and retired workers have health insurance."

In 2001, Bissonnette became one of six people on the steering committee of the LGBT Aging Project, an organization that works toward educating healthcare workers and the public of the needs of lesbian, gay, bisexual, and transgender elders. While she had always felt this was an important issue, it was a particular incident that stirred her into action.

"I was making a house call with a medical student and I noticed another woman out of the corner of my eye, staying back and not making herself too obvious," recalled Bissonnette. "I approached her and asked, 'Are you a couple?' "

Bissonnette said tears came to the woman's eyes as she replied, "No one has ever recognized that we are partners, that we are a couple."

The need for a training program to help professions reach out to seniors who are gay became very apparent, Bissonnette said, as they require and long for the same kind of support that conventional married couples need under the same circumstances.

"This is what marriage is all about," said Bissonnette. "It's not sex; it's about comfort and security and just plain living; why haven't other states done it? I can't understand."

For more on Hearth, visit hearth-home.org or call 617-369-1550. For more on LGBT Aging Project, visit lgbtagingproject.com.

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