Information for Practitioners

MOSH works from a relationship-based care model. This approach creates the opportunity for reciprocal learning between individuals and their health care providers. As this practice evolves MOSH continues to learn profound lessons about how people try to ‘take care of their health’ while living in all kinds of difficult realities. Here are some of the lessons our friends and clients have shared with us while also sharing their hope and resiliency.

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Many individuals who are living in poverty, are down on their luck, are sex working, or are involved in a cycle of drug use have faced judgment and they may find it difficult to talk about their present reality. Just asking “what would be most helpful for you” will go a long way.

  • Presenting health concerns may seem overwhelming and often include addiction.
  • Let the individual identify the priority. Try to stay focused on this concern and if they invite you into other aspects of their lives tread gently and let them guide you.

Consider if an individual can access and manage the care plan you are recommending.

  • If there are options, choose a treatment and delivery method that is the most user-friendly and that requires the least scheduling, for example 2X/day vs 4X/day; without/food vs. with/food.
  • Check if the medication needs special permission to be covered by income assistance. MSI inquires call 902.496.7001. Medications that are exempt need to have a letter sent by the doctor to MSI: Fax to 902.468.9402. If a letter is needed, Health care providers need to write letters of justification – not individuals or Community Services.
  • Some indviduals are banned from certain pharmacies; please discuss which pharmacy (or MOSH agency) would be best before making prescription arrangements.

A goodnight’s sleep is often very difficult for individuals to achieve if they are staying in shelters or sleeping outside. This also means some people do not have anywhere to rest during the daytime hours and as a result are often outside in the elements for long hours each day.

  • If an individual is staying at one of the shelters, sending a medical note for bed rest will ensure the person is able to be in bed during the day.
  • If an individual does not have shelter, contact MOSH to help secure a bed for the person.

Sex work is a reality for many street-involved individuals – both men and women. Sex workers come from all backgrounds.

  • Understand sex work is work. Ask about occupational health and safety practices. Ask a person who identifies they are sex working if they need anything you might have available (e.g. condoms, lube, lip balm/Vaseline, water, etc.)
  • Sexual assault – sex workers often experience sexual assault and find it hard to seek care. Offering the services of the Sexual Assault Nurse Examiner Program, Avalon Centre (902.422.6503/, and the encouragement to care for themselves and seek support would be very helpful. Offer contact information for Stepping Stone.

Frontline staff cannot do personal care, people have to be independent in their care and mobilize without assistance.

  • If an individual needs convalescent care a shelter is not appropriate.
  • Consider keeping an individual with acute needs in hospital for a little longer to further stabilize their condition. This practice can decrease returns to hospital.
  • Call shelter staff and inform them of pertinent information that may affect an individual’s stay. This call will help determine if the referral is appropriate.
  • Fax discharge notes and follow-up appointments to MOSH. MOSH can assist with treatment plans and follow up appointments.
  • Call prescriptions in to the preferred pharmacy listed in the shelter section.