Living with a chronic leg ulcer for over 10 years was the daily reality for Frances; a 40-year-old woman working full-time in retail and living in a squat. This woman had injected heroin for most of her young adult life but was now clean and had not been using for many years.

The leg ulcer was 30 cm long and spread around the circumference of the lower limb. It was deep, raw, and bleeding. Despite Frances being in agony, and the fact the pain was made worse by being on her feet all day, she had learned to live with the pain and to some degree accept it. She was careful to hide the smell from her colleagues, although they were aware there was some problem due to her limp.

Frances no longer considered herself homeless and was initially reluctant to visit CHIP. Her life had changed significantly, she was drug free and was now off the streets, squatting instead. Visiting CHIP was a reminder of where her life had been and some of the things she had had to overcome.

However, Frances was desperate. She had been hiding her wound from everyone – she had not engaged with a GP for years after a negative experience where she was confronted with a conversation about HIV, her partner of over 10 years had never once seen the wound, and she had distanced herself from her family.

Upon arrival, the tissue viability nurse and Frances sat down to discuss the current clinical presentation of the wound and the treatment that was available. It was important to navigate these early conversations carefully in order to build trust and overcome the woman’s fear of services. The ‘light bulb moment’ came when the woman was told this wound was healable. She was dumbstruck and could not believe it. She had come to accept living in constant agony and shame as a part of her life.

The treatment plan included two weekly appointments, and the gold standard therapy of compression bandaging. The patient attended most appointments, although when life did get in the way, the team remained positive and encouraged her to come back. Within three months the 30cm ulcer and halved in size and three quarters had healed.

It was encouraging for Frances, the prospect of a leading ‘normal life’ was no longer a fantasy, but within reach. She was excited at the prospect of wearing whatever she wanted, going to the beach, swimming, and most importantly, reconnecting with her family. Living a life without shame and a painful secret was within reach.

Frances’ story is a demonstration of what’s possible, and testament to the fact that many wounds are preventable, treatable and healable. It highlights the power of positive communication, the importance of taking time to build a relationship and the need for specialist treatment. Wounds can be healed, and people can live more fulfilling lives without these secrets.

This is just one of many stories that demonstrates the need for leg ulceration to be addressed as a physical health need for people experiencing homelessness. Find out more about our health care pilot in this area and discover our key learnings here.