Medical respite post-hospitalization for adults experiencing homelessness.
Cindy Hadenfeldt, Martha J Todd, Chelsea Hamzhie
PMID 36820696WHAT IT FOUND
Adults experiencing homelessness described post-discharge barriers: forgetting instructions, unable to perform dressing changes, and lacking supplies or medications.
Shelter staff said guests arrived after hospitalization without needed medications or equipment, and shelters lacked trained staff.
Key findings
01Adults experiencing homelessness described post-discharge barriers including inability to remember and follow discharge instructions, inability to perform dressing changes using a clean technique, lack of support, and lack of supplies, equipment, or medications.
02Shelter staff reported that guests arrived after hospitalization lacking medications and durable medical equipment, were not always able to perform activities of daily living, and shelters generally did not have trained staff to meet these needs.
03Discharge planners reported that hospitals have difficulty discharging patients experiencing homelessness if there are ongoing health needs or a need for follow-up services due to lack of health insurance or inability to pay, and that discharge is often delayed and hospital stay prolonged when individuals could not be admitted to skilled or long-term-care facilities.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The adults were a convenience sample of 20 shelter guests selected by shelter staff, so they may not represent all adults experiencing homelessness. The study assessed service gaps and experiences, not clinical outcomes of medical respite, so it cannot show that respite improves recovery. The findings came from one Midwestern community and three small participant groups, so they may not apply to other settings. The paper gives two different mean ages for the 20 adults, 40 years in the text and 50 years in the demographic table, so demographic reporting is inconsistent. The pilot medical respite program is described, but no outcomes for that program are reported.
The easy way to misread this
Do not read this as evidence that medical respite improves recovery or reduces hospital use. It reports service gaps and perspectives from 20 adults, 20 discharge planners, and 5 shelter staff, not outcomes of a respite program.