Discharge planning strategies for acutely homeless inpatients

Medical and psychiatric inpatients who become unexpectedly homeless during the course of the hospital stay present an extremely complex and time-consuming challenge to social work staff. The sudden shift from domiciled to undomiciled status creates a crisis for both the patient and the institution. Unanticipated homelessness among inpatients is usually associated with multiple high-risk factors which contribute to the rejection of such patients by numerous community facilities and services. Social workers are under pressure to both effect a timely and safe discharge when acute care ends, and to avoid placing such persons in the shelter system where follow-up care is nonexistent or inadequate. This paper reviews characteristics of persons who become acutely homeless during a hospital admission and suggests approaches which may be used to identify and prevent this perplexing syndrome.