Assessing Older Adults Who Have Experienced Homelessness: Findings from an Exploratory Study.

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Older adults experiencing homelessness face unique health challenges.
• Functional impairments are common but often underassessed in this population.
• The 4Ms framework (Mobility, Medications, Mentation, What Matters) can guide geriatric care.

Purpose of the Study:

• To evaluate a workforce initiative aimed at increasing functional screenings for older adults with a history of homelessness.
• To describe practitioner participation, patient functional status, and patient-reported priorities ('what matters').

Main Methods:

• A workforce initiative trained 34 healthcare practitioners to screen 253 patients aged 50+ using the 4Ms framework.
• Secondary analyses examined practitioner participation and patient functional scores.
• Qualitative analysis explored patient-identified priorities.

Main Results:

• Many practitioners did not complete all functional screenings.
• Among patients, 6% had moderate/severe ADL impairment, 24% had cognitive impairment, 32% had mobility limitations (inability to walk 250 feet), and 46% reported moderate/severe pain.
• Patient-reported resilience strategies developed during homelessness were significant ('what matters').

Conclusions:

• The initiative identified gaps in completing functional screenings among healthcare practitioners serving older adults experiencing homelessness.
• Low reported ADL impairment may reflect survival adaptations or service access needs.
• Further workforce training is essential to improve comprehensive functional assessments in this population.