No Fixed Address, Still in Need: Coordinating Inpatient Rehabilitation for People Experiencing Homelessness: A Case...

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Social Determinants of Health

Background:

• Homelessness presents significant barriers to accessing essential inpatient rehabilitation (IPR) services.
• Individuals experiencing homelessness (PEH) with complex medical and functional needs face compounded challenges.
• Existing healthcare and social service systems are often fragmented, limiting care continuity for PEH.

Purpose of the Study:

• To present a case series illustrating the rehabilitation needs of persons experiencing homelessness (PEH).
• To highlight the barriers PEH encounter when accessing coordinated rehabilitation care.
• To underscore the importance of interdisciplinary collaboration and policy reform for equitable IPR access.

Main Methods:

• Case series methodology detailing three individuals experiencing homelessness with disabilities requiring IPR.
• Focus on interdisciplinary collaboration involving physiatrists, occupational therapists, and social workers.
• Analysis of barriers related to housing, follow-up care, and system fragmentation.

Main Results:

• All three patients successfully accessed inpatient rehabilitation (IPR) through coordinated, interdisciplinary efforts.
• Patients continued rehabilitation post-discharge despite persistent challenges associated with homelessness.
• The cases demonstrate the feasibility of overcoming access barriers with tailored support.

Conclusions:

• Low-barrier, community-based care models and policy changes integrating housing are essential for PEH.
• Recommendations include expanding Housing First (+), enhancing medical respite, and integrating social services.
• Systemic reform is needed to ensure equitable access to rehabilitation services and improve health outcomes for PEH.