homeless patient
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Epidemiology
- 46% with psychosis
- 53% with major depression
- 54% had substance use disorders
- 45% had alcohol use disorders
- 46% report history of traumatic brain injury[2]
Complications
- alcoholism
- infection
- tuberculosis
- pneumonia (poor prognostic factor)
- HIV infection (homeless shelters high risk)
- domestic violence
- cognitive impairment (72%)
- increased risk of early death
- 5-year mortality in older California homeless is 3.5 times higher than that in the general population[6]
Management
- screen for cognitive impairment, mobility impairment, urinary incontinence, & falls[1]
- consider simplified treatment regimens
- medications once a day that do not have to be taken with food (if possible)
- integrate smoking cessation into treatment of addiction[1]
- hepatitis A vaccine[5]
More general terms
References
- ↑ 1.0 1.1 1.2 Fazel S et al The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. The Lancet, Volume 384(9953):1529-1540, 25 October 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25390578 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961132-6/abstract
Hwang SW. Burns T Health interventions for people who are homeless. The Lancet, Volume 384(9953):1541-1547, 25 October 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25390579 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961133-8/abstract - ↑ 2.0 2.1 Stergiopoulos V et al. Neurocognitive impairment in a large sample of homeless adults with mental illness Acta Psychiatr Scand 2015 Jan 21 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25604122
- ↑ Raoult D, Foucault C, Brouqui P. Infections in the homeless. Lancet Infect Dis. 2001 Sep;1(2):77-84. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11871479
- ↑ Stratigos AJ, Stern R, Gonzalez E et al Prevalence of skin disease in a cohort of shelter-based homeless men. J Am Acad Dermatol. 1999 Aug;41(2 Pt 1):197-202. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10426888
- ↑ 5.0 5.1 Doshani M, Weng M, Moore KL, Romero JR, Nelson NP. Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness. MMWR Morb Mortal Wkly Rep 2019;68:153-156 https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a6.htm
- ↑ 6.0 6.1 Brown RT et al. Factors associated with mortality among homeless older adults in California: The HOPE HOME study. JAMA Intern Med 2022 Aug 29; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36036902 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2795475