Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108261

Carol Waldmann, MD, Boston Healthcare for the Homeless Program, 729 Massachusetts Ave, Boston, MA 02118, 781 221-6565, cwaldmann@bhchp.org and Jill Roncarati, PA-C, Boston Health Care for the Homeless Program, 729 Massachusetts Avenue, Boston, MA 02118.

Traumatic brain injury is common in the general population and is particularly common within the homeless population. Many homeless are at risk of brain injury because of their daily exposure to violence on the streets, the high incidence of trauma and accidents, and the prevalence of substance abuse within this population. Many persons become homeless after suffering neuro-psychiatric and behavioral deterioration following TBI. Alcoholism, very common in the homeless population, decreases the brain's ability to heal and increases the risk of neuro-psychiatric and physical sequelae of brain injury. People with multiple diagnosis including mental illness, substance abuse and traumatic brain injury often find it difficult to access appropriate services. These individuals may have trouble negotiating complex systems due to cognitive or behavioral problems. Even with help, barriers exist. Each discipline has diagnosis specific assistance. The multiply diagnosed are often unable to get assistance because of their co-morbid diagnosis. When a multiply diagnosed patient is homeless these barriers are magnified. Many healthcare providers and support staff are under educated on the complexities, barriers to care and opportunities for intervention for this group of patients. In my presentation I plan to elucidate the potential sequelae of TBI and discuss how the neuro-psychiatric and behavioral difficulties can handicap patients ability to care for themselves or access assistance. Through case discussion I hope to show potential approaches that can lead to success in this complicated group. Cases will be drawn from my urban homeless primary care practice with Boston Healthcare for the Homeless Program.

Learning Objectives: After the session the learner should be able to

1
list at least three potential barriers to accessing healthcare that face homeless individuals with a brain injury. 2
Recognize the importance of asking patients about past head trauma.
• recognize that some behavior issues and cognitive difficulties may be a result of brain injury.
• List at least 3 potential long term sequelae of traumatic brain injury.

Keywords: Traumatic Brain Injury, Homelessness

Presenting author's disclosure statement:


I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation

Interventions and Barriers to Services for Homeless Populations

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA