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APHA Scientific Session and Event Listing

Recorded presentation

Carol Waldmann, MD, Boston Healthcare for the Homeless Program, 729 Massachusetts Ave., Boston, MA 02118, 781 221-6565, cwaldmann@bhchp.org

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. I hope to show potential approaches that can lead to success in this complicated group. Example experiences will be drawn from my urban homeless primary care practice with Boston Healthcare for the Homeless Program.

Learning Objectives:

• List 5 sequelae of traumatic brain injury.
• Understand the experience and causes of brain injury of homeless persions.
• Assist patient in engaging in care and obtaniing services and support.

Keywords: Health Care Access, Homeless Health Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation