OT considerations in the acute care setting

In the United States, homeless persons are an underserved population who use more Emergency Department (ED) visits than housed persons (Canham et al., 2018; Hammig et al., 2014). Evidence suggests that despite social stigma around this population, most homeless individuals who use ED services are sicker than the average person (Doran & Raven, 2018). Paudyal and colleagues (2021) describe that homeless individuals often use ED services for pain disturbances, injury and trauma, drug and alcohol related complications, and complications of infections or wound management. These factors may be exacerbated in individuals exposed to higher instances of crime, limited access to shelters, comorbid conditions, and engagement in risky behaviors such as commercial sex work (Hammig et al., 2014). In the United States, among the homeless population who visited the ED, 13% also carried a comorbid diagnosis of psychiatric disorder and/or substance abuse disorders (62%) increasing their risk of health complications and recidivism (Hammig et al., 2014). A United Kingdom study of ED use of homeless individuals showed that as many as 24% require admission to the hospital (Paudyal, et al., 2021). In summary, individuals experiencing homelessness may present with complex issues that require inpatient hospital services.