Homeless-- where do they go after discharge?

[AmericanChai]

Today in clinicals there was a pt who had on their chart that they were homeless. They had been in hospital for awhile recovering and making progress. But what happens after discharge to such people? Do they get turned back out on the streets when they get better? Or are they placed in a group home or something? It just seems a shame to spend effort and time (not to mention tax money) to heal someone, feed them good food, get them all better, just to turn them back out on the street again. This person seemed to have some mental health issues but maybe not severe enough to have court ordered help.

[caliotter3]

Well, in Los Angeles they get a ride to skid row according to news stories that ran awhile back.

[traumaRUs, MSN, APRN]

I worked in an inner city ER and being homeless is multifactorial:

1. Homeless people have a higher incidence of ETOH/drug abuse so they aren't usually welcome at the mission run by religious organizations.

2. States have closed many of the inpt mental health beds so again, these homeless don't have the resources to fill out paperwork, go to an office and sit waiting for aid, etc. For instance, in IL,several years ago our illustrious governor closed all of the mental health hospitals....and didn't open any group home beds....so where are these people going?

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3. With the economy bad, many of the newer homeless folks are families and many missions have no room or ability to care for children. We have a crisis nursery for children where parents can drop them off for 24 hours at a tiime. However, usually DCFS becomes involved.

So....in the end, it is a huge problem and not one that is easily fixed.

[mom and nurse]

Sometimes they are discharged to places like this one in DC http://www.christhouse.org/

other times they end up back on the street....or back in a shelter or group home.

[traumaRUs, MSN, APRN]

The problem of homelessnes is huge in the US. Thanks for asking about what happens to these folks.

[nursynurseRN]

In Orange county, San BErnardino County, and LA county California.... The social worker tries to place the person in some sort of shelter and gives them a taxi voucher to get there. Those who refuse to go to the shelter go to the street which some say is better then being in a shelter. From what I have seen....

[Hushdawg]

We should all petition our respective State governments to create state-by-state initiatives to have vocational and social rehabilitation programs for the homeless. Shelters don't fix the problem anymore, they only allow it to stagnate. Federal programs never get implemented so it is only at the state and community level tha anything can really get done.

There are many areas away from urban centers that homeless people who are willing to improve their lives could be moved to for the rehabilitation program. Outside of familiar areas they would be more willing to integrate a new lifestyle and develop new habits to replace the bad ones that got them in trouble in the first place.

Additionally, more state recognition and support for the clinically insane would alleviate the homeless problem as those suffering from actual mental disorders could then be treated and allowed to live normal lives.

A small pebble rolling downhill can start an avalanche; never think you are too small to do something big.

Write your representatives and tell others about the concept.

[TheCommuter, BSN, RN]

I work at a LTCF that admits younger people from the streets as a way to keep census high. When we're discharging a homeless person, the facility social worker will usually arrange to have the person discharged to a shelter.

[loriangel14, RN]

I have cared for homeless pts but we didn't send them back onto the street.Usually we put the papers in for nursing home placement and we hold them until a bed comes up. But I am in Canada so it may be different up here.....

[StNeotser, ASN, RN]

I have had a couple of homeless patients in for frostbite - after discharge one went to a friends, the other went to a shelter.

The one who went to a friends house you'd never have known was homeless as he didn't fit my misconceptions of what a homeless person would be like. He had lost his job, then got foreclosed on, then couldn't admit to anyone it had happened.

[cokristinug]

"just seems a shame to spend effort and time (not to mention tax money) to heal someone, feed them good food, get them all better, just to turn them back out on the street again."

welcome to the healthcare field. :)

[traumaRUs, MSN, APRN]

While I agree that shelters aren't the answer, we have had some success in our area with a huge church-sponsored organization. It is in the inner city, run by a multitude of churches in the area. They have:

1. Childcare - if you are a homeless Mom with kids you have to have childcare in order to go to school or get a job.

2. Job training - mostly vocational courses that will allow you to do some type of entry level work.

3. Social skills classes - how to interview for a job, how to talk/dress in society.

4. Parenting classes - fill two needs: they fulfill the DCFS requirements but more important they help parents to interact in a positive manner with their children.

5. Homework help for the children - kids that are homeless, go to many schools and need help to get back on track.

It is always important to remember too that the homeless are someones child and many times these people do have families that would welcome them back.