Aged Care, Homelessness and Brain Injury

Neuroscience & Psychology

For over 25 years Wintringham aged care services in Melbourne, Australia have been supporting people who have experienced or are at a high risk of experiencing homelessness. Older men and women from homeless and low socio-economic backgrounds often face disadvantage with respect to equity of access to quality health and aged care. Coupled with other significant social, health and psychosocial challenges, these individuals are placed at greater risk of a rapid decline in health and wellbeing with subsequent premature ageing and mortality. As a consequence many are in need of aged care at younger ages than the general population. For this reason, Australia as with many other nations, has deemed that people aged 50 years and older who are experiencing homelessness are eligible to receive the support of government funded aged care services. This in itself has created obstacles to the access and delivery of appropriate care to people who have aged physically but not psychologically and therefore do not easily assimilate with mainstream aged care populations.

Another, more compounding impediment to the delivery of appropriate aged care to this population is the high prevalence of behaviours manifesting from unmet need exhibited by its constituents. Although the group of people living with an acquired brain injury (ABI) constitute only a small proportion of the total number of aged care residents living with some form of cognitive impairment, they present severe and ongoing challenges to support services. Most problematic is the frequency with which significant problems with impulse control, social skills and self-awareness accompany the diagnosis of an ABI. Brain dysfunction due to trauma from multiple sources, leads many service users to display preservative, high risk behaviours which are often aggressive in nature. Research evidence has shown that the presence of a brain injury is highly prevalent within the older homeless population. People experiencing homelessness report an exceptionally high rate of trauma exposure. Approximately fifty percent of homeless service users (58% of homeless men and 42% of homeless women) have a history of traumatic brain injury. The most common of which are acquired brain injuries (ABI) arising from long-term exposure to the harmful levels of alcohol intoxication and/or head trauma. People living with multiple diagnoses including mental illness, substance abuse and ABI often find it difficult to access appropriate services. These individuals can be slow to respond to questions and perform tasks, due to slower thought processing speeds and may have trouble negotiating complex systems due to cognitive or behavioural problems. Commonly accompanying these injuries is an overlay of complex behaviour that may further alienate the individual from social inclusion and accessing mainstream aged care support.

International Journal of Physical Medicine & Rehabilitation welcomes research articles, review articles, methodologies, commentaries, case reports, perspectives and short communications encompassing all aspects of Physical Medicine & Rehabilitation. This journal provides latest developments in theoretical, experimental and clinical investigations in physical Medicine & Rehabilitation for Physiatrists and Rehabilitation researches.

This peer reviewed journal includes following topics but are not limited to: acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, amputation, prosthetics and orthotics, mobility, gait, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis studies, etc.

Rebecca J Posted on: Oct 28, 2021