Homeless people's experiences of medical respite care following acute hospitalisation in Denmark

Abstract

The aim of this study was to explore homeless people's health perspectives and experiences of a 2-week medical respite care programme following acute hospitalisation. There is a high level of health inequality when comparing the health status of homeless people to the general population, including increased mortality and morbidity. Homelessness predisposes an increased risk of infectious disease, cancer and chronic illness, such as diabetes and cardiovascular disease. Moreover, homeless people have a higher frequency of acute hospitalisation than general population estimates. In order to facilitate the transition from hospitalisation back to life on the streets, homeless people who were acutely hospitalised in the Capital Region of Denmark were offered 2 weeks of medical respite care from the day of discharge by a non-governmental organisation. This is a qualitative study with a phenomenological hermeneutical approach based on narrative interviews of 12 homeless people who received medical respite care from 1 March 2016 to 30 September 2016. Data were collected through individual semi-structured interviews and analysed according to Lindseth and Norberg's presentation of Paul Ricoeur's theory of interpretation. The analysis identified four themes: (i) basic needs are of highest priority; (ii) a safe environment provides security and comfort; (ii) social support is just as important as healthcare; and (iv) restitution facilitates reflection. The findings indicated that the medical respite care centre provided a place of rest and restitution following hospitalisation, which made room for self-reflection among the homeless people regarding their past and present life, and also their wishes for a better future. This study also indicates that a medical respite care stay can contribute to the creation of a temporary condition in which the basic needs of the homeless people are met, enabling them to be more hopeful and to think more positively about the future.

Hospital-to-Shelter/Housing Interventions for Persons Experiencing Homelessness

“…Similar to research on the outcomes of medical respite or convalescent care programs that offer post-acute care to PWLEs following hospital discharge (Biederman et al, 2014;Pedersen et al, 2018), participants from both Program A and B identified the facilitation of rest and recovery until their health has stabilized enough to work on other goals as a strength. These programs, which support rest, recovery, and stabilization, offer a mechanism for continuity of care for PWLEs who would have otherwise been without a safe place to convalesce following hospital discharge.…”

Post-hospital medical respite care for homeless people in Denmark: a randomized controlled trial and cost-utility analysis

“…At the same time, the intervention group had higher costs for general care services, rehabilitation, and treatment of substance abuse problems. One of the key results of the qualitative study by Pedersen et al, who studied the same respite care center, was that a post-hospital medical respite care stay allowed time for reflection on, for example, addiction problems [17]. It appears that some of the homeless people attended drug or alcohol therapy after the respite care stay.…”

“…In addition, medical respite care enables cooperation with other social and health care services, such as primary care, social services, and outpatient medical care [14]. Staying in respite care and the improved opportunity to cooperate with municipalities seems to have a positive impact on substance abuse problems [15,17]. Thus, it seems likely that medical respite care for homeless people can be part of the solution to a complex problem.…”

Post-hospital medical respite care for homeless people in Denmark: A randomized controlled trial and cost-utility analysis.

“…At the same time, the intervention group had higher costs for general care services, rehabilitation, and treatment of substance abuse problems. One of the key results of the qualitative study by Pedersen et al, who studied the same respite care center, was that a posthospital medical respite care stay allowed time for reflection on, for example, addiction problems (17). It appears that some of the homeless people attended drug or alcohol therapy after the respite care stay.…”

“…In addition, medical respite care enables cooperation with other social and health care services, such as primary care, social services, and outpatient medical care (14). Staying in respite care and the improved opportunity to cooperate with municipalities seems to have a positive impact on substance abuse problems (17,18). Thus, it seems likely that medical respite care for homeless people can be part of the solution to a complex problem.…”