College of Social Work.
College of Architecture and Planning, Department of Community Metropolitan Planning.
Med Care. 2021 Apr 1;59(Suppl 2):S146-S153. doi: 10.1097/MLR.0000000000001335.
Older persons with lived or living experience of homelessness (PWLEs) often live with complex physical and/or mental health conditions which are challenged by poor access to health services, especially primary care. To fill the gap in the continuum of care following hospital discharge for PWLEs, medical respite provides health and shelter support for PWLEs who do not have acute care needs that qualify for a stay in a hospital bed, yet are too sick or frail to recover on the streets or in a traditional shelter.
This study examines how a medical respite could be designed for older PWLEs in Metro Vancouver, BC.
Using a community-based participatory research approach, in-depth interviews and focus groups were conducted with PWLE (n=15) and service provider (n=11) participants.
Participants offered rich suggestions about (a) the culture of the medical respite, (b) the physical design of a medical respite, (c) individuals who should be involved in medical respite delivery, (d) services a medical respite should provide, and (e) who the medical respite should serve.
When designing a medical respite for older PWLEs, considerations include providing an environment where patients can rest, but also feel safe and be surrounded by persons who they trust and who care for them. Developing a medical respite that adheres to the tenets of trauma-informed and patient-centered care acknowledges the mistrust and traumatization that often accompanies homeless patients presenting to health care.
有过或正在经历无家可归经历的老年人（PWLE）通常患有复杂的身体和/或心理健康状况，由于难以获得医疗服务，尤其是初级保健服务，这些状况受到了挑战。为了填补 PWLE 出院后护理连续体中的空白，医疗暂息为那些没有符合住院条件的急性护理需求但又因病情太重或身体太虚弱而无法在街头或传统收容所中康复的 PWLE 提供健康和住所支持。
本研究旨在探讨如何在不列颠哥伦比亚省大温哥华地区为老年 PWLE 设计医疗暂息服务。
使用基于社区的参与式研究方法，对 PWLE（n=15）和服务提供者（n=11）参与者进行了深入访谈和焦点小组讨论。
参与者就以下方面提出了丰富的建议：（a）医疗暂息的文化；（b）医疗暂息的物理设计；（c）应该参与医疗暂息服务提供的人员；（d）医疗暂息应提供的服务；以及（e）医疗暂息应服务的人群。
在为老年 PWLE 设计医疗暂息服务时，需要考虑为患者提供一个可以休息的环境，但也要确保他们感到安全，并被他们信任和关心他们的人所包围。制定符合创伤知情和以患者为中心的护理原则的医疗暂息服务承认了无家可归患者在寻求医疗保健时经常伴随的不信任和创伤。
