Interim chart review analysis for Project Dignify: A novel intensive case management program for older adults experiencing homelessness with mental health challenges
Author(s): Grace Kuang, Joseph J. O’Rourke, Ummay Salma Rahman, Alex Zsager, Michael Tau, Andrew D. Pinto
Description:
Older adults experiencing homelessness face unique health challenges and life transitions compounded by advanced age and mental illness that contribute to lower life expectancies, isolation, marginalization, and disengagement from health and social services. Project Dignify, based out of St. Michael’s hospital, is the first case management program known to the study team that specifically targets older adults experiencing homelessness with mental health challenges, a growing population across Canada. As part of the mixed methods evaluation involving surveys, interviews with patients and staff, and health care administrative sources, we conducted chart reviews of a preliminary cohort (n=7; Mage=72 years; nmale= 5; nfemale=2). Descriptive statistical analysis was performed to summarize patient demographics, housing status, and engagement with Project Dignify.
Participants in Project Dignify received over ten mental health diagnoses, two substance-use disorder diagnoses and had more than 30 different medical comorbidities. At the time of admission, five patients lived alone, one patient lived in a shelter, and another lived in a group home. At the time of discharge, three patients lived in long-term care, one had no fixed address, one lived at home, one had passed away, and one was lost to follow-up. Mean enrolment time in Project Dignify was 240 days, with an average of 10 days from referral to first contact. Referrals predominantly came from St. Michael’s Hospital in-patient units.
This interim chart review has helped characterize our patient population as part of a comprehensive evaluation to demonstrate the impact, acceptability, and potential for scale-up of this unique program.