Elder Connect: A Tool to Recognize and Respond to Elder Homelessness

Background:  In healthcare settings, providers interacting with older adults often feel ill-equipped to assess their risk of homelessness and connect them to needed services and supports. Precipitates of homelessness among older adults include inadequate income, failing health, and lack of social support. If providers fail to identify these risk factors and to link them to appropriate services, it can result in poor choices at discharge. Cases where patients were dumped by hospitals at homeless shelters without appropriate assessment, medical follow-up, or support are all too common. Healthcare workers must be better able to recognize and respond to needs of at-risk older adult patients.

Program background:  Designed to support health and human service providers—particularly those involved with discharge planning from hospitals, community health centers, and behavioral health facilities— Elder Connect is an innovative communication tool that facilitates more thorough provider communication with patients/clients. This two part tool consists of an online learning module that helps health care providers examine trends in homelessness among older people, understand health and social issues faced by older people experiencing homelessness, and learn strategies for overcoming barriers to care, as well as an online screening tool that aims to ensure key social and economic factors are assessed. These factors include current housing status; income sources and amounts; percentage of income needed to cover housing, food, and medications; familial support; and client/patient knowledge of community resources. 

Evaluation Methods and Results:  Using existing health and social services networks, the Center for Social Innovation is recruiting agencies in three distinct settings: a hospital discharge unit, a community health center, and a community senior center. Providers are participating in focus groups and administrators in telephone interviews. Data from one site have been collected. Preliminary findings show providers use minimal technology in their work setting. However, most believe that using technology would help facilitate communication with older clients, reporting that tablets could help when workstations do not have internet access. Google is used most frequently to find referrals, and providers currently have no reported measures in place to follow-up with clients after discharge. Mistrust of technology on the part of older adult clients is a key concern for providers. They also report difficulties securing housing and food stamps for older clients because of eligibility requirements and long waiting lists. Administrators report that a centralized system for accessing referrals would be valuable, but that human service organizations are behind on technology, (e.g., not all providers have computers).

Conclusions:  Through this study we are assessing the feasibility of the Elder Connect tool. We have furthered our understanding about current referral processes and discharge planning, and about challenges associated with technology use in provider communication with older adults in these settings.

Implications for research and/or practice:  We have confirmed a clear need for improved referral processes and discharge planning for older adults. However, funding and resources are limited in human services. Further research and development on low-cost programs and tools is needed. This project is funded by the National Institute on Aging.