Abstract
Cognition may be assessed as a predictor of ability to maintain housing in people experiencing homelessness. A scoping review was completed to identify current methods for evaluating functional cognition in PEH, including implications for OT practice
Primary Author and Speaker: Caitlin E. Synovec
Additional Authors and Speakers: Lee Westover, Leonie Boland
The increased prevalence of cognitive impairment in people experiencing homelessness (PEH) has placed a focus on the use of measures of cognition to predict functioning and determine eligibility for housing. A scoping review was conducted to synthesize the existing literature, identify how functional cognition is evaluated in PEH, and identify implications for homeless and housing services. This scoping review was conducted using the Joanna Briggs Institute protocol. Of 7,742 articles retrieved from the initial search, 37 articles were determined to meet inclusion criteria for data extraction. Narrative analysis identified domains of cognition and function assessed, and relationships determined between cognition and function. Only the domain of Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) were found to have a consistent relationship with cognition when performance-based assessments were used. Several studies identified that even with the presence of decreased cognition, PEH are able to maintain housing when given individualized and appropriate supports. Challenges with generalizing study findings broadly include: study populations do not reflect demographics of PEH; a variety of assessment tools for cognition and function are utilized; and the broad use of the term function encompasses several different areas of community living. Theses findings indicate inconsistent methods to assess cognition and functional cognition within PEH. Performance-based assessments of ADL/IADL are more likely to identify the impact of cognition on function. Assessments should focus on identifying strengths and individualized supports for transitioning from homelessness to housing. The findings of this review indicate a need for performance-based assessments to evaluate functional cognition for PEH. Performance-based assessments are in the scope of OT practice and should be more integrated into homeless and housing services.
Stone, B., Dowling, S., & Cameron, A. (2019). Cognitive impairment and homelessness: A scoping review. Health & Social Care in the Community, 27(4), e125–e142. https://doi.org/10.1111/hsc.12682
Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Chapter 11: Scoping reviews (2020 version). In Aromataris, E. & Munn, Z. (Eds), JBI manual for evidence synthesis. https://jbi-global-wiki.refined.site/space/MANUAL/4687342/Chapter+11%3A+Scoping+reviews