Clinical Management of the Homeless Patient with Traumatic Brain Injury and Cognitive Impairment

The global incidence of traumatic brain injuries (TBIs) in the homeless population has been estimated to be up to 53%. TBI is almost always associated with cognitive impairment, even if only transiently. Cognitive impairments are a risk factor for becoming homeless and may impede an individual’s ability to escape homelessness by interfering with their ability to sustain employment. Management of both conditions in the homeless population is complex given the numerous barriers encountered in their healthcare. A holistic and multimodal approach may be the optimal strategy for care, but first understanding what a traumatic brain injury is, what conditions are associated with it, and what other factors may be impairing cognition is perhaps the most important step in developing tailored treatments for a homeless patient with TBI and cognitive impairments.