Housing as Palliative Care for People With SUD and SMI Dual Diagnosis

{"title":"Housing as Palliative Care for People With SUD and SMI Dual Diagnosis","authors":"DorAnne Donesky PhD ANP-BC ACHPN FPCN","doi":"10.1016/j.jpainsymman.2025.02.055","DOIUrl":null,"url":null,"abstract":"<div><h3>Outcomes</h3><div>1. Discuss a financially sustainable model for housing people who live with substance use disorder and serious mental illness in a family-style setting.</div><div>2. Examine the palliative care implications of managing a Sober Living Environment home for people living with serious mental illness and substance use disorder.</div></div><div><h3>Key Message</h3><div>Sober living homes are an opportunity for relieving the suffering of serious illness. This session presents a reproducible model that benefits residents with substance use disorder and serious mental illness who enjoy living in community, citizens who want to \"do something\" about the housing crisis, real estate investors, and the healthcare system. No one needs to live on the street!</div></div><div><h3>Abstract</h3><div>Some people living with both Substance Use Disorder (SUD) and Serious Mental Illness (SMI) have come to realize that living in a Sober Living Environment (SLE) home is their best opportunity to live a life of dignity and serenity (1). A family became aware of some long-term SLE residents who were being evicted because the SLE owner had died, so they purchased a different home three years ago and started a new SLE.</div></div><div><h3>Objectives</h3><div>Describe the development of a new SLE, discuss the factors that affect the success of the home, and explore the steps for real estate investors to partner with community mentors to reproduce a financially sustainable SLE.</div></div><div><h3>Discussion</h3><div>Using a palliative care lens focused on relief of suffering, the SLE owner has committed to creating a family-style environment with the residents, where each person's strengths are appreciated. Five residents who are over the age of 60 plan to live at the SLE for the rest of their lives. The “senior residents,” two of whom have more than 10 years of sobriety, serve as mentors for younger residents who typically stay between 2 and 18 months. Residents are completely independent in meals and daily activities. They are required to attend weekly house meetings, complete daily chores, attend two 12-step meetings per week, remain abstinent from drugs and alcohol, and participate in treatment for their SMI. With double occupancy, residents are able to afford rent out of disability or retirement income that pays for all expenses of the home.</div></div><div><h3>Conclusion</h3><div>This SLE provides a model that could be reproduced as a community partnership that benefits multiple segments of society. Residents who have a long history of sobriety and enjoy living in SLE environments are important team members, in collaboration with investors, the healthcare team, and community mentors.</div></div><div><h3>References</h3><div>1. Polcin, D. L., Mericle, A. A., Braucht, G. S., &amp; Wittman, F. D. (2023). Moving social model recovery forward: Recent research on sober living houses. Alcoholism treatment quarterly, 41(2), 173-186.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 5","pages":"Page e443"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0885392425001150","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}