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

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2025-04-10 DOI:10.1016/j.jpainsymman.2025.02.055

DorAnne Donesky PhD ANP-BC ACHPN FPCN

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Outcomes

1. Discuss a financially sustainable model for housing people who live with substance use disorder and serious mental illness in a family-style setting.

2. Examine the palliative care implications of managing a Sober Living Environment home for people living with serious mental illness and substance use disorder.

Key Message

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!

Abstract

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.

Objectives

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.

Discussion

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.

Conclusion

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.

References

1. Polcin, D. L., Mericle, A. A., Braucht, G. S., & Wittman, F. D. (2023). Moving social model recovery forward: Recent research on sober living houses. Alcoholism treatment quarterly, 41(2), 173-186.

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住房作为SUD和SMI双重诊断患者的姑息治疗

Outcomes1。讨论在家庭环境中为患有药物使用障碍和严重精神疾病的人提供经济上可持续的住房模式。检查管理一个清醒的生活环境对严重精神疾病和物质使用障碍患者的姑息治疗影响。养老院是减轻重病患者痛苦的一个机会。这一环节提出了一个可复制的模式，有利于享受社区生活的物质使用障碍和严重精神疾病的居民，想要为住房危机“做点什么”的公民，房地产投资者和医疗保健系统。没人需要露宿街头！【摘要】一些同时患有物质使用障碍（SUD）和严重精神疾病（SMI）的人已经意识到，住在一个清醒生活环境（SLE）的家里是他们过上尊严和宁静生活的最好机会(1)。一个家庭意识到一些长期居住在SLE的人因为SLE主人去世而被驱逐，所以他们在三年前购买了另一个家，开始了一个新的SLE。目的描述一个新的SLE的发展，讨论影响家庭成功的因素，并探讨房地产投资者与社区导师合作的步骤，以重现一个财务可持续的SLE。讨论采用以减轻痛苦为重点的姑息治疗，SLE业主致力于与居民创造一个家庭式的环境，在这里每个人的长处都得到赏识。5名60岁以上的居民计划在SLE度过余生。“老年住院医生”中有两位已经戒酒10年以上，他们会为年轻住院医生担任导师，这些年轻住院医生通常会待2到18个月。居民在吃饭和日常活动上完全独立。他们被要求每周参加家庭会议，完成日常家务，每周参加两次12步会议，保持戒除毒品和酒精，并参加重度精神障碍的治疗。如果是双人居住，居民就可以用残疾或退休收入来支付房屋的所有费用。结论：SLE提供了一种模式，可以复制为社区伙伴关系，使社会的多个部分受益。有长期清醒历史并喜欢在SLE环境中生活的居民是重要的团队成员，与投资者、医疗团队和社区导师合作。Polcin， D. L, Mericle， A. A., Braucht， G. S., &；惠特曼，f.d.（2023）。推动社会模式的恢复：最近对清醒生活屋的研究。酒精中毒治疗季刊，41(2),173-186。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.