Exploring the experiences and needs of homeless aboriginal and torres strait islander peoples with neurocognitive disability

Abstract

Objective:The current study explored the experiences and aspirations of a cohort of Aboriginal and Torres Strait Islander adults with neurocognitive disability residing in a homeless shelter in regional Queensland, Australia. Neurocognitive disability (NCD) refers to any acquired disorder or injury to the brain where the primary clinical deficit is in cognitive function.Method:The data reported on in this paper emerged from a broader study that aimed to understand the extent and nature of neurocognitive disability amongst homeless Aboriginal and Torres Strait Islander people. The broader study found high levels of NCD which impacted on people’s ability to participate in society. As part of the study, qualitative information was sought regarding participant life experiences. A culturally safe and acceptable structure of “past, present and future” was applied to open-ended questions.Results:Thematic analysis of the data identified four broad themes of i) normalisation of illness and disability; ii) trauma and loss; iii) socioeconomic disadvantage; and iv) hope and disempowerment. This paper reports on these themes and experiences, which occurred across the life span, intersected with NCD, and contributed to what we have termed ‘complex disablement’ amongst this cohort.Conclusions:While causal links between life experience, disability and disablement are not always clear, our findings suggest that attempts to address homelessness must engage with this complexity. The application of holistic, intersectoral supports, which encompass culturally informed, community driven approaches are needed. Understanding the impacts of individual and intergenerational trauma is crucial to safe and effective service provision for this cohort.

Responding to the needs of homeless Aboriginal and Torres Strait Islander young people with complex disability: The Guddi for Young People

“…Holistic, empowering approaches, which recognise and respond to the specific needs of homeless Aboriginal and Torres Strait Islander people, are required (Memmott et al, 2012). It is vital that services acknowledge and understand Indigenous concepts of disability and the impact of trauma; recognise the impact of the past on Aboriginal and Torres Strait Islander peoples' access and engagement with services; and utilise culturally safe and appropriate screening processes which accurately assess cognitive and psychosocial needs (Townsend et al, 2017a).…”

“…Although limited, research suggests that many marginalised Indigenous Australians experience complex multiple problems including NCD, FASD, intellectual disability and mental health problems (Massey, Jane, Lindop, & Christian, 2013;Stephens, Cullen, Massey, & Bohanna, 2014;Townsend et al, 2017a). The nature and extent of NCD among homeless Aboriginal and Torres Strait Islander young people is unclear, but is thought to be reflective of the adult population, and therefore likely to be high.…”

A qualitative exploration of older people’s lived experiences of homelessness and memory problems – stakeholder perspectives

“…There is a critical gap in understanding what could lead to improvements in care, support and housing and inform intervention for older people experiencing memory problems and homelessness. Although studies have explored the lived experiences of older people experiencing homelessness [ 26 ], we found only one Australian study which privileged the voices of people living with memory problems and experiencing homelessness, through in-depth qualitative interviews, and this was in a single hostel and did not focus on older people [ 27 ]. Qualitative and ethnographic studies are increasingly being conducted to inform practice, intervention development and policy in homelessness [ 19 , 28 ].…”

A case study approach to understanding the pathway to individualised funded supports under the National Disability Insurance Scheme for community-dwelling individuals with acquired brain injury

“…Indeed, Blaxland et al (2020) found that only 4% and 7% of people with ABI and stroke respectively self managed their NDIS plans while only 8% and 13% respectively were partially managing their plans. These issues may be more challenging for those with recent ABI (Foster et al, 2012;Zasler, Ameis & Riddick-Grisham, 2013), those from Aboriginal or Torres Strait Islander backgrounds (Stephens, Cullen, Massey & Bohanna, 2014;Townsend et al, 2018) and those with socio-economic disadvantage (Cortese et al, 2021). They may further be complicated where individuals with ABI have little family support (Cortese et al, 2021) or where transitions are required between existing insurance or disability services (Esterman et al, 2018;Lakhani et al, 2018).…”