ABSTRACT

Older adults experiencing homelessness face complex challenges, including rising healthcare and housing costs, high rates of cognitive impairment, and limited access to appropriate care. In the United States, over 146,000 adults aged 55 and older experience homelessness annually, with a significant portion screening positive for cognitive disorders such as dementia. Shelters often lack access to trained professionals and experience long referral delays, limiting their ability to provide timely, specialized dementia care. In response, a multidisciplinary memory clinic was launched in August 2024 through a partnership between a university, a federally qualified health center (FQHC), and a shelter serving older adults. The clinic provides neurocognitive evaluations, imaging, and early treatment when indicated. To date, more than 100 sheltered seniors have received care through this model. This has facilitated improved housing coordination and transitions from congregate shelter settings to individualized senior transitional housing for high-risk individuals. A key component of the program was the involvement of nurse practitioner (NP) students. Initial cognitive testing was implemented onsite at the shelter by NP students and continued as part of their clinical training within the memory clinic. This approach not only improved early identification and care coordination but also provided students with valuable, hands-on experience working with vulnerable populations. The clinic employs a person-centered, integrated care model that addresses both immediate medical needs and broader social determinants of health, including housing access and long-term care applications. Services are coordinated by a multidisciplinary team, with a focus on reducing cognitive decline and improving housing stability among