Student Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Caring for Special Populations Teaching Presentation
Hello, everyone. I hope you are having a productive day. My name is ________. In this presentation, we will examine the specific healthcare challenges faced by homeless individuals and explore culturally sensitive nursing strategies to improve health outcomes for this vulnerable population.
Introduction to the Special Population Group
Homelessness refers to the lack of a stable, secure, and safe place to sleep consistently. Individuals experiencing homelessness often face limited access to essential resources, including food, healthcare, and social support networks. The nature of homelessness varies widely. Unsheltered individuals live in locations not intended for human habitation, such as sidewalks, parks, or abandoned buildings, exposing them to harsh weather conditions and unsanitary environments. Others may stay in temporary shelters or transitional housing programs (Rodriguez et al., 2021). Chronic homelessness involves prolonged periods without stable housing and is frequently associated with physical or mental disabilities. People at risk due to financial hardship often live in overcrowded or unstable housing situations, increasing their likelihood of homelessness.
Homelessness is a significant public health issue affecting millions in the United States annually. It contributes to severe health outcomes, including higher rates of infectious diseases, mental health disorders, and premature mortality. Annually, over 3.5 million Americans experience homelessness, with rates increasing during the COVID-19 pandemic (Willison et al., 2023). Data from the U.S. Interagency Council on Homelessness shows that approximately 1.25 million people accessed emergency shelters in 2020, while 1.29 million utilized healthcare services through homeless assistance programs. On a single night in January 2022, roughly 582,462 individuals were without stable housing (U.S. Interagency Council on Homelessness, 2020). Certain groups, including families with children, youth living alone, veterans, and racial minorities, are disproportionately affected (Sleet & Francescutti, 2021).
Homeless individuals face deep health disparities, including increased risks for chronic illness, mental health conditions, substance use disorders, and limited access to preventive care. The combination of unstable housing, systemic barriers, and mistrust of medical institutions amplifies susceptibility to illness. Nurses must provide compassionate, trauma-informed, and culturally aware care to mitigate these risks (Rodriguez et al., 2021).
Cultural Values and Beliefs Relevant to Healthcare
Homeless individuals often prioritize immediate survival needs—such as food, safety, and shelter—over seeking healthcare. This results in delayed treatment for acute illnesses and chronic conditions. Many develop mistrust toward healthcare systems due to previous experiences of discrimination or neglect. They often perceive healthcare providers as disconnected from the realities of homelessness and as failing to treat them with respect (Willison et al., 2023).
Barriers to healthcare access include financial constraints, stigma, and logistical issues such as transportation difficulties or lack of identification. These challenges prevent homeless individuals from receiving timely medical attention (Crawford et al., 2022). Specific subgroups within the homeless population face unique obstacles:
| Subgroup | Challenges |
|---|---|
| Children | Limited access to pediatric care, disrupted education, vulnerability to health issues |
| Veterans | High prevalence of mental health disorders, substance use, and chronic disease |
| LGBTQ+ Youth | Familial rejection, risk of violence and exploitation, limited support networks |
Culturally competent nursing approaches must account for these distinct experiences to improve access to care for all subpopulations (Sleet & Francescutti, 2021).
Healthcare Disparities Faced by Homeless Individuals
Homelessness significantly impacts access to healthcare. Individuals without stable housing often delay care until medical conditions become emergencies due to a lack of consistent healthcare providers. These barriers include limited routine screenings, insufficient vaccinations, and inadequate chronic disease management, which exacerbate negative health outcomes (Richards & Kuhn, 2022).
Mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), and schizophrenia, are prevalent among homeless populations, affecting 25–92% of individuals globally (Schiffler et al., 2023). Substance use disorders are widespread, yet access to treatment and harm reduction services remains limited. Unsanitary living conditions increase susceptibility to infectious diseases such as tuberculosis, influenza, HIV, and skin infections. Additional barriers, including insurance gaps, lack of identification, and limited transportation, further restrict access to essential medical care (Richards & Kuhn, 2022).
Social Determinants of Health and Homelessness
Homelessness is strongly influenced by social determinants such as economic instability, education, employment, and housing affordability. Financial hardship often prevents individuals from maintaining secure housing. Environmental factors, including exposure to extreme weather, lack of clean water, and limited access to nutritious food, worsen health outcomes. Unsanitary conditions increase the risk of infectious diseases and compromise immune function (Richards & Kuhn, 2022).
Psychosocial and systemic factors also perpetuate homelessness. Many individuals have experienced trauma, such as domestic violence, childhood abuse, or combat-related PTSD, contributing to long-term mental health challenges. Limited access to mental health services and structural barriers like long waitlists, restrictive eligibility, and scarce affordable housing complicate efforts to achieve stability (Schiffler et al., 2023). Disciplinary policies prohibiting public sleeping further hinder access to care (Rodriguez et al., 2021). Addressing these determinants is critical for policy, healthcare, and social service interventions aimed at reducing homelessness and improving health.
Strategies for Culturally Competent Nursing Care
Effective nursing care for homeless populations requires cultural competence and trauma-informed practices. Nurses must build trust-based relationships, recognizing past adversity and creating nonjudgmental care environments (Crawford et al., 2022). Strategies include:
| Strategy | Description |
|---|---|
| Harm Reduction | Naloxone distribution, sterile supply access, medication-assisted treatment for substance use disorders |
| Prioritizing Basic Needs | Addressing food, hygiene, and shelter before medical interventions to stabilize patients |
| Mobile Healthcare Units | Providing on-site medical care and preventive services |
| Telehealth Expansion | Improving access to mental and physical healthcare remotely |
| Case Management | Coordinating housing, employment, and continuous healthcare resources |
These interventions foster trust, improve engagement with care, and enhance overall health outcomes (McWilliams et al., 2022; Garvin et al., 2022).
Communication Strategies for Effective Care
Effective communication is vital for engaging homeless individuals. Healthcare providers should use clear, simple language and patient-centered approaches. Recognizing trauma histories is critical to avoid triggering distress. Visual aids, verbal reinforcement, and interactive teaching methods can enhance comprehension and empower individuals to manage their health (Crane et al., 2023).
Case Study: Culturally Competent Nursing in Action
Research on Case Study Sites (CSSs) highlighted the effectiveness of mobile and specialized GP services compared to standard clinics. Participants valued accessibility, professionalism, respect, and nonjudgmental care, while conventional GP settings often led to feelings of stigma. Factors such as staff attitudes, holistic support, and flexible service delivery were critical in fostering patient trust and engagement (Crane et al., 2023). These findings reinforce the need for trauma-informed, patient-centered care models.
Resources for Homeless Healthcare Support
A range of resources supports healthcare for homeless populations:
| Resource | Role |
|---|---|
| National Health Care for the Homeless Council (NHCHC) | Provides training, advocacy, and clinical resources |
| Substance Abuse and Mental Health Services Administration (SAMHSA) GBHI Program | Funds community-based integrated mental health and addiction services |
| VIP Community Services New York | Offers medication-assisted treatment with mental health support |
| Federal Programs | Medicaid and Housing First initiatives provide long-term stability and access to care |
These programs facilitate access to essential healthcare services, mental health support, and substance use treatment (NHCHC, n.d.; SAMHSA, 2023; Sleet & Francescutti, 2021).
The Role of Nurses in Advocacy and Policy Change
Nurses play a crucial role in advocating for expanded housing and healthcare policies, emphasizing harm reduction and equitable access. Collaboration with social workers and community organizations ensures individuals can access food, shelter, and mental health services. By influencing policy reforms, nurses help reduce healthcare disparities, combat stigma, and promote sustainable housing solutions (McWilliams et al., 2022).
Conclusion
Homeless populations face significant barriers to healthcare, including stigma, mistrust, financial hardship, and logistical obstacles. Nurses can address these issues through culturally sensitive, trauma-informed, and patient-centered care. Strategies such as mobile healthcare, telehealth, harm reduction, and coordinated case management can improve health outcomes. A comprehensive approach, combining clinical care with advocacy and resource coordination, is essential to addressing the complex needs of this vulnerable population.
References
Crane, M., Joly, L., Daly, B. J., Gage, H., Manthorpe, J., Cetrano, G., Ford, C., & Williams, P. (2023, October). Perspectives of Case Study Sites: case study participants and people experiencing homelessness but not accessing the sites. National Institute for Health and Care Research. https://www.ncbi.nlm.nih.gov/books/NBK596155/
Crawford, G., Connor, E., McCausland, K., Reeves, K., & Blackford, K. (2022). Public health interventions to address housing and mental health amongst migrants from culturally and linguistically diverse backgrounds living in high-income countries: A scoping review. International Journal of Environmental Research and Public Health, 19(24), 16946. https://doi.org/10.3390/ijerph192416946
Garvin, L. A., Greenan, M. A., Edelman, E. J., Slightam, C., McInnes, D. K., & Zulman, D. M. (2022). Increasing use of video telehealth among veterans experiencing homelessness with substance use disorder: Design of a peer-led intervention. Journal of Technology in Behavioral Science, 8, 234–245. https://doi.org/10.1007/s41347-022-00290-2
McWilliams, L., Paisi, M., Middleton, S., Shawe, J., Thornton, A., Larkin, M., Taylor, J., & Currie, J. (2022). Scoping review: Scope of practice of nurse‐led services and access to care for people experiencing homelessness. Journal of Advanced Nursing, 78(11), 3587–3606. https://doi.org/10.1111/jan.15387
NHCHC. (n.d.). Quality. Access. Justice. Community. https://nhchc.org/
Richards, J., & Kuhn, R. (2022). Unsheltered homelessness and health: A literature review. AJPM Focus, 2(1), 100043. https://doi.org/10.1016/j.focus.2022.100043
NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation
Rodriguez, N. M., Lahey, A. M., MacNeill, J. J., Martinez, R. G., Teo, N. E., & Ruiz, Y. (2021). Homelessness during COVID-19: Challenges, responses, and lessons learned from homeless service providers in Tippecanoe County, Indiana. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11687-8
SAMHSA. (2023). FY 2023 Grants for the benefit of homeless individuals. https://www.samhsa.gov/sites/default/files/grants/pdf/fy-23-gbhi-nofo.pdf
Schiffler, T., Kapan, A., Gansterer, A., Pass, T., Lehner, L., Salmeron, A., McDermott, D. T., & Grabovac, I. (2023). Characteristics and effectiveness of co-designed mental health interventions in primary care for people experiencing homelessness: A systematic review. International Journal of Environmental Research and Public Health, 20(1), 892. https://doi.org/10.3390/ijerph20010892
Sleet, D. A., & Francescutti, L. H. (2021). Homelessness and public health: A focus on strategies and solutions. International Journal of Environmental Research and Public Health, 18(21). https://doi.org/10.3390/ijerph182111660
United States Interagency Council on Homelessness. (2020). Homelessness Data & Trends. https://www.usich.gov/guidance-reports-data/data-trends
NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation
Willison, C., Unwala, N., Singer, P. M., Creedon, T. B., Mullin, B., & Cook, B. L. (2023). Persistent disparities: Trends in rates of sheltered homelessness across demographic subgroups in the USA. Journal of Racial and Ethnic Health Disparities, 11, 326–338. https://doi.org/10.1007/s40615-023-01521-9