Capella 4015 Assessment 4

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’re all doing well. My name is _____. Today’s presentation focuses on the health challenges faced by homeless individuals and outlines culturally competent nursing strategies to enhance care delivery and health outcomes for this vulnerable group.

Introduction to the Special Population Group

Homelessness refers to a condition where individuals lack a permanent, safe, and adequate place to sleep at night. It encompasses a range of living situations, including staying on the streets, in parks, or abandoned buildings—places not meant for human habitation. Many individuals also rely on emergency shelters or transitional housing (Richards & Kuhn, 2022). Chronic homelessness typically involves long-term or repeated episodes often linked with disabilities or severe health issues. Additionally, people who live in unstable, overcrowded, or temporary housing due to financial constraints also fall within the broader definition of housing insecurity.

According to the U.S. Department of Housing and Urban Development’s 2023 Annual Homeless Assessment Report, more than 580,000 individuals experienced homelessness in January 2020. Approximately 61% of these individuals were sheltered, while the remaining lived in unsheltered settings such as streets or abandoned buildings. A troubling trend shows an increase in unsheltered homelessness over four consecutive years, especially in states like California. Vulnerable groups—including children, veterans, unaccompanied youth, and people of color—are disproportionately affected (Sleet & Francescutti, 2021).

Homeless individuals often suffer from heightened rates of chronic illnesses, mental health conditions, and substance use disorders. However, they face significant barriers to accessing consistent and compassionate healthcare. Combined with limited housing, healthcare mistrust, and logistical obstacles, these challenges place homeless individuals at elevated risk for disease and early mortality—often 30 years younger than the general population (Bedmar et al., 2022). Nursing care rooted in compassion and cultural understanding is essential to mitigate these disparities.

Cultural Values and Beliefs Relevant to Healthcare

Homeless individuals typically prioritize survival—securing food, shelter, and safety—over medical care. This delay in addressing health issues often worsens both acute and chronic conditions. Many harbor mistrust of healthcare institutions due to prior negative experiences, perceived discrimination, or lack of respect (Miller et al., 2024).

These individuals face numerous systemic barriers including stigma, social exclusion, financial limitations, transportation issues, and lack of documentation like ID or insurance (Thorndike et al., 2022). Additionally, subpopulations within the homeless community face unique struggles: homeless children may lack consistent pediatric care, veterans often contend with untreated PTSD or addiction, and LGBTQ+ youth are frequently displaced due to familial rejection (Sleet & Francescutti, 2021). Nurses who are culturally aware can tailor their approaches to meet the distinct needs of these groups.

Healthcare Disparities Faced by Homeless Individuals

Healthcare inequality is prominent among homeless individuals, largely due to limited access to primary and preventive care services. Without a consistent healthcare provider, many delay treatment until emergency care becomes unavoidable. The lack of preventive screenings and chronic disease management exacerbates untreated conditions (Miller et al., 2024).

Homeless individuals have higher incidences of diabetes, hypertension, and respiratory illnesses due to poor living conditions and nutrition. Mental health and substance use disorders are prevalent, with studies indicating that up to 80% of homeless individuals have at least one behavioral health condition, and nearly half are at risk for suicide (Bedmar et al., 2022). Additionally, limited access to psychiatric services results in untreated conditions like schizophrenia and PTSD. Infectious diseases such as hepatitis, tuberculosis, and HIV also pose serious threats due to unsanitary living conditions and limited healthcare resources (Bensken et al., 2021).

Social Determinants of Health and Homelessness

The root causes of homelessness and the resulting health outcomes are deeply intertwined with social determinants. These include:

Determinant Category	Key Issues	Health Impacts
Economic Factors	Poverty, job insecurity, unaffordable housing	Limited access to healthcare, poor nutrition
Environmental Factors	Exposure to extreme weather, unsanitary living conditions	Increased vulnerability to infectious and chronic diseases
Psychosocial Factors	Trauma from abuse or violence, mental health disorders	Heightened risk of substance abuse, difficulty maintaining housing
Policy Barriers	Limited housing programs, punitive public policies	Restricted access to stable housing and healthcare (Sleet & Francescutti, 2021; Thorndike et al., 2022)

By addressing these social determinants, healthcare and community leaders can better formulate policies and interventions aimed at reducing homelessness and improving health equity.

Strategies for Culturally Competent Nursing Care

Effective nursing care for homeless populations requires empathy, flexibility, and cultural competence:

• Nurses should foster trauma-informed relationships, acknowledging past trauma and building trust to enhance care delivery (Barry et al., 2023).
• Compassionate, nonjudgmental interactions that respect each individual’s circumstances are crucial.
• Harm reduction strategies—such as distributing clean supplies, naloxone, and MAT—can mitigate substance use risks.
• Providing for basic needs like food, hygiene, and shelter before offering medical services helps establish trust and improves engagement.
• Street outreach and mobile health units are effective in reaching homeless individuals directly and addressing urgent health issues (Kaufman et al., 2024).

Communication Strategies for Effective Care

Communication is a vital element in delivering patient-centered care to homeless individuals:

• Use simple, clear language to overcome literacy or cognitive barriers.
• Approach conversations with sensitivity, recognizing the impact of trauma and mistrust (Barry et al., 2023).
• Display genuine care and advocate for the patient to foster rapport and trust (Crane et al., 2023).
• Incorporate visual aids, demonstrations, and repeated verbal explanations to ensure understanding.

Case Study: Culturally Competent Nursing in Action

A study comparing Case Study Sites (CSSs)—such as Mobile Teams and Specialist GPs—to standard GP practices found higher patient satisfaction with CSS services (Crane et al., 2023). These patients appreciated the staff’s respectful and nonjudgmental demeanor. In contrast, traditional GP settings were often seen as stigmatizing and unaccommodating. Holistic care, accessibility, and a flexible approach were key elements in building trust and promoting long-term health improvement. This underscores the need for trauma-informed, culturally competent care models.

Resources for Homeless Healthcare Support

Several organizations and programs offer critical support services to homeless populations:

Resource/Program	Service Provided
National Health Care for the Homeless Council (NHCHC)	Advocacy, education, and clinical support for homeless healthcare (NHCHC, n.d.)
Community Clinics and Shelters	Preventive services, chronic disease management, wound care
Substance Abuse and Mental Health Services Administration (SAMHSA)	Grants for integrated care via the GBHI program for mental health and addiction support (SAMHSA, 2023)
Boston Health Care for the Homeless Program (BHCHP)	MAT programs offering buprenorphine or methadone with mental health support
Medicaid and Housing First Programs	Healthcare access and housing initiatives for long-term solutions

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References

Barry, M. M., Clarke, A. M., Petersen, I., & Jenkins, R. (2023). Implementing mental health promotion. World Psychiatry, 22(1), 70–71. https://doi.org/10.1002/wps.21052

Bedmar, C., Frías-Osuna, A., González-Torres, M. C., & Fernández-Alcántara, M. (2022). Health and social outcomes of homeless people. Healthcare, 10(2), 246. https://doi.org/10.3390/healthcare10020246

Bensken, W. P., Alberti, P. M., Koroukian, S. M., & Singer, M. E. (2021). Health outcomes in Medicaid expansion states. Health Affairs, 40(9), 1424–1431. https://doi.org/10.1377/hlthaff.2020.02449

Capella 4015 Assessment 4

Crane, M., Cetrano, G., Joly, L., Coward, D., Daly, C., Macdonald, G., & Johnson, S. (2023). Evaluation of specialist healthcare models for homeless people. BMC Health Services Research, 23, 62. https://doi.org/10.1186/s12913-023-09074-4

Kaufman, B. G., Whitaker, R. G., Pink, G. H., & Holmes, G. M. (2024). Trends in mobile clinic use among underserved populations. American Journal of Public Health, 114(1), 88–95. https://doi.org/10.2105/AJPH.2023.307454

Miller, E. C., Mott, K., Kim, J., & Knopf-Amelung, S. (2024). Health equity and primary care access for homeless individuals. Family Medicine, 56(1), 13–20. https://doi.org/10.22454/FamMed.2024.765849

NHCHC. (n.d.). National Health Care for the Homeless Council. https://nhchc.org

Richards, R., & Kuhn, R. (2022). Structural determinants of homelessness. Annual Review of Public Health, 43, 137–155. https://doi.org/10.1146/annurev-publhealth-052620-114342

SAMHSA. (2023). Grants for the Benefit of Homeless Individuals (GBHI). Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/homelessness-programs-resources/gbhi

Sleet, D. A., & Francescutti, L. H. (2021). Injury prevention and homelessness. American Journal of Public Health, 111(3), 408–412. https://doi.org/10.2105/AJPH.2020.306117

Capella 4015 Assessment 4

Thorndike, A. N., Burke, K. E., & O’Connell, J. J. (2022). Addressing housing and health disparities. New England Journal of Medicine, 386(23), 2201–2203. https://doi.org/10.1056/NEJMp2200554