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

Introduction to Homelessness as a Special Population

Homelessness continues to be a widespread public health concern impacting countless individuals globally. People experiencing homelessness or housing insecurity encounter various obstacles in obtaining adequate healthcare, such as limited access to medical treatment, mental health services, and preventive care (Bedmar et al., 2022). This presentation aims to analyze the values and beliefs of this group, the disparities they face, and culturally responsive strategies nurses can use to improve care. Through real-life scenarios, we will explore effective nursing interventions and conclude by highlighting key educational and clinical resources to promote compassionate and equitable care.

Overview of the Homeless Population

Homelessness presents a multifaceted challenge at the intersection of social and healthcare issues, impacting hundreds of thousands across the United States. Between 2018 and 2022, approximately 327,000 individuals lived in shelters—amounting to 0.1% of the national population (Glassman, 2024). Several systemic issues such as poverty, mental illness, substance use disorders, and the lack of affordable housing contribute to this problem. Housing insecurity spans a spectrum from transient to chronic homelessness, often resulting in unstable environments such as overcrowded accommodations or living on the streets. These inconsistent living situations are strongly associated with poor health outcomes due to unsanitary conditions, exposure to extreme weather, and minimal access to hygiene facilities or medical services (Fornaro et al., 2022).

Additionally, this population suffers disproportionately from untreated physical and mental health conditions. Many individuals delay or avoid care altogether due to systemic barriers. Nurses must recognize these factors and employ trauma-informed and culturally tailored care to mitigate health disparities and improve long-term outcomes (Fornaro et al., 2022).

Cultural Values and Beliefs Impacting Healthcare Engagement

Homeless individuals come from varied cultural and social backgrounds, yet many share lived experiences that shape distinct beliefs and behaviors toward healthcare. A prevailing value is self-reliance, driven by the necessity to survive independently with limited resources. This may result in reluctance to seek care, especially when past encounters with healthcare professionals involved discrimination or judgment (Gilmer & Buccieri, 2020). Institutional mistrust is another recurring theme; individuals may avoid hospitals or clinics due to perceived or actual neglect or mistreatment in these settings.

Survival often takes precedence over health. Immediate needs like food and shelter overshadow managing chronic conditions or preventive care. Mental health stigma further deters individuals from accessing necessary services for depression, PTSD, or substance use. Understanding these values enables nurses to establish trust and deliver care that is both respectful and culturally attuned to patients’ needs (Gilmer & Buccieri, 2020).

Health Disparities Among the Homeless

People experiencing homelessness endure significant disparities rooted in economic instability, limited healthcare access, and environmental exposure. These factors, which align with the broader category of social determinants of health (SDOH), exacerbate existing vulnerabilities.

Disparity Category	Description	Reference
Financial Constraints	Inability to afford healthcare services, medications, or nutritious food worsens chronic illnesses.	Flaubert et al., 2021
Limited Access to Services	Lack of transportation, identification, and health insurance restricts healthcare utilization.	Gilmer & Buccieri, 2020
Social Isolation	Absence of social support contributes to mental health deterioration and poor health-seeking behavior.	D’Souza & Mirza, 2021
Environmental Hazards	Living in unsafe or unsanitary conditions increases the risk of infections and physical injuries.	Fornaro et al., 2022

These disparities emphasize the need for healthcare systems to incorporate mobile clinics, integrated housing-healthcare models, and trauma-informed practices to bridge access gaps.

Strategies for Delivering Culturally Competent Nursing Care

Culturally competent nursing care for the homeless must begin with trust-building and patient-centered communication. Nurses should practice empathy, active listening, and avoid stigmatizing language to create a welcoming environment (D’Souza & Mirza, 2021). Accessibility enhancements, such as walk-in appointments or partnerships with shelters and outreach services, can significantly reduce barriers to care.

Equally vital is the application of trauma-informed principles, which account for past experiences of violence, neglect, or institutional betrayal. Strategies such as clearly explaining medical procedures, offering choices, and preserving patient autonomy can mitigate fear and mistrust (Dobischok et al., 2024). Nurses should also adapt educational materials to be low-cost, literacy-sensitive, and visually oriented. Finally, collaboration with interdisciplinary teams—including mental health providers and social workers—ensures that both medical and social health determinants are addressed holistically.

Case Studies Illustrating Best Practices

Case Study	Location	Intervention	Outcome
Street Nursing Initiative	Southern Oregon	Nurses delivered trauma-informed care directly to individuals experiencing homelessness.	Improved trust and continuity in care for patients with tri-morbidity.
Mobile Substance-Use Treatment Program	Portland, Oregon	Mobile units administered opioid treatment such as buprenorphine and methadone on-site to homeless individuals.	Expanded care access and demonstrated successful integration of culturally sensitive interventions.

(OHSU School of Nursing, n.d.; Post, n.d.)

These examples illustrate that outreach-based, culturally aligned interventions can improve access to care and overall health equity for the homeless population.

Resources for Continued Learning

Numerous professional and educational resources are available for nurses seeking to deepen their understanding of homelessness and culturally sensitive care strategies.

Resource	Focus Area	Provider
Medical Respite Care Toolkit & Webinars	Training on culturally humble and trauma-informed practices	National Healthcare for the Homeless Council (NHCHC), 2021
Public Health Guidelines	Infectious disease prevention and public health management among vulnerable groups	Centers for Disease Control and Prevention (CDC)
Continuing Education Courses	Training on trauma-informed care, SDOH, and health equity	American Nurses Association (ANA), Sigma Theta Tau
Volunteering Opportunities	Hands-on learning through shelters, street medicine programs, and free clinics	Local Community Organizations

These tools equip nurses with the knowledge and practical skills needed to advocate for, and effectively serve, homeless individuals.

Conclusion

Delivering high-quality care to people experiencing homelessness demands an integrative and culturally aware approach. Recognizing the core values, health disparities, and social determinants affecting this population enables nurses to adopt compassionate, trauma-informed practices. Interventions such as mobile clinics, street nursing, and harm reduction programs show promise in closing healthcare gaps. Ongoing professional development through educational resources enhances nursing competencies and fosters a culture of inclusion and equity in healthcare delivery. Ultimately, improving care for the homeless supports broader public health goals and uplifts underserved communities.

References

Bedmar, M. A., Veny, M. B., Lelong, B. A., Mut, F. S., Pou, J., Moyano, L. C., Toro, M. G., & Yáñez, A. M. (2022). Health and access to healthcare in homeless people: Protocol for a mixed-methods study. Medicine, 101(7). https://doi.org/10.1097/MD.0000000000028816

Dobischok, S., Archambault, L., & Goyer, M.-È. (2024). Trauma-informed care (TIC) interventions for populations experiencing addiction and/or homelessness: A scoping review of outcomes. Journal of Drug Issues. https://doi.org/10.1177/00220426241263264

D’Souza, M. S., & Mirza, N. A. (2021). Towards equitable health care access: Community participatory research exploring unmet health care needs of homeless individuals. Canadian Journal of Nursing Research, 54(4), 084456212110321. https://doi.org/10.1177/08445621211032136

Capella 4015 Assessment 4

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). Social determinants of health and health equity. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573923/

Fornaro, M., Dragioti, E., De Prisco, M., Billeci, M., Mondin, A. M., Calati, R., Smith, L., Hatcher, S., Kaluzienski, M., Fiedorowicz, J. G., Solmi, M., de Bartolomeis, A., & Carvalho, A. F. (2022). Homelessness and health-related outcomes: An umbrella review of observational studies and randomized controlled trials. BMC Medicine, 20(1). https://doi.org/10.1186/s12916-022-02423-z

Gilmer, C., & Buccieri, K. (2020). Homeless patients associate clinician bias with suboptimal care for mental illness, addictions, and chronic pain. Journal of Primary Care & Community Health.

Nurse Journal. (2025). Online learning for healthcare professionals. https://www.nursejournal.org

OHSU School of Nursing. (n.d.). Street nursing program. https://www.ohsu.edu/nursing

Capella 4015 Assessment 4

Post, M. (n.d.). Mobile unit expands opioid treatment access for the unhoused. https://www.opb.org