NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation

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Capella university

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

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Date

Caring for Special Populations Teaching Presentation

Hello, everyone. I hope you are all having a great day. My name is ________. This presentation will explore the unique healthcare barriers for the homeless and explore culturally sensitive nursing approaches to improving health outcomes for this vulnerable population.

Introduction to the Special Population Group

Homelessness is defined by the absence of a consistent, secure, and suitable place to sleep at night. It includes restricted access to vital resources and a lack of social support systems. The experience of homelessness varies widely, taking multiple forms. Individuals experiencing unsheltered homelessness live in places not intended for human habitation, such as sidewalks, public parks, and abandoned structures. It often endures harsh weather and inadequate sanitation. Many seek refuge in emergency shelters or temporary housing programs (Rodriguez et al., 2021). Chronic homelessness refers to persistent episodes of homelessness. It is often linked to disabilities or serious health conditions. Individuals without stable housing due to financial hardship face eviction risks, reside in overcrowded spaces, or struggle with ongoing housing instability. These unwarranted living conditions increase the chance of homelessness.

Homelessness is a prevalent public crisis impacting millions of Americans annually. It leads to severe health consequences, including infectious diseases, mental disorders, and increased mortality rates. Each year, over 3.5 million persons in the United States (U.S) experience homelessness, a figure that has risen in the COVID-19 pandemic (Willison et al., 2023). According to the U.S Interagency Council on Homelessness, around 1.25 million persons utilized emergency shelters in 2020, while 1.29 million accessed healthcare services through homeless assistance programs. On a single night in January 2022, an estimated 582,462 people were without stable housing (U.S Interagency Council on Homelessness, 2020). Homelessness has continued to increase for the last few years, with unsheltered homelessness surging, particularly in New York. Certain populations, such as families with children, solitary youth, veterans, and racial minorities, are strangely affected (Sleet & Francescutti, 2021).

NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation

Homeless individuals endure profound health inequities, facing heightened risks of chronic illnesses, mental health disorders, substance abuse, and restricted access to preventive care. Their ability to secure compassionate medical attention is severely hindered. The combination of unstable housing, mistrust in healthcare, and logistical obstacles intensifies their susceptibility to infectious diseases (Rodriguez et al., 2021). Nurses must address these disparities by delivering empathetic, culturally attuned, and trauma-sensitive care.

Cultural Values and Beliefs Relevant to Healthcare

Homeless persons prioritize fundamental survival needs, such as food, shelter, and personal safet,y over medical care. It leads to delayed treatment for both acute illnesses and chronic conditions. Many individuals experiencing homelessness develop mistrust toward healthcare organizations due to discrimination and feelings of exclusion within medical settings. This skepticism stems from the perception that healthcare experts lack awareness of the challenges faced by homeless populations and fail to provide them with dignity and respect (Willison et al., 2023). Accessing healthcare remains a substantial challenge for homeless individuals due to multiple barriers. Financial hardships make it difficult to afford medicines and necessary follow-up care. Stigma and societal bias discourage them from seeking medical attention. Undesirable interactions with staff instill fear and resistance toward medical institutions (Crawford et al., 2022).

Logistical obstacles such as transportation problems and administrative needs such as identification and insurance documentation prevent many from receiving suitable medical treatment when needed. Homeless research must address the unique challenges different subgroups face within this population. Homeless children experience barriers to pediatric healthcare while also dealing with disrupted education. Veterans struggle with mental health conditions and substance use disorders, while LGBTQ+ youth become homeless due to familial rejection. It increases their risk of violence and exploitation (Sleet & Francescutti, 2021). A culturally competent nursing approach that recognizes the distinct experiences of these vulnerable groups is vital for improving healthcare accessibility.

Healthcare Disparities Faced by Homeless Individuals

Homeless individuals face disparities in healthcare access, primarily due to the limited availability of essential medical services and consistent treatment for chronic illnesses. The absence of regular healthcare provider forces them to postpone seeking medical attention until their conditions heighten into emergencies. Barriers such as restricted access to routine screenings, lack of vaccinations, and inadequate chronic disease management contribute to worsened health outcomes and severe complications (Richards & Kuhn, 2022). The instability associated with homelessness disrupts their ability to adhere to medical advice, attend follow-up schedules, take prescribed medications consistently, and maintain a nutritious diet. It leads to decreased physical and mental health.

Homeless persons are at a heightened risk of developing mental health conditions and infectious illnesses due to their limited access to healthcare services. Harsh living conditions, inadequate nutrition, and a lack of medical gaps contribute to the prevalence of conditions such as diabetes, hypertension, and infectious diseases. Global research indicates that mental health disorders, including depression and anxiety, affect between 25% and 92% of people experiencing homelessness. It significantly surpasses rates among housed populations (Schiffler et al., 2023). Without reliable access to psychiatric care, many individuals struggle with Post-Traumatic Stress Disorder and schizophrenia. It further complicates their well-being.

Substance use disorders remain widespread, yet addiction treatment facilities and harm reduction programs are underfunded and limited in availability. Unsanitary living conditions increase susceptibility to tuberculosis, influenza, skin infections, and Human Immunodeficiency Virus (HIV). Additional barriers, including gaps in health insurance, identification conditions, and lack of reliable transportation, restrict access to vital medical care (Richards & Kuhn, 2022).

Social Determinants of Health and Homelessness

Homelessness stems from a multifaceted network of social determinants that influence well-being. Economic hardship is a key contributor, as unemployment, financial insecurity, and unaffordable housing prevent individuals from maintaining stable residences. Many face employment barriers due to limited job openings, insufficient education, or disabilities restricting work opportunities. Escalating rent prices paired with stagnant wages intensify housing instability. It forces families into shelters or homelessness.

Additionally, financial constraints hinder access to medical care. It exacerbates pre-existing health conditions and increases vulnerability to chronic diseases (Sleet & Francescutti, 2021). Environmental factors worsen these hardships, as persons experiencing homelessness endure exposure to extreme weather, unsanitary settings, and inadequate access to clean water and nutritious meals. These adverse conditions heighten susceptibility to hepatitis and HIV while weakening immune defenses and contributing to health deterioration (Richards & Kuhn, 2022).

NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation

Psychosocial and systemic factors also play a pivotal role in prolonging homelessness and its associated health challenges. Many individuals have histories of trauma. It includes domestic violence, childhood abuse, or combat-related PTSD, which contribute to long-term psychological distress. Limited mental health services leave many without proper treatment for conditions such as schizophrenia and depression. Substance dependence is often a means of coping, which further complicates efforts to regain stability (Schiffler et al., 2023). Structural barriers, including a shortage of affordable housing, extensive waitlists, and rigid eligibility requirements, obstruct pathways to permanent shelter.

Disciplinary policies that forbid sleeping in public spaces add to the distress of homeless individuals. It makes it even more difficult to access essential healthcare and social support (Rodriguez et al., 2021). Tackling these social determinants is crucial for policymakers, healthcare experts, and social service organizations to implement effective strategies that reduce homelessness and enhance health outcomes.

Strategies for Culturally Competent Nursing Care

Effective healthcare delivery for homeless individuals depends on a workforce that embraces cultural awareness and trauma-informed practices. Nurses must establish trust-based, trauma-sensitive relationships, as many persons experiencing homelessness have suffered severe adversity. Creating a compassionate, nonjudgmental care setting reduces stigma and encourages patients to seek medical attention (Crawford et al., 2022).

Beyond direct care, nurses should advocate policy reforms that enhance healthcare accessibility and expand housing assistance for homeless populations. Empathy is crucial in patient interactions. Healthcare providers must approach each individual’s circumstances with understanding and without bias. Implementing harm reduction strategies is vital in addressing substance use disorders. It includes initiatives such as naloxone distribution, access to sterile supplies, and medication-assisted treatment that can mitigate overdose risks and promote recovery. Prioritizing essential needs, including nutrition, hygiene, and shelter connections, lays the groundwork for successful medical interventions (McWilliams et al., 2022).

It fosters stability and trust between patients and providers. Mobile healthcare units and street outreach teams further bridge gaps in care by delivering immediate medical support to needy persons. Coordinated case management services are integral in linking homeless individuals to housing, employment, and sustained healthcare resources. Expanding telehealth services improves access to medical and mental health support in underserved areas (Garvin et al., 2022).

Communication Strategies for Effective Care

Clear and compassionate communication is essential for engaging homeless individuals in healthcare. Many face limited health literacy or cognitive difficulties, making it crucial to use simple, accessible language to enhance understanding. Histories of trauma, including abuse or institutional neglect, create barriers to trust. Nurses should adopt a patient-centered approach, avoiding language or behaviors that trigger distress. Demonstrating authentic empathy and actively supporting patients’ needs fosters meaningful connections and encourages participation in their care (Crane et al., 2023). Visual tools, verbal reinforcement, and interactive demonstrations improve comprehension and empower individuals to manage their health.

Case Study: Culturally Competent Nursing in Action

We have previously explored various obstacles that prevent homeless individuals from accessing healthcare. It includes stigma, adverse past experiences, and systemic barriers. Recognizing and addressing their specific needs is essential. The research examined the perspectives of homeless individuals regarding healthcare services provided through Case Study Sites (CSSs) compared to the treatment they received at their usual General Practitioner (GP) clinics (Crane et al., 2023). Alternative CSS models, such as Mobile Healthcare Teams and Specialist GP services, received higher ratings for accessibility, quality of care, and patient trust than conventional GP practices. Homeless individuals appreciated the CSS staff’s professionalism, respect, and nonjudgmental approach. In contrast, some patients at standard GP facilities reported feeling stigmatized. Key factors influencing their experiences included staff attitudes, service accessibility, and the availability of holistic support. Healthcare specialists must adopt a flexible, patient-centered approach to meet this population’s complex needs effectively. My perspective aligns with advocating for trauma-informed, compassionate care that fosters trust and facilitates sustained healthcare and social support.

Resources for Homeless Healthcare Support

Addressing healthcare challenges among homeless populations requires a network of essential resources. Healthcare services and supportive programs are crucial for individuals without stable housing. The National Health Care for the Homeless Council (NHCHC) plays a key role by offering medical and clinical resources, training initiatives, and advocacy efforts to improve healthcare accessibility for vulnerable groups (NHCHC, n.d.). Entry points for medical care within shelters and community health centers provide essential preventive care, wound management, and chronic disease treatment. Mental health initiatives and substance use recovery programs support homeless individuals by offering counseling, peer-led support, and Medication-Assisted Treatment (MAT) for those with co-occurring disorders.

The Substance Abuse and Mental Health Services Administration (SAMHSA) facilitates the Grants for the Benefit of Homeless Individuals (GBHI) program, which funds community-based organizations to deliver integrated mental health and addiction care services (SAMHSA, 2023). A leading example of specialized care is the VIP Community Services New York, which operates MAT services using buprenorphine or methadone alongside mental health support for individuals battling opioid addiction. Lastly, federal programs like Medicaid and Housing First are foundational pillars for delivering sustained healthcare and housing solutions. It ensures long-term stability and improved health outcomes (Sleet & Francescutti, 2021). 

The Role of Nurses in Advocacy and Policy Change

Nurses are vital in advocating for policies that expand affordable housing and healthcare access. They safeguard that legislation prioritizes the well-being of homeless populations. Their advocacy efforts help shape healthcare initiatives that target underserved communities. It emphasizes harm reduction and equitable service delivery (McWilliams et al., 2022). Nurses collaborate with social workers and local organizations to connect individuals to critical resources, including food, shelter, and mental health support. Nurses leverage their clinical expertise to push for policy reforms that address homelessness and healthcare inequities. It improves accessibility, combating stigma, fostering sustainable housing solutions, and bridging gaps in care.

Conclusion

This presentation offers a comprehensive exploration of the unique healthcare challenges the homeless population faces. It highlights key barriers, including mistrust, stigma, financial hardship, and logistical obstacles, all of which hinder access to healthcare. Nurses can address these issues through culturally sensitive and trauma-informed care, ensuring that care is compassionate, nonjudgmental, and patient-centered.

Several strategies for improving healthcare delivery include mobile healthcare units, telehealth services, harm reduction programs, and case management to link individuals to essential resources. This is a well-rounded approach to addressing homelessness in healthcare settings, highlighting the challenges and actionable solutions for improving health outcomes among this vulnerable population.

References

Crane, M., Joly, L., Daly, B. J., Gage, H., Manthorpe, J., Gaia Cetrano, 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

NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation

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. Nhchc.org. 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

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. Substance Abuse and Mental Health Services Administration 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

NURS FPX 4015 Assessment 4 Caring for Special Populations Teaching Presentation

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). National Library of Medicine. https://doi.org/10.3390/ijerph182111660 

United States Interagency Council on Homelessness. (2020). Homelessness Data & Trends. Www.usich.gov; United states interagency council on homelessness. https://www.usich.gov/guidance-reports-data/data-trends

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