Capella FPX 4015 Assessment 4

Capella FPX 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

Welcome to the presentation. Homelessness is a growing public health crisis that affects millions of individuals worldwide. Homeless and housing-insecure individuals face significant barriers to healthcare, including a lack of access to medical services, mental health support, and preventive care (Bedmar et al., 2022). This presentation explores this population’s cultural values and beliefs, the healthcare disparities they experience, and strategies for providing culturally competent nursing care. Through real-life case studies, we will examine how nurses can better support homeless individuals and improve health outcomes. Finally, we will highlight resources for further learning, equipping healthcare providers with the knowledge to deliver compassionate, equitable care.

Introduction to the Special Population Group

Homelessness is a complex social and public health issue affecting millions of individuals worldwide. From 2018 to 2022, approximately 327,000 individuals in the United States experiencing homelessness resided in shelters, representing a small fraction (0.1%) of the country’s population (Glassman, 2024). Homelessness results from various factors, including poverty, unemployment, lack of affordable housing, mental illness, and substance use disorders. Housing insecurity exists on a spectrum, ranging from individuals who are temporarily displaced to those living chronically without stable shelter. Many homeless individuals experience frequent transitions between shelters, streets, temporary housing, or overcrowded living conditions with family or friends. These unstable living situations contribute to poor health outcomes due to exposure to extreme weather, lack of hygiene facilities, food insecurity, and limited access to healthcare (Fornaro et al., 2022). 

Many homeless individuals suffer from chronic health conditions, untreated mental illness, and substance use disorders exacerbated by limited access to consistent medical care. Healthcare providers play a critical role in addressing the needs of this vulnerable population by implementing culturally competent, trauma-informed, and accessible care strategies. Understanding the unique challenges homeless individuals face is essential for improving their health outcomes and reducing disparities (Fornaro et al., 2022). Thus, the presentation explores the cultural values, healthcare disparities, and best practices for providing effective nursing care to homeless individuals.

Cultural Values and Beliefs Relevant to Healthcare

Although homeless individuals come from diverse cultural backgrounds, they share a common experience of housing insecurity that shapes some values and beliefs that affect their interactions with healthcare providers. Self-reliance is one of the key values, because many of the homeless people have learnt to live their lives with very little support. This may cause reluctance to seek medical care, especially if they have been stigmatized or discriminated against in health care practices (Gilmer & Buccieri, 2020). Another belief is that there is a distrust of institutions, such as hospitals and clinics. Exposed to various hands of the healthcare system, many homeless have felt alienated and skeptical of medical recommendations and now have few positive experiences revolving around healthcare, law enforcement, or social services. Past experiences of being dismissed, judged (Gilmer & Buccieri, 2020), or receiving inadequate care because one does not have insurance may reinforce this distrust. 

They also include those homeless who give precedence to immediate survival over long-term health by first obtaining food, shelter, and safety with little concern about preventive care or managing chronic illnesses. Additionally, there is mental health stigma, and untreated conditions such as depression and PTSD may keep individuals from seeking necessary support (Gilmer & Buccieri, 2020). Nurses and healthcare providers need to understand these values and beliefs to provide culturally competent care, build trust with homeless individuals, and provide compassionate, nonjudgmental, and accessible healthcare services.

Healthcare Disparities Faced by Homeless Individuals

Homeless individuals face severe healthcare disparities due to economic instability, limited healthcare access, social isolation, and environmental risks—all key social determinants of health (SDOH). 

• Financial instability, including unemployment and poverty, prevents many homeless individuals from affording healthcare, medications, or nutritious food (Flaubert et al., 2021), worsening chronic conditions like diabetes, hypertension, and respiratory diseases. 
• Limited healthcare access is a major barrier, as many homeless individuals lack health insurance, transportation, or identification needed for medical services. Even when care is available, stigma and discrimination from providers can discourage them from seeking help (Gilmer & Buccieri, 2020). This results in preventive care neglect, leading to untreated chronic illnesses, infections, and mental health disorders. 
• Social isolation and lack of support systems contribute to poor health outcomes. Many homeless individuals suffer from untreated mental illnesses such as depression, PTSD, and schizophrenia. Without access to consistent mental health services, these conditions often worsen, increasing the risk of substance use and self-neglect (D’Souza & Mirza, 2021).
• Environmental factors also play a role in health disparities. Exposure to extreme weather, violence, and unsanitary living conditions increases the risk of infections, wounds, and physical injuries. Addressing these disparities requires integrating healthcare with housing programs, expanding mobile health services, and promoting trauma-informed, culturally competent care.

Strategies for Culturally Competent Nursing Care

Providing culturally competent care to homeless individuals requires a patient-centered, nonjudgmental, and trauma-informed approach. Nurses should first build trust by demonstrating respect, active listening, and empathy. Many homeless individuals have faced discrimination in healthcare settings, so a welcoming and non-stigmatizing attitude can encourage engagement (D’Souza & Mirza, 2021). Ensuring accessibility is another key strategy. Offering flexible appointment scheduling, walk-in services, and mobile health clinics can help homeless individuals receive timely care. Nurses can also advocate for partnerships with shelters, food banks, and outreach programs to connect patients with essential resources.  

A trauma-informed approach is essential when caring for this population. Recognizing that many homeless individuals have experienced abuse, violence, or neglect helps nurses approach interactions with sensitivity (Dobischok et al., 2024). Simple actions like explaining procedures in advance, providing choices in care, and ensuring a safe, private environment can reduce anxiety and promote trust. Health education should also be adapted to meet the needs of homeless individuals. Providing practical, low-cost health management strategies and written instructions in simple language or visual formats can improve adherence to treatment plans. Lastly, collaborating with interdisciplinary teams, including social workers, mental health professionals, and community organizations, ensures a holistic approach to care that addresses medical and social health determinants.

Case Study: Culturally Competent Nursing in Action

Several case studies illustrate the culturally competent care provided to homeless individuals in the United States. These include:

Case Study 1: Street Nursing in Southern Oregon

In Southern Oregon, a street nursing program was developed to provide healthcare directly to people experiencing homelessness. This initiative employed a trauma-informed, culturally appropriate approach, recognizing the unique challenges faced by this population (OHSU School of Nursing, n.d.). Nurses received specialized training to address the tri-morbidity often seen in homeless individuals, co-occurring psychiatric disorders, substance use disorders, and chronic medical conditions. By delivering care in familiar environments and building trust through consistent, respectful interactions, the program improved health outcomes and advanced health equity among homeless individuals.

Case Study 2: Mobile Substance-Use Treatment in Portland

In Portland, Oregon, a mobile medical unit was introduced to provide substance-use treatment directly to unhoused residents (Post, n.d.). This initiative aimed to eliminate barriers such as transportation challenges often preventing homeless individuals from accessing care. By bringing services like buprenorphine and methadone administration to the streets, the program addressed the immediate needs of individuals with opioid use disorder. Plans are underway to expand this mobile clinic service across Oregon, including rural areas and Native American lands, demonstrating a commitment to culturally competent, accessible care. 

These case studies underscore the importance of culturally competent care tailored to the unique needs of homeless individuals. By integrating cultural understanding, trauma-informed practices, and accessible services, healthcare providers can effectively address health disparities within this vulnerable population. 

Resources for Further Learning 

Nurses seeking to expand their knowledge of homelessness and culturally competent care can utilize various educational resources, training programs, and professional organizations.

1. The National Healthcare for the Homeless Council (NHCHC) offers webinars, research publications, and clinical guidelines on addressing the unique healthcare needs of homeless individuals. Their Medical Respite Care Toolkit and Cultural Humility Training are valuable for direct care nurses (NHCHC, 2021). 
2. The Centers for Disease Control and Prevention (CDC) provides data and guidelines on managing infectious diseases common among homeless populations, including tuberculosis and hepatitis. Their resources help nurses understand public health interventions for vulnerable populations. 
3. The American Nurses Association (ANA) and Sigma Theta Tau International (STTI) offer continuing education courses on trauma-informed care and social determinants of health. 
4. Online courses from ANA and CDC provide free and affordable learning opportunities on healthcare equity and culturally responsive nursing practices (Nurse Journal, 2025). 
5. Local organizations, including shelters, free clinics, and street medicine programs, allow nurses to gain hands-on experience in homeless healthcare through volunteering and community outreach.  

By engaging in these resources, nurses can develop critical skills in advocacy, culturally competent care, and interdisciplinary collaboration to improve health outcomes for homeless individuals.

Conclusion

In conclusion, caring for homeless people requires a caring, culturally competent, multidisciplinary approach. The unique cultural values, healthcare disparities, and social determinants of health add to nurses’ understanding of the importance of providing respectful, effective care. Nurses can enhance health outcomes for this vulnerable population by utilizing trauma-informed communication strategies and addressing barriers to health care and community resources. The role of mobile clinics, street nursing, and harm reduction programs in bridging care gaps is highlighted through case studies. The professional organizations and training programs help nurses continuously learn nursing skills. Encouraging appropriate healthcare for homeless people benefits public health and nursing practice in 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 

Capella FPX 4015 Assessment 4

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 

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, 11(11), 215013272091028. https://doi.org/10.1177/2150132720910289 

Capella FPX 4015 Assessment 4

Glassman, B. (2024, February 27). New survey data provides demographic profile of population experiencing homelessness who lived in emergency and transitional shelters. Census.gov. https://www.census.gov/library/stories/2024/02/living-in-shelters.html

NHCHC. (2021, March 3). Medical respite care tool kit. National Health Care for the Homeless Council; nhchc.org. https://nhchc.org/resource/medical-respite-recuperative-care-tool-kit/

Nurse Journal. (2025, February 24). Free online nursing courses & classes you can take right now. 2019 NurseJournal.org. https://nursejournal.org/articles/online-nursing-courses-you-can-take-for-free/ 

OHSU School of Nursing. (n.d.). Street nursing team. Ohsu.edu. https://www.ohsu.edu/school-of-nursing/street-nursing-team

Post, P. (n.d.). Mobile health care for homeless people: Using vehicles to extend care. nhchc.org. https://nhchc.org/wp-content/uploads/2019/08/mobilehealth-1.pdf 

 

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