Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Hello everyone, and thank you for joining today’s session. This presentation focuses on delivering care to special populations, particularly individuals experiencing homelessness. We will explore the challenges they face, cultural considerations, healthcare disparities, and strategies for providing compassionate, culturally competent care.
Individuals who experience homelessness or housing instability face significant challenges that affect their health, safety, and access to healthcare. Many live in precarious conditions, such as shelters, vehicles, tents, or temporarily with friends, experiencing daily stress, danger, and uncertainty. According to the U.S. Department of Housing and Urban Development (HUD), nearly 653,100 individuals in the United States experienced homelessness on a single night in 2023 (Glassman, 2024).
This presentation emphasizes understanding the unique healthcare needs of people experiencing homelessness, including cultural considerations, social determinants of health, and the nurse’s role in delivering culturally sensitive and effective care. The ultimate goal is to identify practical interventions that improve health outcomes and overall quality of life for this population.
Individuals experiencing homelessness or housing insecurity often lack stable and safe housing. Some may live in shelters, cars, or on the street, while others move frequently between temporary accommodations. Housing insecurity includes challenges such as difficulty paying rent, overcrowded living conditions, or risk of eviction (Volunteers of America, n.d.). These living conditions often deprive individuals of basic necessities, including access to food, water, and healthcare.
Living without stability has significant implications for both physical and mental health. Individuals often struggle to follow treatment plans, access medications, or maintain regular medical appointments. Chronic health conditions such as diabetes, heart disease, depression, and anxiety are common (SAMHSA, 2025). Poor nutrition, inadequate sleep, and high stress exacerbate these conditions.
Nurses play a critical role in caring for this population. Providing compassionate, nonjudgmental, and culturally aware care requires understanding the social, economic, and psychological factors that contribute to homelessness (Currie et al., 2023). Empathy, patience, and respectful communication help build trust and create positive interactions that can improve health outcomes.
People experiencing homelessness come from diverse backgrounds, including varying cultural, linguistic, and religious identities. Some may be veterans, others may have experienced trauma early in life, and many value independence and privacy due to survival needs (Šimon et al., 2024). Trust is a crucial factor in healthcare interactions, as past experiences with institutions such as law enforcement, healthcare systems, and social services may have been negative.
| Consideration | Explanation |
|---|---|
| Respect for autonomy | Many individuals value independence and may be uncomfortable relying on others for assistance. |
| Trauma history | Past experiences can affect willingness to trust healthcare providers. |
| Spirituality | Engagement in spiritual practices can provide comfort during difficult times. |
| Family connections | Some individuals may be estranged from family, influencing emotional well-being. |
| Communication | Asking permission before physical contact and listening attentively demonstrates respect and builds trust. |
By acknowledging these cultural and personal values, nurses foster dignity, respect, and trust. Such approaches improve patient engagement, adherence to care, and overall outcomes.
Homeless individuals face significant gaps in healthcare access. Many lack insurance, cannot afford care, and encounter barriers such as transportation issues, missing identification, and long clinic wait times. These challenges often delay care until illnesses worsen. Additionally, fear, shame, and prior negative experiences can prevent individuals from seeking treatment (Vohra et al., 2022).
Common health challenges in this population include:
| Health Issue | Description |
|---|---|
| Chronic illness | Higher prevalence of diabetes, hypertension, heart disease. |
| Infectious diseases | Increased risk of HIV, tuberculosis, and other infections. |
| Mental health disorders | Depression, anxiety, PTSD, and other psychiatric conditions. |
| Substance use | High rates of substance use as a coping mechanism. |
| Environmental risks | Exposure to cold, unsafe sleeping conditions, and malnutrition exacerbate health problems. |
Healthcare systems are often unprepared to meet the unique needs of homeless individuals. Standard treatment plans assume stable living situations, access to refrigeration for medications, and regular meals—assumptions that often do not apply. This results in missed follow-up care, reduced trust, and increased reliance on emergency departments (Vohra et al., 2022).
Providing effective care to people experiencing homelessness requires trust, respect, and flexibility. Nurses should:
Approach patients with a friendly, respectful demeanor to foster safety and trust.
Practice active, nonjudgmental listening to validate the patient’s experiences (Currie et al., 2023).
Use clear, plain language to enhance understanding, particularly for individuals with low literacy or cognitive challenges.
Deliver flexible care, such as mobile clinics, walk-in hours, or on-site services at shelters.
Implement trauma-informed care, explaining procedures, obtaining consent, and offering choices to reduce re-traumatization (Cochran et al., 2022).
Collaborate with social services, housing providers, and mental health professionals to support the individual holistically.
Include peers with lived experience on care teams to increase trust and demonstrate recovery possibilities.
Culturally competent care addresses both health disparities and the basic needs of individuals, creating a foundation for equitable and respectful treatment.
A nurse-managed outreach program in Czechia exemplifies successful care for homeless individuals. Nurses provided primary care in shelters and community spaces without requiring appointments or insurance cards (Currie et al., 2023). Initially, many individuals had avoided healthcare for years due to negative experiences. Through consistent presence, empathy, and collaboration with housing and social services, trust was built.
The program reduced emergency room visits, improved timely care, and allowed physicians to be compensated for additional time spent with complex patients (Šimon et al., 2024). This approach highlights how nurse-led, person-centered care can enhance dignity, trust, and health outcomes for vulnerable populations.
Healthcare professionals can access several organizations and resources to enhance care for homeless populations:
| Organization | Resources Offered | Contact |
|---|---|---|
| National Alliance to End Homelessness | Data, policy updates, strategies, webinars | 1518 K Street NW, 2nd Floor, Washington, DC 20005; (202) 638-1526; dessrow@naeh.org |
| Volunteers of America | Housing, healthcare, mental health, and addiction programs | 1660 Duke Street, Alexandria, VA 22314; (703) 341-5000; voa.org |
| HUD | Educational materials, funding programs, supportive housing guidance | hud.gov |
| SAMHSA | Toolkits, grant opportunities, trauma-informed care resources | hhs.gov/samhsa |
Engaging with these resources promotes professional development, reduces stigma, and improves care quality for individuals experiencing homelessness.
Providing care for individuals experiencing homelessness demands compassion, flexibility, and cultural sensitivity. Nurses play a pivotal role in addressing both medical and social needs, building trust, and advocating for vulnerable populations. Recognizing the influence of past trauma, cultural values, and systemic barriers supports respectful and effective care. Nurse-led outreach and collaborative community partnerships demonstrate that meaningful change is possible. Continuous learning, advocacy, and empathy help nurses improve health, dignity, and equity for those experiencing homelessness.
Cochran, A. L., McDonald, N. C., Prunkl, L., Brusher, E. V., Wang, J., Oluyede, L., & Wolfe, M. (2022). Transportation barriers to care among frequent health care users during the COVID pandemic. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-14149-x
Currie, J., McWilliams, L., Paisi, M., Shawe, J., Thornton, A., Larkin, M., Taylor, J., & Middleton, S. (2023). Nurses’ perceptions of the skills, knowledge, and attributes required to optimize the scope of practice and improve access to care for people experiencing homelessness in Australia: A cross-sectional study. Collegian, 30(4), 586–594. https://doi.org/10.1016/j.colegn.2023.02.002
Glassman, B. (2024, February 27). A demographic profile of the population experiencing homelessness. Census.gov; United States Census Bureau. https://www.census.gov/library/stories/2024/02/living-in-shelters.html
National Alliance to End Homelessness. (2025). Home. National Alliance to End Homelessness. https://endhomelessness.org/
Šimon, M., Latečková, B., & Potluka, O. (2024). Health and healthcare use of the homeless population: Evaluation study of joint social work and healthcare provision. International Journal of Nursing Studies, 161(104929), 104929. https://doi.org/10.1016/j.ijnurstu.2024.104929
Substance Abuse and Mental Health Services Administration (SAMHSA). (2025). Homelessness programs and resources. https://www.hhs.gov/press-room/samhsa-announces-19m-supplemental-funding-strengthen-housing-capacity-homeless-people-serious-mental-illness.html
Vohra, N., Paudyal, V., & Price, M. J. (2022). Homelessness and the use of emergency departments as a source of healthcare: A systematic review. International Journal of Emergency Medicine, 15(1). https://doi.org/10.1186/s12245-022-00435-3
Volunteers of America. (n.d.). Home page. Volunteers of America: National. https://www.voa.org/
