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on 24 April 2015

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Homeless Culture
the homeless must depend on themselves to survive.
- the homeless appreciate conversation and social interactions because it makes them feel more accepted.
-a kind word, a smile or hello can brighten their day and let them know their presence is known.

Barriers to Healthcare
Cause of Homelessness
Loss of Job
Families Disown them
Run away teens
Abusive Relationships
Addiction to drugs
Mental illness
Natural Disasters
Mental illness
-schizophrenia, psychosis, bipolar disorders, depression, obsessive-compulsive disorder
Substance abuse
-drugs and alcohol
Diseases & physical health conditions
-HIV/AIDS, Hepatitis C, Hepatitis B, T.B., hypertension, diabetes, high cholesterol, stroke, heart disease, liver disease, kidney disease, cancer, asthma, frostbite, hypothermia, chronic digestive disease
Values, Cont

-maintaining hope helps make the homeless person's situation a bit more bearable.
Basic necessities
-the homeless are grateful for
food, shelter and clothes they receive.
Lack of funds/insurance
Lack of access to transportation
Embarrassment about appearance
Anxiety about completing healthcare forms
Lack of knowledge on where to get treated

Illness Among the Homeless
Without A Roof
Body or mouth odor
Unusual skin color, pallor
Poor hygiene
Soiled clothing
Frequent infections (e.g., upper respiratory infection [URI], urinary tract infection [UTI])
Frequent toothaches
Obesity or anorexia
Chronic fatigue
Apathetic attitude
Substance abuse
Gourdian G. (2015, January 1). The Inner Seed. Retrieved April 3, 2015, from http://www.theinnerseed.com/homeless-people-some-of-the-best-people-on-earth
Health Care and Homelessness. (2009, July 1). Retrieved April 3, 2015, from http://www.nationalhomeless.org/factsheets/health.html

Spotlight on The Homeless Population. (2010, March 29). Retrieved April 3, 2015,
from https://nursing322sp10.wordpress.com/spotlight-on-the-homeless-population/

Patient will improve knowledge on health maintenance by the end of student nurse shift AEB:
Patient will demonstrate interest in improving health status by keeping scheduled appointment at community outpatient clinic on 4/24/2015 at 1200 hours.

Patient will be able to identify 3 measures to reduce frequent infection on 4/24/2015 at 1200 hours.
Patient will be able to verbalize a minimum of 3 risk factors of substance abuse on 4/24/2015 at 1200 hours.
Assess the patient's learning style.
Assess for feelings of hopelessness, decreased sense of self-worth, thoughts of suicide.
Determine if patient's cultural beliefs contribute to current health status or way of living.
Provide patient with informative pamphlets on where to obtain free food, shelter and health care.
Educate patient on health risks involved with substance abuse. Also, teach patient about STD prevention measures.
"Each patient has his or her own learning style, which must be considered when designing a teaching program. Some persons may prefer written over visual materials, or they may prefer group versus individual instruction. Matching the learner's preferred style with the educational method will facilitate success in mastery of knowledge." (Gulanick/Myers, p. 124)
"Hopelessness is associated with dysfunctional personality characteristics as well as suicidal ideation and behaviors." (Gulanick/Myers, p. 99)
"Health teaching may need to be modified to be consistent with cultural or religious beliefs." (Gulanick/Myers, p. 94)
"Patients may not be aware of all the support services available to them that can help them move through this stressful situation (e.g., home care aides, financial assistance, free medications, community counseling programs, legal services, companion services)." (Gulanick/Myers, p. 99)
"Patients who abuse drugs and/or alcohol have a high risk for developing hypertension and stroke." Also, "condomns, when used correctly, can reduce the risk for transmission of most STDs." (Gulanick/Myers, p. 856, 979)
Gulanick, M. (2011). Nursing care plans: Diagnoses, interventions, and outcomes (7th ed.). St. Louis, Mo.: Elsevier Mosby

Patient was able to improve knowledge on health maintenance by keeping current appointment and by being able to identify specified health risks by 1200.
Overall Goal Met
They don't want to get a job.
They choose to be homeless.
They don't want to get help they just want money.
They are uneducated.
They are Lazy.
They all have drug and alcohol addictions.
1640-homelessness was seen as a character flaw, morally deficient-
1820-30-Industrialization led to displacement-
1850- poor safety regulations in factories led to disability and death.
1861-1865 (Civil war) - post traumatic stress syndrome
1870-1890- opiate addiction, morphine was first introduced.
1980- HUD cuts in early 1980s have led us to the homelessness as we know it today
presented by
Sarah Gilbert
Inez Miller
Elizabeth Mosely
Atyu Simon

Ineffective Health Maintenance R/T
Lack of support systems
Demonstrates lack of knowledge regarding basic health practices
Poor hygiene
Frequent infections
Substance abuse
Failure to keep appointments


Types of Homelessness
Transitional homeless
- Enter shelter system for short time, homeless when transferring from one home to another usually due to a catastrophic event.

Episodic homeless
-Those who frequently shuttle in and out of homelessness individuals often are chronically unemployed and experience medical, mental health, and substance abuse problems.
Chronic Homeless
- Older adults "hard-core unemployed." disabilities and substance abuse.

SEARCH Homeless Services
Star of Hope
"Positive life changes are encouraged through structured programs which focus on spiritual growth, education, employment, life management and recovery from substance abuse."
"Works to engage, stabilize, educate, employ and house individuals and families who are homeless."
Harris Health System
"Through a number of strategic partnerships, the Healthcare for the Homeless Program provides on-site mental health and substance abuse counseling."
There is no set language or dialect to the general homeless culture.
The homeless culture is divided into multiple subcultures, therefore, they speak the language of their origin.
Past history, educational background and social status all have an effect on an individuals way of communicating.
Furthermore, not all homeless individuals speak in broken grammar.

Religion in the homeless community varies from person to person.

The two major religions represented by the homeless are Christianity and Catholic.

Nursing Implication
Assess your own personal values & beliefs
Learn about the culture's unique needs
Treat each person as an individual & avoid stereotyping
Listen to the patient's stories
Ask simple open-ended questions
Physical and Psychosocial assessment

Gerber, L. (2013). Bringing home effective nursing care for the homeless.
Nursing made incredibly easy.
Lippincott Nursing Center.
Thank you for your participation!

Knowing Your Terminology
Bag lady
(noun impolite)
a woman who has no home and walks around the streets carrying everything hat she owns in bags.


someone without a home or job who moves from one place to another and ask people for food, work, or money.

Tent camp/city
a place where a lot of people live in tents because they lost their homes due to unfortunate events.


a child who has no home.


someone who travels from place to place because they don't have a home or job.

Personal Appearance
Many homeless people dress in regular clothing.

They make the best out of what they have and what is given to them.

Some clothes may not fit comfortably and some may not be in the best of shape.

Clothes may appear worn out or dirty.

Also, some people may be missing certain articles of clothing.
Fischer R. The history of homelessness in America 1640's-present www.dceh.org.the-history-of-homelessness-in -America-1640s-to -present/
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