Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 33 Homelessness

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Homelessness Prevalence Challenges associated with homelessness Causes

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Historical Development of Homelessness Great Depression and World Wars 1950s 1960s 1970s

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Recent Developments 1980s 1990s 2000s Who are the homeless?

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Etiology of Homelessness Economic influences Social influences Personal influences Political influences

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Impact of Homelessness Individual  Powerlessness  Low self-esteem  Trapped in a vicious cycle

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Impact of Homelessness (cont.) Family  Single parent families at risk  Link with domestic violence  Effects on parent  Effects on children  Effects on elders

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Impact of Homelessness (cont.) Community  Community concern  Intervention strategies

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in Homeless Populations Nutritional deficiencies  Impact on development of illness  Inability to consume a balanced diet Peripheral vascular disease  Increased risk for leg ulcers, cellulites  Risk factors

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in the Homeless Chronic conditions  Challenge managing chronic conditions  Greater risk for acute illness

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in the Homeless (cont.) HIV/AIDS infection  Disease management concerns Infectious diseases  Tuberculosis  Risk factors

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in Homeless Populations Thermoregulatory disorders  Hypothermia  Frostbite  Burns  Heat-related illnesses

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in the Homeless Infestations  Living conditions Alcoholism and substance abuse  Early treatment  Promote recovery  Remove treatment barriers

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Problems Common in the Homeless (cont.) Mental Illness Trauma Childhood Illnesses

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 International Perspective Prevalence Vulnerable groups Trends

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Responses to the Problem Private sector  Shelters  Soup kitchens  Outreach vans  Day programs

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Responses to the Problem (cont.) Public sector  Local  State  Federal

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Nursing Care of Homeless People Healthy People 2010 Intervention strategies  Housing assistance  Nurse managed clinics  Improving access to health care

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Care for the Homeless - Challenges Priority placed on obtaining food and shelter Fear of institutionalization Embarrassment to seek care Fragmentation of care Lack of financial resources

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Health Care for the Homeless – Challenges (cont.) Follow-up care Lack of transportation Lack of permanent address

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Nurse’s Role in Prevention Primary  Care for homeless where they congregate  Outreach  Interventions Direct care Education and referral

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Nurse’s Role in Prevention (cont.) Secondary  Early detection  Disability prevention Tertiary  Treatment of chronic illness

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Application of Nursing Theories Henderson  Mutual understanding Watson  Human to human caring

Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 33 Key Concepts Increasing prevalence of homelessness Homeless are diverse Homeless at greater risk for illness Limited access to health care Plan with the homeless client