SDSU School of Nursing: CNSA-Committee on Cultural Awareness

March, 2012 ISSUE 4

Homeless
California Statistics (# of Homeless people): 188,300 total in California -24,000 are Veterans -17,700 are children <18

CNSAs'Committee'on'Cultural' Awareness'(CCA)'aims'to'increase' cultural'competency'to'help' eliminate'culture'related' healthcare'disparities'between' patient'and'provider.'The'CCA' presents'to'you'our'4th'issue'on'' the'homeless'population.''

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How'to'treat'your'homeless' patient:''

FMake!your!homeless!patient!feel! like!a!person! FMake!eye!contact! FBe!compassionate!! FNonFjudgmental!interactions! FBe!a!good!listener!! FAllow!the!patient!time!to!answer!! questions! FGive!simple!explanations!and! summarize!information!!given!to!help! them!understand! FGive!patient!ample!time!to!tell!you! about!his/her!situation! FElicit!info!about!patients!perception! about!their!illness! FTailor!questions!to!patients!housing! and!behavioral!situation! FQuestion!about!family!and!social! relationships!and!possibility!for! reconnection!

Home!Again!SD.org:!Supportive! housing:!$10,000/person/year!vs.! saving!millions!in!healthcare!costs!for! homeless.! According!to!SD!Rescue!Mission,! some!hospitals!delay!release!of! homeless!patients!for!costly!days! because!they!cant!find!somewhere! to!go.!! !

Where'do'they'go'for'care?:'
43%!Clinic! 25%!ER! 17%!Do!not!go!for!care!

Violence:'

92%!of!homeless!women!have! experienced!severe!physical!or!sexual! abuse.! !

Military:'

' Financial'Considerations:' ' Reasons'for'homelessness:'! 37%!Unemployment! 10%!Eviction/Foreclosure! 10%!Drugs! 8%!Alcohol! 7.8%!Choose!to!be!homeless! 4%!Runaway!from!home!
Please'email'Mitzi'Albano'at:' mitzi.albano@yahoo.com'' if'you'would'like'to'become' involved'with'the'CCA.'

According!to!2010!New!England! Journal!of!Medicine!homeless!people! spend!4!days!longer!in!the!hospital! comparable!to!nonFhomeless!people.' Extra!cost:!$2,414/hospitalization!! ! *Continuing!our!current!path!(doing! nothing)!is!much!more!expensive! than!moving!a!homeless!off!the! street.!

Approximately!1/3!of!military! homeless!served!in!the!Vietnam!War! (August!1964FApril!1975).!

Interesting Fact:
According to CNN, 1/50 children are homeless. !

Nursing Considerations
Lorem Ipsum

Discharge'Teaching:'

FBe!as!thorough!in!your!discharge! teaching!as!you!would!with!any! patient! FLook!at!the!patient!as!an!individual! and!determine!how!compliant!they! are!with!changing!their!lifestyle! FIf!nonFcompliant,!suggest!resources! that!are!applicable!to!that!patient! FPhysical!health!and!access!to!health! care!resources! FThe!key!to!a!successful!discharge!plan! is!to!build!a!trusting!relationship!with! the!patient!so!you!can!develop!a!plan! that!fits!within!the!reality!of!his!or!her! daily!life! FUsing!a!compassionate!approach! helps!build!trust' !

Hospital'Hopping:'

Student'Nurse'Considerations:' HTalk!to!your!clinical!instructor!if!you!

Many!homeless!people!become! frequent!flyers!at!hospitals,! especially!during!the!month! before!death.! Research!has!found!that!when! healthcare!givers!spend!time! talking!with!homeless!patients! and!hearing!about!their!lives,! patient!satisfaction!improves!and! repeat!hospital!visits!decrease.!By! providing!compassionate!care!for! homeless!patients!and!using! specific!strategies!for!their! assessment!and!discharge! planning,!nurses!can!help! homeless!adults!manage!their! chronic!diseases!and!prevent!early! death.!!

Window'into'the'life'of'a' homeless'person:'

Below!is!a!website!of!homeless! people!helping!homeless!people:! www.homelessforums.org! Here!is!an!excerpt!from!one!of!the! forums!titled!Before!You!Runaway:! ! Please,!please!talk!to!somebody.!A! teacher,!a!friend,!a!minister,!even! Joe!Schmo!from!the!grocery!store,!I! don't!care.!You!do!not!want!to!do! this,!darlin'.!I!know!that!some!of!our! posts!make!being!homeless!sound! almost!like!an!adventure,!a! temporary!condition!that!we!can! easily!pull!ourselves!out!of,!but!for!a! lot!of people,!its!not!temporary,!and! its!not!easy!on!anybody.!When! you're!a!kid,!and!female,!its!even! worse.! Remember,'always'keep'an'open' mind'and'a'compassionate'heart.'

feel!uncomfortable!working!with!the! homeless! FDont!be!scared!to!approach! someone!to!express!how!you!feel! FWork!together!to!resolve!the! problem! FIf!you!find!yourself!avoiding!your! homeless!patient,!identify!reasons!for! your!avoidance!and!seek!guidance!to! resolve!the!issue!' FBe!empathetic,!compassionate,! volunteer,!inform!and!advocate!! '

What'can'you'do?' HBecome!familiar!with!homeless!

clinics!in!your!area! FEducate!yourself!! FDeal!with!your!personal!biases!! FIndividualize!treatment!plans!while! taking!into!considerations!cause!of! their!homelessness' FWork!with!case!managers,!social! work!and!charge!nurses!to!help! prevent!unnecessary!reF hospitalization! !
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Mental>Illness'among' homeless:'

National!Coalition!for!the! Homeless!estimate!20F25%!of! single!adult!homeless!persons! suffer!some!form!of!mental!health! illness.!! 40%!Major!Depression! 39%!Bipolar!Disorder! 21%!Schizophrenia! 15%!PTSD! 10%!ADHD!

Be kind, for everyone you meet is fighting a harder battle. -Plato