[hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]Rates of homelessness are rising across the U.S. due to a lack of affordable housing.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]People experiencing homelessness experience barriers to healthcare including poor transportation, discrimination, substance misuse, and poor mental health.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Nursing care for homeless patients must begin by addressing the common lack of trust while prioritizing needs, and advocating on a micro and macro level.[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-text variant=”b4″]The number of people experiencing homelessness is rising faster than in past years, primarily due to a lack of sufficient income and affordable housing. According to data gathered by [hen-ui-link href=”https://www.wsj.com/amp/articles/homeless-numbers-rise-in-u-s-cities-fd59bc7b” target=”_blank”]The Wall Street Journal[/hen-ui-link] from 150 organizations that count people experiencing homelessness, the numbers indicate a sharper climb than in recent years, underscoring growing pressure from rising costs.[/hen-ui-text][hen-ui-text variant=”b4″]According to the [hen-ui-link href=”https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness/” target=”_blank”]National Alliance to End Homelessness[/hen-ui-link], the U.S. has experienced a 6% rise in homelessness since 2017, with record highs reached in 2022. As of January 2022, over 580,000 people in the U.S. were experiencing homelessness.[/hen-ui-text][hen-ui-text variant=”b4″]Nurses must face the challenges of providing care for patients who are homeless, houseless, unhoused, or unsheltered, often without adequate healthcare resources. Let’s briefly consider some of the barriers to care before offering several tips nurses can use to care for these patients.[/hen-ui-text][hen-ui-heading variant=”h2″]Barriers to Care for People Experiencing Homelessness[/hen-ui-heading][hen-ui-text variant=”b4″]Several barriers limit access to care for those experiencing homelessness, which can be nearly [hen-ui-link href=”https://onlinelibrary.wiley.com/doi/10.1111/phn.12552″ target=”_blank”]one-half million people[/hen-ui-link] on any given night. These barriers can make it difficult to access proper healthcare and increase the risk of chronic disease and premature death. Some of those barriers include:[/hen-ui-text][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]Poor access to reliable transportation[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Discrimination[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Poverty[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Lack of reliable access to clean water and electricity[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Substance misuse[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Poor mental health[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Negative past healthcare experiences[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Competing life priorities such as housing, safety, or transportation[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Lack of trust in healthcare providers and poor therapeutic relationships[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Affordability[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-text variant=”b4″]Nurses working with these vulnerable populations often witness the results of these challenges when patients arrive at the hospital for care in poor physical and mental condition. Some healthcare providers are also not aware of the barriers that exist for individuals experiencing homelessness.[/hen-ui-text][hen-ui-text variant=”b4″]For example, when care includes medication that requires refrigeration or washing and changing a wound twice daily, it may not occur to the provider that the patient does not have access to consistent refrigeration or clean running water.[/hen-ui-text][hen-ui-text variant=”b4″]Those experiencing homelessness may not have a safe place to store their medication or wound supplies, and they may not follow recommendations when they do not trust healthcare providers.[/hen-ui-text][hen-ui-heading variant=”h2″]Tips for Caring for Patients Experiencing Homelessness[/hen-ui-heading][hen-ui-text variant=”b4″]Whether patients seek general healthcare or urgent treatment, nursing care for patients who are homeless requires an adept response to their living situation, compassion, and advocacy. These tips help healthcare clinicians address the healthcare needs of those experiencing homelessness directly and champion outreach programs that help them make healthier choices.[/hen-ui-text][hen-ui-heading variant=”h3″]Use a Holistic Nursing Approach[/hen-ui-heading][hen-ui-text variant=”b4″]Data demonstrates that [hen-ui-link href=”https://onlinelibrary.wiley.com/doi/10.1111/phn.12552″ target=”_blank”]nurse-led models of healthcare[/hen-ui-link] for those experiencing homelessness improve patient outcomes. Using a holistic nursing approach can help ensure optimal treatment for patients experiencing complex mental, physical, and social health problems.[/hen-ui-text][hen-ui-heading variant=”h3″]Establish Trust[/hen-ui-heading][hen-ui-text variant=”b4″]The first step to providing quality care is establishing trust. Listening to the patient and finding ways to bridge gaps is crucial for the healthcare provider’s understanding of how people experiencing homelessness care for themselves.[/hen-ui-text][hen-ui-heading variant=”h3″]Assess Both Immediate and Long-term Needs[/hen-ui-heading][hen-ui-text variant=”b4″]Nursing care for patients who are homeless must include prioritizing their immediate and long-term needs to make positive health-related changes and improve their quality of life. By using simple approaches, nurses can take the first steps in initiating case management, treatment for substance use, access to housing, or income assistance.[/hen-ui-text][hen-ui-heading variant=”h3″]Provide Trauma-Informed Care[/hen-ui-heading][hen-ui-text variant=”b4″]Using a trauma-informed approach, nurses can assist those experiencing homelessness in accessing medical homes or advocating for a broader approach to this societal challenge.[/hen-ui-text][hen-ui-heading variant=”h3″]Advocate for Patients[/hen-ui-heading][hen-ui-text variant=”b4″]Advocacy happens on the micro and macro levels. [hen-ui-link href=”/articles/how-to-advocate-for-patients/”]Nurses advocating[/hen-ui-link] for individuals who are homeless can help provide necessary items and services, such as clothing, phone calls, transportation, job opportunities, and survival kits containing items for cold and hot weather.[/hen-ui-text][hen-ui-text variant=”b4″]Through fundraising and working with corporate sponsorship, nurses can have a significant impact on their immediate geographical area. On a macro level, advocacy can focus on addressing the systemic causes to create lasting and permanent change. For example, working to bridge the housing gap through legislative change or organizing housing situations for large groups.[/hen-ui-text][hen-ui-heading variant=”h2″]Resources for Nurses and Caregivers[/hen-ui-heading][hen-ui-accordion variant=”no-background”] [hen-ui-accordion-item title=”Sources”] [hen-ui-text-stack gap=”sm”] [hen-ui-text variant=”b4″]Kamp J, et al. [hen-ui-link href=”https://www.wsj.com/amp/articles/homeless-numbers-rise-in-u-s-cities-fd59bc7b” target=”_blank”]Homeless Numbers Rise in U.S. Cities[/hen-ui-link]. (2023). WSJ[/hen-ui-text][hen-ui-text variant=”b4″][hen-ui-link href=”https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness/” target=”_blank”]State of Homelessness: 2023 Edition[/hen-ui-link]. (2023). The National Alliance to End Homelessness[/hen-ui-text][hen-ui-text variant=”b4″]Weber, J. [hen-ui-link href=”https://onlinelibrary.wiley.com/doi/10.1111/phn.12552″ target=”_blank”]A systematic review of nurse-led interventions with populations experiencing homelessness[/hen-ui-link]. (2018). Wiley[/hen-ui-text] [/hen-ui-text-stack] [/hen-ui-accordion-item][/hen-ui-accordion][hen-ui-text variant=”b4″]Page last reviewed August 8, 2023[/hen-ui-text]