There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
The lack of shelter creates many health hazards for the homeless and the lack of regular health care exacerbates chronic illnesses and fosters poor health practices within this group. Homeless children lack immunizations, evidence developmental delays and have increased school related health problems. Nursing, along with other health care professions, is concerned about health care available for the homeless. Schools of nursing and individual nurses have joined with other health care providers in developing special programs to meet the needs of this population. These providers have now documented specific information about the composition of the homeless as a group and their health care needs. This book provides a national perspective of nurses' service delivery, research and experiences in working with the homeless.
This volume highlights the socioeconomic concerns related to medical care for homeless patients and places them at the interface of common psychiatric and medical problems clinicians encounter. Written by experts in psychiatry and other medical specialties, this volume is a concise, yet comprehensive overview of the homeless crisis, its costs, and ultimately, best practices for improved outcomes. The text begins by examining the scope and epidemiology of the problem and discusses its costs. It then examines the best practices for both physical and psychiatric care before concluding with a section on working with special populations that have unique concerns across the country including LGBTQ, women, children, veterans, and aging adults. As the first medical book on homelessness, it is designed to cover a broad range of concerns in a concise, practical fashion for all clinicians working with homeless patients. Clinical Management of the Homeless Patient is written by and for psychiatrists, general internists, geriatricians, pediatricians, addiction medicine physicians, VA physicians, and all others who may encounter this crisis in their work.
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
"Brings together leading and emerging researchers to advance understanding of the complex relationships between homelessness and health. Covering a wide range of topics from youth homelessness to end-of-life care, contributors outline policy and practice recommendations to respond to this public health crisis."--Back cover.
A nurse’s field guide to improving health outcomes for distinct patient populations This practical text is distinguished by its in-depth coverage of populations, ranging from opioidaddicted veterans to young children suffering from obesity. Focused on the educational needs of students in undergraduate and bridge programs, this book is grounded in evidence-based practice, in-depth content, and clinical case studies. Five sections address population health in the following settings: community-based care, home and rural health, school-based and primary care, medical home and palliative care, and acute and long-term care. Each section begins with an overview chapter addressing fundamental concepts, characteristic trends, expenditures, and critical considerations. Subsequent chapters provide descriptions of varied patient populations, relevant care settings, and examples of the RN’s role within each setting. Chapters conclude with a case study that illustrates a day in the life of a typical nurse, which includes assessment and evaluation of present symptoms, demographic information, social and environmental determinants, and medical background. Chapters also encompass advocacy and policy roles, care access, emergency preparedness, and community resiliency. Key Features: Focuses on the needs of students in undergraduate and bridge programs Provides specific examples and context using a “population of interest” approach Exposes nurses and future nurses to a multitude of diverse work settings Case studies are written from the nurse’s perspective Addresses current medical issues among populations with an emphasis on practical content application Grounded in evidence-based principles Clinical reasoning exercises (Q&As with rationales) and lists of key terms with definitions Supplemental Instructor’s PowerPoints included
Dr. O'Connell's collection of stories and essays, written during thirty years of caring for homeless persons in Boston, gently illuminates the humanity and raw courage of those who struggle to survive and find meaning and hope while living on the streets.
