Healthcare professionals provide care in many settings, including hospitals, clinics, schools and people’s homes, but for those individuals who don’t have a fixed address and require care, some community health services staff go to them.
Kim Mears is a home care nurse who has been working with the vulnerable population in Victoria since 2016, many of whom are struggling with mental illness and substance use problems.
“People experiencing homelessness are some of the most vulnerable to experience poor health outcomes across the population,” said Mears.
“They have a unique set of healthcare needs, many of which are unrecognized or untreated. The nurses on our team assist them in meeting their individual needs, which can range from treating dermatologic infections and pneumonia to wound and palliative care in their preferred location, surrounded by their community.”
People who are homeless or who are at risk of being homeless include those who do not have a consistent place at which to reside.
“The homeless are a resilient population, said Mears. “Often they want to know how to manage their own wounds, as it’s difficult for them to adhere to a schedule. We teach them how to care for their infections, including how to use drugs safely, and leave them with instructional handouts and supplies to care for their illness.”
Building trust and accepting an individual's situation is important. Healthcare professionals who work with the homeless or those at risk of homelessness learn what life is really like for these clients and treat them without judgment.
Leanne Stepp is a social worker who supports the vulnerable population in Downtown Vic West. She focuses on the individual outside of their disease and strives to ensure they feel listened to and understood.
“It’s important to meet people where they are at, both physically and cognitively,” she said. “When we focus on who they are as a person outside of their diagnosis it helps to build trust and provides them with a sense of dignity. Caring for the most vulnerable by treating them directly in a convenient location for them gives them faster, uncomplicated access to healthcare, something we all deserve.”
Prevention is a primary goal in healthcare and these nurses provide interventions and services to guide their clients.
Stephanie Rempel is an RN who specializes in working with the geriatric population in Victoria who are over age 75, and who are struggling with poor cognitive impairment. She is part of a seniors outreach team made up of physicians, social workers, psychiatrists and nurses who look after the aging population that is experiencing cognitive decline.
“The goal is to keep these seniors living independently for as long as they safely can, “she said. “But when they are schizophrenic, delusional, or are struggling with substance misuse and become harmful to themselves, we have no choice but to intervene. These seniors are often evicted and we help find them alternate living arrangements where they can be looked after more closely, such as in homeless shelters, subsidized housing or assisted living sites.”
The ability of healthcare staff like Kim, Leanne and Stephanie to build trusting, non-judgemental and non-threatening relationships with their vulnerable clients is a significant contributor to the positive outcomes for these clients. They demonstrate the importance of the humanistic side of healthcare, and that being empathetic and listening to the needs of our vulnerable population is more important than ever.
For Rempel, the rewards far outweigh even the most challenging days working with sometimes unpredictable seniors.
“If they let me into their world and trust me enough to help them, then that is a big deal,” she says. “To be accepted by such a vulnerable population is very meaningful.”