What different factors do you have to consider when treating a homeless patient?

You must remember that these people do not have access to regular preventative care. They usually are very sick and end up in the ER. They have no money for medications when discharged. Food insecurity and the fact they have no home play into how you handle them. Above all try your best not to treat them any different.

you will be working with the MSW discharge planner. They try to get a patient into a shelter. Most of the shelters have case workers that follow the patient: remind them about their appt, take care of insurance needs etc. This is how it works in NY. If the patient refuses a shelter, they are on their own so they will likely be lost to follow-up. Adult protective services consider them competent so they cannot be forced to stay in a shelter. Treat all patients with respect. I called them sir or maam. Keep in mind they have likely been through the system before and they left. Do not underestimate them and do not be demanding. Every assessment and treatment I Did, I told them ahead of time. If I had to make an assessment, I would ask them if it's okay to do so, what I would be doing and how long it will take. Do not underestimate what they are capable of. IF the patient is an addict, he will be calm for awhile once he gets stabilized, then, he may go into withdrawal. Predictable unpredictability is the key.

They will have mental health issues that will have to be addressed l: ETOH or drug abuse, methadone program. Thy may have to be placed in a facility: this will be done with both the RN case manager (medical needs) and MSW case manager for housing and mental health needs. Make sure they meet with the patient timely ( usually on day of admission). Transporation is arranged for patient to get to the shelter upon discharge if that is the plan.