[Purple Cohort] Module 6

[Leslie Kao]

Please submit your SOAP Reflections below:

[Ahmed Yeddi]

Living on the street or in crowded homeless shelters is personally stressful and made worse by being exposed to communicable disease (e.g. TB, respiratory illnesses, etc.), violence, malnutrition, and harmful weather exposure. Hence, common conditions such as high blood pressure, diabetes, and asthma become worse because there is no safe place to store medications or syringes properly. Maintaining a healthy diet is difficult in soup kitchens and shelters as the meals are usually high in salt, sugars, and starch (making for cheap, filling meals but lacking nutritional content). Behavioral health issues such as depression or alcoholism often develop or are made worse in such difficult situations, especially if there is no solution in sight. Injuries that result from violence or accidents do not heal properly because bathing, keeping bandages clean, and getting proper rest and recuperation isn’t possible on the street or in shelters. Minor issues such as cuts or common colds easily develop into large problems such as infections or pneumonia. Conditions among people who are homeless are frequently co-occurring, with a complex mix of severe physical, psychiatric, substance use, and social problems. High stress, unhealthy and dangerous environments, and an inability to control food intake often result in visits to emergency rooms and hospitalization which worsens overall health. Thus, it is not surprising that those experiencing homelessness are three to four times more likely to die prematurely than their housed counterparts.

[Carli Denholm]

Homelessness is being without a stable living environment. As the video mentioned, it does not necessarily mean being on the streets or in shelter or transitional housing. People become homeless for a wide variety of reasons and once in the cycle, it is extremely difficult to get out of. Often, people who are on the streets have already used up any social resources that they had. That’s if they had social resources at all, since many chronically homeless grew up in unstable homes.
We should be asking our patients about their living situations and the stability of their living situations so that we can identify patients who are homeless, or at risk for homelessness, so that we can connect them to resources in the community. We may not have all the answers, but we can adapt our care to best serve these patients. We can address mental health and substance abuse disorders which are common in the homeless community. As citizens and as a program we can help by volunteering. We can provide medical to homeless patient where they live with organizations such as Street Medicine. Or we can try to address more basic needs like food with organizations like DRMM, preparing and serving food in soup kitchens. In these ways, we can address multiple areas of the biopsychosocial model.

[mowyad Khalid]

Homelessness affects pts on many levels including physical, and mental.
Interplay between mental issues, financial, transportation and insurance affects the physical health tremendasouly.
In DCC clinic these issues become more obvious.
Physicians should pay attention more to these factors and try to help as much as we can by providing a reference to pts to places like Detroit rescue mission and covenant house of michigan.

[Haider Aldiwani]

This Week the subject was about homelessness. Fortunately I was able to incorporate what we discussed in our meeting this week into actual work. One of my patients’ work for charity organization that afford shelter for 90 days until residents find place, food and clothing . Ii’s hard to imagine someone without home, food or struggles to put some cloths on. This organization helps a lot of Detroit area residents men and women. I will share what I have with other patients’ who really need help.

[Msutafa Ajam]

In light of the current socioeconomic difficulties, the rate of homelessness and unemployment as its major contributor is still high despite the most recent data showing slight improvement since the recession in 2007. The impact on physical and mental health cannot be neglected. Fortunately we have multiple easily accessible resources for this important portion of the community. However, continuing to support homeless patients is necessary to achieve residential stability; which I think is the major challenge to every nation. Ideally this would be best achieved via a multidisciplinary approach involving care for mental and physical health, providing employment and education opportunities.

[Ahmad Abu-Heija]

Homelessness has many devastating implications on one’s well-being, be it on their health, their sickness or their relationships. Medically speaking homelessness carries the most implications in terms of access to medication storage, clean supplies for injections, and basic hygiene, as such addressing only one’s medical needs during a visit is of little to no significance if unaware of their social situation and home situation. I learned about many resources that could be provided to patients, that I kept on my computer, at a click-away to enable me to reach my patient’s needs easily and quickly.

[Raya Kutaimy]

I am not sure how that happened, but tis week I have my first ever homeless patient in GMAP, I usually have homeless patients as inpatients but never had any patient in the clinic. My patient Mrs. X , she came for medications refill but she revealed that she does not feel well as she is homeless for 3 weeks , she used to live with a friend who asked her to leave the apartment. It was very difficult to hear her story, but I was to a part happy that I was able to help her as I was able to give her the resources that we discussed in the lecture and asked the clinic staff for other resources as well. My patient had a history of homelessness so she is familiar with few of the resources but still I was able to help her with other resources that she was not aware of.
The teaching part for me was not only with my patient, but also in the social lecture this week, when I imagined for a moment of all the things that I wont be able to do if I am homeless( like coffee, food, shower, ) simple things that we don’t even thing about, that makes me really grateful for the things I have in my life and it better helps me understand what a homeless person is suffering.

[Pranav Shah]

This week I think I understood the video at a deeper level. I had a patient and I asked her where she lived. She easily responded with: oh I live with my friend. At first I assumed this was her roommate and she and her friend shared rent. Later in the encounter I asked the patient if she was sexually active and she said she was whenever she was staying with her boyfriend. I believed all these to just be normal living – until I finally asked her: “Do you have your own place?” and the patient responded – “No”. I am unsure how many patient’s have been through my clinic and I haven’t picked up on this fact. The patient had been bouncing around from place to place just for a roof over her head and all I had thought about was a referral for another specialist. Homelessness is likely just a bad or difficult as many of the medical illnesses we diagnose patient’s with. To not have access to showers, dental hygiene, or warmth are all forms of compromising our immune system. Perhaps I need to stop beating around the bush and ask the hard questions so I too can help patient’s connect with resources and find a place for them to call home.

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