Addressing Health Challenges in Homeless Populations – A Case of Furuncle Presentation

Addressing Health Challenges in Homeless Populations – A Case of Furuncle Presentation

The case of a 52-year-old homeless female presenting with a large lump on her shoulder, suspected to be a furuncle, raises concerns about her overall health and well-being. As a healthcare provider at a free clinic, it is crucial to approach this patient with compassion, understanding, and a comprehensive assessment to address her immediate concerns and the potential underlying health issues that may have contributed to her current condition.

What’s going on

The patient’s homelessness raises significant concerns about her hygiene, nutrition, and shelter access. Living in unsanitary conditions with limited access to healthcare resources has contributed to developing the furuncle and open lesions. These open lesions may indicate poor wound healing and infection vulnerability, suggesting potential underlying health problems, such as malnutrition, compromised immune function, or chronic illnesses (Silva et al., 2022). Homelessness is associated with numerous health risks, including mental health issues, substance abuse, infectious diseases, and lack of consistent medical care. Thus, conducting a thorough medical history, physical examination, and appropriate investigations is essential to comprehensively identify and address all health issues (Liu & Hwang, 2021).

Treatment Approach

Immediate Care for the Furuncle

The furuncle requires immediate attention to prevent further complications. The primary treatment would involve draining the furuncle, which can be done in a sterile setting at the clinic. After drainage, the wound should be cleaned, and appropriate dressings should be applied. Antibiotics might be necessary if signs of spreading infection or systemic symptoms are present (Silva et al., 2022). The patient should receive clear instructions on wound care and hygiene practices.

Management of Open Lesions

The small open lesions should also be assessed and treated promptly. Proper wound care, including cleaning, disinfection, and dressing, is essential to prevent infection and promote healing (Silva et al., 2022). A tetanus shot should be administered if the patient’s vaccination status is not current.

Addressing Underlying Health Issues

The patient’s medical history and current health status should be thoroughly evaluated to provide comprehensive care. Blood tests can help identify nutritional deficiencies, signs of infection, or other systemic problems. Tuberculosis (TB) screening should also be conducted due to the patient’s living conditions and potential exposure risks (Andermann et al., 2020).

Mental Health Assessment and Support

Given the challenges of homelessness, assessing the patient’s mental and emotional well-being is vital. The stress and trauma associated with homelessness can exacerbate health issues and hinder adherence to treatment plans (Liu & Hwang, 2021). Referral to mental health services or counseling should be offered, along with support in accessing resources for housing assistance.

Social Services and Case Management

The patient should be linked with social services to address her immediate needs, such as food, shelter, and clothing. Engaging a case manager can provide ongoing support and care coordination, helping the patient navigate various services and programs available for the homeless population (Andermann et al., 2020).

Education and Empowerment

Empowering the patient by providing education on health and hygiene practices is vital. Consistently, teaching her to recognize early signs of infection and when to seek medical help is important. Furthermore, the patient should be encouraged to take an active role in her health and well-being (Liu & Hwang, 2021).

Conclusion

The case of a homeless patient with a furuncle and open lesions demands a comprehensive approach to address both immediate medical concerns and the broader health challenges associated with homelessness. By providing immediate treatment for the furuncle and open lesions, evaluating and managing underlying health issues, addressing mental health concerns, and connecting the patient with social services, healthcare providers can offer holistic care to improve the patient’s well-being and quality of life. Additionally, support, education, and empowerment are critical in helping the patient break free from the cycle of homelessness and regain control of her health.

References

Andermann, A., Bloch, G., Goel, R., Brcic, V., Salvalaggio, G., Twan, S., … & Pottie, K. (2020). Caring for patients with lived experience of homelessness. Canadian Family Physician, 66(8), 563-570.

Liu, M., & Hwang, S. W. (2021). Health care for homeless people. Nature Reviews Disease Primers, 7(1), 5. https://doi.org/10.1038/s41572-020-00241-2

Silva, J. M. R., Varandas, P., Santos, F., Cardoso, C., & Leite, S. (2022). Cutaneous furuncle-like lesions with an unexpected diagnosis: a case report. Revista Portuguesa de Medicina Geral e Familiar, 38(3), 305-10. https://doi.org/10.32385/rpmgf.v38i3.13441

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A 52-year-old female presents to your free clinic. She states that she is currently homeless and usually sleeps in the park. She states she has a large lump on her shoulder and thinks she has a spider bite. You determine that it is a Furuncle. You also notice a couple of additional small open lesions. What else is going on here? How will you proceed with treatment?