With the advent of smart phones and on-line personal health programs, coupled with access to health care providers, being in tune and keeping track of one’s health and observations of daily living (ODLs) can be easy. But what if you don’t have access to personal technology and health care? Are, ODLs only present in the segment in the population that has the resources to monitor and manage them?
While volunteering at a local homeless shelter and speaking to a group of women, the answer to this question became clear to me: an emphatic no. A large part of this is because illness is a big part of many homeless people’s lives:
- 46% of homeless people report chronic health conditions such as high blood pressure, diabetes, or cancer
- 39% report some form of mental health problem
- 20-25 % meet criteria for serious mental illnesses
If you combine this with a chronic lack of income or a stable place to live, noticing and managing your own health can be an important part of a homeless person’s life.
One of the women I spoke to that night at the shelter talked about how she is on two medications for two chronic illnesses. She desperately needs the medications to control her illnesses, but the cost is much more than she can afford. A new mother trying to save money to get housing, she rations the pills, taking them only every other day instead of every day. She hates having to do it, but feels she needs to.
Other women spoke about sensory observations such as their stress and what in their environment acts as triggers. Many spoke of observing their sleep, or lack of it, due to late-night disruptions made by other shelter clients, how it affects them, and how they try to mitigate the problem. One woman has chronic debilitating migraines and struggles managing them because of her lack of health care. So in the meantime, she observes the quality of the migraine and her potential triggers.
This is likely only a small subset of observations that these women make periodically about their health situation and the pressures put on managing or addressing illness due to the constraints of being homeless. The strains that homelessness puts on a person’s life, especially regarding the lack of access to health care and a regular provider, forces many of these women to be acutely aware of their health status or factors associated with their health, such as medication availability.
Assisting the homeless with their ODLs is something that needs to be done. However, without an increase in access to health services, including mental health service and medication availability, to alleviate some of the burdens of caring for one’s health, there is only so much that observing, mitigating, and coping can do to improve the health and life circumstances of our homeless population.
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