Real Life Scenario

As you learn about the complex relationship between primary health care and homelessness, we encourage you to begin with this real life composite scenario. Take a moment here to pause and consider this person’s experience.


Tom is a 75-year-old retired electrician who is currently living in a local shelter. His wife of 45 years died 3 years ago , and with her death, the pension that was sustaining the household ended. Tom was unable to meet his‚ÄĮexpenses. As a small business owner for 45 years, he had no pension of his own.  He was able to live on the proceeds of the sale of his home for a couple of years; however,‚ÄĮhis wife had managed their money for their entire marriage and without money management skills‚ÄĮTom‚Äôs‚ÄĮmoney‚ÄĮran  out. He had been living on the streets until recently. Tom presents at the local Community Health Centre with significant weight loss, lack of appetite, weakness, and memory loss. He reports that he has a persistent cough even though he gave up smoking 2 years ago. He has not seen his own Family Physician, who is in a city 30 km away, in two years. His immediate family members, two sons, live in a different province. His former neighbours have tried to keep in contact with him, however Tom has been reclusive. Staff in the shelter have noted that he has periods of confusion in the evenings and that his sleep is significantly disrupted. The Nurse Practitioner (NP) assessing Tom has no health records to draw upon and he questions Tom‚Äôs ability to share an accurate health history.‚ÄĮ 


Reflection Questions

With this scenario fresh in your mind, consider these reflection questions. You may wish to record your answers before moving on to the next section. We will return to the scenario again at the end of the chapter. 

Reflection Questions

  • How do you feel when you hear Tom‚Äôs case?
  • What challenges does the NP face in managing Tom‚Äôs care?
  • How do you feel even mild dementia might affect a person‚Äôs housing status?



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Understanding Homelessness in Canada Copyright © 2022 by Kristy Buccieri, James Davy, Cyndi Gilmer, and Nicole Whitmore is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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