ABSTRACT
This research explored the healthcare needs of homeless adults in San Diego, California, where more than 15,000 homeless individuals seek healthcare annually. Little is known about their perception of their own health needs and wants, access-to-care issues, problems with care fragmentation, and difficulty in obtaining medications and follow-up care. Many of these issues directly impact the provision of emergency department services to this population. A faculty member/nursing student team conducted interviews with homeless adults who lived on the streets. A qualitative approach using grounded theory methodology was used to develop a grounded theory related to the process of obtaining/utilizing healthcare by these homeless adults. Shelter residents had improved access to emergency healthcare and assistance with obtaining benefits, but the truly homeless had very little support. Barriers to access/utilization included many factors, with a core category of "existing in the moment but losing ground over time." This model can inform nursing education, practice, and research related to the appropriate delivery of emergency care to homeless adults.