Comm Final: Day one presentations Flashcards
-Job loss, mental illness, natural disasters, spouse passing and main breadwinner, drugs and alcohol, medical bills, Poverty
Homelessness and Poverty
Causes
having insufficient resources or funds to meet basic living expenses such as food, shelter, clothing, transportation and health care
General: homelessness and poverity
live in dangerous environments, be underemployed/work high risk jobs, eat less nutritious foods=whatever they can, have many stressors
-Can lead to homelessness
Poverty
More likely to:
Decreased earnings
Increased unemployment rates
Changes in retirement benefits/labor force
Increase in female-headed households
Inadequate education and job skills=3 jobs to support
Inadequate antipoverty programs/welfare benefits
Weak enforcement of child support statutes
Declining Social Security payments to children
Increased number of children born to single women
Poverty Factors that effect a growing number:
People become homeless for a number of reasons
Families are especially at risk for becoming homeless
-Typical sheltered family is made up of a single mother with 2-3 children
Many once had homes and survived on limited income
Includes every age, sex, ethnicity and family type
Homelessness
- Lives marked by hardship and struggle
Homelessness transient/episodic; brief stays in shelters or other temporary accommodations
Crisis poverty
- Typically chronically homeless
Many have mental or physical disabilities along with alcohol/drug abuse, severe mental illness, chronic health problems, or chronic family problems
Lack money, family support and need economic help, rehabilitation, ongoing support
Persistent poverty
Poor health can contribute to being and being can lead to poor health
Cycle hard to get out of
Limited health care makes worse
Try to provided support: what is provided isn’t always going to help them
Health promotion activities are a luxury for individuals
Poor health outcomes are often secondary to barriers that impede access to care: increased infant mortality rate, increased hospitalization,
Homeless & health
inconvenient clinical hours, attitudes of health care workers toward poor clients
homelessness and health
Barriers:
- -Alcohol abuse, high sodium foods
- -Intravenous drug use, risky sexual practices
- pneumonia and tuberculosis, wound and skin infections
- Crowded living conditions, poor hygiene, lack of first aid, no clean place to fix up wound
homeless and poverty Common diseases 1. hypertension 2. AIDs 3. viral and bacterial infections
- Higher rates of prematurity, low birth weight, and birth defects
- Increased incidence of traumatic death and injuries, nutritional deficits, iron deficiency anemia, elevated blood lead levels, infections
- Lead to more hospitalization and more stress
Effects of poverty and health of children
- Approximately 26% of all homeless have severe and many are not being treated
- Overall, about 6% of American adults have serious
- Many with severe live in poverty or are homeless because lack ability to earn/maintain suitable standard of living: cycle hard to break need health care but can’t afford it
- Serious mental illness disrupts ability to carry out essential aspects of daily life
- May prevent people from forming and maintaining stable relationships or cause them to misinterpret others’ guidance and react irrationally=Results in pushing away family, caregivers and friends
- These factors + stress of mental disorder make these people more at risk to become homeless
Mental Illness and Homelessness
-Moved many from state psychiatric hospitals to communities
Community-based services were not often in place when persons released into community or not affective
Families were not prepared for the treatment responsibilities
Staff in nursing homes and personal care settings often lacked adequate knowledge and skills
Some were released into rooming houses and single-room occupancy hotels=Little to no help or no supervision: taking meds
Others placed in prisons and jails: Estimated that 14% of males and 33% of females in jail suffer from mental illness
Deinstitutionalization
mental illness poverty and homeless
-Create trusting environment
Show respect, compassion, and concern
Do not make assumptions
Coordinate a network of services and providers, resources they can use
Advocate for accessible health care providers: can’t afford won’t go
Focus on prevention: keeping them from becoming in first place
Role of the Nurse
homeless and poverty
Concept of who is poor has changed
Income is usually a qualifying factor for programs
Federal Income Poverty Guidelines determine whether a person is financially eligible for assistance
Some families earn slightly more than the government-defined income levels and are not eligible for government assistance programs, but are unable to meet their living expenses
Who Can Help?
homeless and poverty
mission is to prevent homeless, protecting civil rights
The National Coalition for the Homeless (NCH):
help families with children under 19, help maintain jobs, medical assistance, transportation, food stamps
Temporary Assistance to Needy Families (TANF):
promote, health screening, counseling, promote breast feeding
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC):
: largest funding
Medicaid
snack-alleviate hunger and easier to afford, now electric card given monthly
Food Stamps:
: huge organization, help with homeless, donate coats, safe places, addiction counseling, homeless find work
Salvation Army
: federal program, school readiness from birth to 5 years old, receive help regardless
Head Start
house families that have to stay for long time, can’t afford housing, 15$ a night
Ronald McDonald House:
: case managers to veteran to get back on feet, help find jobs
HUD- Veterans Affairs Supportive Housing Program (HUD-VASH)
- Help chronically sick and mentally ill homeless, guidance, how to change life and resources how to change
Case management programs
- Mentoring, Addiction control, Family and marriage counseling, Parenting classes, Anger management, GED Preparation courses, Bible study, Class on finding and maintaining jobs
Homeless shelters: provide shelter for evening
provide 24 hour access to stay in
Emergency Shelters:
- Difficult to know how many people are homeless
- Homeless are often hard to locate: with relatives, on streets
- Many refuse to be interviewed: don’t want attention or judgment
- Some go through episodes of homelessness
- Lack of compliance with treatments: no money, don’t follow up, no place to store
- Economic barriers: can’t pay for medication or care
- Difficult to generalize from one location to another
Complications with providing adequate services
- A pregnancy will make them turn their life around
- 68% of young females said they had been pregnancy between the ages of 15-18 years old and were also homeless.
- Most homeless young mothers do not have a steady place to sleep, do not have access to prenatal vitamins, malnourished diet, and no support system.
- Their babies will not have an easy road either: low birth weight, developmental problems, parental issues, lack of nutrients, and safety concerns.
Young homeless women
Shelters just for women address
Mental disorders, Provide a support system, On site “at home pregnancy tests”
-Once the young woman finds out she is pregnant, the shelter can set her up with welfare and subsidizing housing
-From there, the shelter helps the young woman find a job.
-The shelter also sets them up with a female mentor that has been through the same experience to help along the way as a support person.
Interventions: homeless women:
The shelters that are for people as a one/ two day stay offer the basics- Food, Water, Shelter, Clothing
Interventions: short stay shelters:
The basics: food, water, clothing, shelter
- Mental counseling, Medical services, Substance abuse treatment
- Training of independent living skills: try to get ppl to get job and find a home
Interventions: longer duration shelters:
- Trying to connect with the “difficult to reach” individuals
Once the staff builds trust with the person, they’ll get case management involved to really help the individual out
-Specialized services, Crisis counseling
Substance abuse support and treatment
Vocational services, Educational programs
Education on HIV/ AIDS/ STDs/ Pregnancy as well
Interventions: Drop-In shelters
- The Drop-In shelters offer education of HIV/ AIDS, STDs prevention, and pregnancy prevention
- The young women homeless shelter offers condoms as a state of prevention as well
Primary intervention homelessness and poverty
-For the women shelters that offer pregnancy tests, this is a type of screening process
Secondary intervention homelessness and poverty
-An individual with HIV, the staff would be teaching signs and symptoms of a flare up so they know when to seek medical attention
Tertiary intervention homelessness and poverty
nurse who provides care to individuals in these areas, geographical location or low population density, in a specified area. Individuals include those that do not have easy access to health care.
Defined by location, population density, distance from or to an urban center
Began with Red Cross Nursing Service in 1912
Growing number of migrant workers and their unique health needs
settings are based upon a continuum
Typically self-employed in seasonal or part-time careers
Rural/migrant nurse:
- Lack of technology, initiative, transportation, and financial ability
- Scared to miss a day of work: some only work part time or seasonal
- Increase in health issues
- Unpredicted weather or travel conditions
- Care and services are not culturally appropriate: come from other countries may not believe in the same things
- Inadequate provider attitudes and understanding about the population
Current Trends
rural migrant nursing
defined generally either in terms of the geographic location and population or distance from or the time needed to commute to an urban center, fewer than 99 persons per square mile and communities having fewer than 20,000 inhabitants/ Farm residency
Rural:
region surrounding a city, very developed (houses, commercial buildings, roads, bridges, and railways)/ Nonfarm residency
Urban:
Rather than being one or the other, residencies are placed on a continuum. This ranges from living on a remote farm to a village to a small town to a larger town or city to a metropolitan area with a core (inner city)
Rural-urban continuum:
-Not fully understood and residents have a poor perception of their overall health=don’t think preventative care is necessary and don’t want to miss work
Compared to urban Americans, have:
-Higher infant and maternal morbidity rates
-Higher rates of chronic illness (heart disease, COPD, suicide, HTN, DM, and CA)
-Unique health risks associated with their occupations (chemicals, pesticides=farm workers, heavy machinery)
-Stress-related health issues and mental illness, at risk for depression and suicide
Health status of rural residents
-The four high-risk industries are forestry, mining, fishing, and agriculture. Each day over 200 agricultural workers suffer lost work time injuries and almost 5% result in permanent impairment. Sometime OSHA (occupational safety and health administration) is not enforced because of the small enterprises. Workers’ Compensation is usually not available for agriculture industry.
Occupational and Environmental Health problems in Rural Areas
Most common unintentional injuries in farming is being run over from tractor falls and trailing equipment. Other injuries can rage from fractures or sprains from falls, prolonged stooping, heavy lifting.
Occupational and Environmental Health problems in Rural Areas
Unintentional injuries:
Harvesting crops 12-14 hours per day takes a toll on the musculoskeletal system. For example, stooping low all day to pick up strawberries. Neck and back pain are the most common chronic pain that can cause workers to leave or change jobs
Occupational and Environmental Health problems in Rural Areas
Physical demand: