Homeless Flashcards
What are the 3 main concepts of vulnerable populations in the conceptual model?
What is at the center of all this in order to help those who are vulnerable populations?
1) Lack of resource availability
2) Health status of increased morbidity & mortality
3) Increased risk factors
Resources (research), nursing practice, ethical & policy analysis
Who are the vulnerable?
A subpopulation that is related to ethnicity/race, uninsured, HIV/AIDS, children, elderly, poor, and homeless.
What is the vulnerable populations conceptual model?
How does this model work though?
Resource availability, relative risk, and health status
It is a cycling feedback loop.
What does lack of resources lead to?
Increased risk factors and the inability to avoid illnesses.
With the vulnerable populations model you have a feedback loop occurring form health status and the lack of resources which lead to…
Higher mortality and morbidity
What is the Behavioral model for Vulnerable populations?
Variables that explain health that have more to do with demographics, social, and health beliefs.
demographics - age, gender, marital status
social - education, employment, ethnicity, social networks
health beliefs - values and attitudes towards health and services)
External variable essentially.
What is meant by the “Framework for Studying Vulnerable populations: macro and micro-perspective; differential vulnerability hypothesis; social capital and human capital”?
- explain macro vs micro and their role
- explain differntial vullnerabiltiy
- explain social capital
- explain human capital
You will look at the communities big picture to understand the smaller pictures.
- a communities lack of resources affects the individual
Differential vulnerability hypothesis pretty much mean some people go through shit that makes their life harder
- death, divorce, etc
- chronic stress leads to physical health problems
- these stressors are more felt by lower SES
Social capital is like how much value in society you hold based off how many life goals/levels you’ve managed to unlock
- marriage? family structure?
- social life? volunteer work maybe?
- church? clubs?
Human capital is more of an investment in you skills and pertains to
- housing
- income
- education
T/f
Better health status is associated with higher education
Personal and political power of people affects how well off their access is to things like better school. housing, and employment that can help someones health
true
true
T/F
Childhood traumas have no affect on overall health
False!
They can be a chronic stressor and thus affects a person’s life and status to the point those things affect their health
- it can also directly affect someones health too
T/F
Those who live in groups are at more risk of health issues
False.
It is actually the ones who lack social interaction from living alone
- in this day and age, we have harder times developing relationships.
So REVIEW
Which model includes the demographic, social, and health beliefs in its defintion?
Behavioral model for vulnerable populations
Why are vulnerable populations difficult to measure?
Due to overlapping populations
- people w behavioral health issues are homeless etc
Root causes of vulnerable populations?
So what are some populations that you can think of?
Socioeconomic status or poverty
Uninsured or underinsured (some people have insurance but its not good enough)
Race & ethnicity
- Chronic illness/disability
- Mental illness
- Substance abusers
- Victims of abuse/domestic abuse
- High risk mom and baby
- Immigrants and refugees
How does poverty make you vulnerable?
If you don’t have money , you can’t afford to live in a safe neighborhood or do activities that promotes a healthy lifestyle
Why are uninsured or underinsured people at risk?
Bc they don’t have that primary/secondary prevention opportunities and they only come in for tertiary and by then, it’s too late.
What is the definition of social determinants of health?
Acknowledged conditions associated with the health outcomes
Socioeconomic gradient explained????????
As someone moves higher on the pay scale, their health problems decrease
What are 3 health disparities?
Poor access to quality care or care at all
Overt discrimination
Levels and types of care and care settings
SDOH health people 2020 diagrams
Neighborhoods Traveling Community Education Economic stability
Neighborhood/environment safety
Do they have health care close or do they have to travel?
- not safe for moms and baby
Community
- do people have your back?
Education
- huge
- socialization is important
Economic stability
- can they afford? do they have jobs?
How to be effectively caring as a nurse?
Assist clients to develop capabilities to take charge of life and make their own changes
Open the door for them by referring them to certain programs and support groups
Engage and rapport
How can you as the nurse open the door for the clients?
You can educate them on places like Hunter Health
- and stay away from the stigma when educating
Why is it so important to be engaging and rapporting?
These people aren’t used to having someone on their side. Be different than “the big man”
Why do we need to role model?
We are teaching as we role model. We are setting an example on how to talk and interact.
How can we make a difference?
Show protective factors and encourage resilience
Mental health transition key documents
Health people 2020
Surgeon General
New freedom initiative
- stigma
- unfair tx limitations and financial requirements:
the insurance companies mental health folks separate out mental health insurance therefore less coverage and help
- fragmented mental health system doesn’t work well
What population can hold their mental illnesses until they’re 40+?
Women!
- often come on the news as a tragedy
One goal of healthy people 2020 was that suicide would decrease. Did we hit the goal?
No, it is increasing but we are also noticing it more.
Did eating disorders increase or decrease?
Increased
Trend of substance abuse treatment?
Increased due to insurance now covering it
- in 80-90’s decreased due to insurance not wanting to pay for ongoing care
Cirrhosis death trend
Opioid death?
still a problem
still a problem
What do we screen for w mental health?
Screen for the need to hospitalize
What is addiction
When your body needs a substance
if you cut any of these off , you go into physical withdrawal symptoms
- benz0
- alcohol
opioid cut off won’t kill you but just give you flu symptoms
meth or amphetamine withdrawal will make you want to sleep
What does the community health nurse need to know about substance abuse?
What drug is killing people?
Understand the issues and how it affects the person w side effects and know about popular substances out in the community
K2 (meth amphetamines ) and it is legal
What do nurses need to know about resources for substance abuse?
Means how can a person get treatment
What does know trends of community w substance abuse?
What areas are using what types of drugs
What does it mean by know consequences of community due to substance use?
How is it affecting the area and economic impact
Routine screening for mental illness tools?
Brief Psychiatric Rating Scale
Beck Depression Scale
Montgomery Asberg Depression scale
- most common
pscyh people use these more not nurses
What are the levels to substance use screening
Actual consumption
At risk drinking
SUDS or substance use disorders
Substance use level of risk is based off what
based on level of consumption
Self report substance use screeings
Michigan alcoholism
Drug abuse screening test
CAGE questions
DUSi or drug use screening inventory
Biological substance use screening
urine, blood, hair, saliva, breath, and meconium
What is our substance use screening is positive
Do possible brief intervention
Community level intervention nursing process
community assessment and focus internvetions
What type of assessment in community
integrative for substance abuse bc it all work s on the brain in different areas
- we need to put something in the substances place
Explain continuum of care of behavioral health
promotion, prevention, treatment, recovery
Multifaceted role of chn bc
- use epidemiology
- advocate for clients, reduce stigma, promote public understanding, politics
- education
- case manage
- collab (pharmacy especially for affordable meds)
Homelessness definition
Lack of fixed night time residence
- public shelter is not a residence
- group home is a residence
Age of homelessnes stats
78% over 18 years old
2.8% over 62 years old
T/F
poverty is linked to homelesness
homeless gender is female
true
false single male
Most common ethinicity w homelessness?
variable with geography
fasting growing segment of homelessness?
families w kids
contributing factors to homelessness 1
Poverty , lack of affordable health care , no employment
- bills can be too large
contributinh factors to homelessness 2
domestic violence
mental illness
addiction disorders
- shelters can be hard to find
contributing factors to homelessness 3
person or financial crisis
natural disaster
personal choices
homeless stats of Wichita
men
women
less than 1% or 2588 were homeless
Males : More chance of disdained treatment , 63%
Females: most have severed traumatic events like Domestic violence
how many children are homeless in the US?
1 in 30 so 2.5 mil
- increased 8% nationally
vets % of homelessness
11% in 2015 were vets
and 34% of vets were unsheltered
rural homelessness
Usually due to working families being homeless for first time
They are living in streets, cars, and substandard housing due to no shelter in the rural areas they are in.
older homeless
3.5% are older than 65
lgbtq homeless
20% of this homeless population are youth lgtbq - sexual violence victim risk increases with them by 7 times.
They also commit suicide at a much higher rate
Are we likely to come in contact with homeless people as nurses with chronic or acute problems?
Acute
What chronic health problems are we going to see homeless for?
TB and HIV/AIDS
Diabetes and Hypertension
Addictions and Mental Disorders
Who is more likely to be a victim of trauma and criminalization? Someone who is rich or someone who is homeless?
Homeless population
Why will the homeless population have oral health issues?
Due to poverty, substance abuse ruining their teeth and gums (chew or alcohl), poor nutrition, and coexisting illness (like for instance cancer in the throat)
How prevalent is HIV in the homeless population?
3x greater
Only major piece of federal legislation passed in 1987 for emergency shelters, transitioning, education and housing for homeless
McKinney Vento homeless assistance act
public sector resources
Mckinney Interagency council on homelessness Center for Medical health services PATH National Resource center on Homelessness and mental illness HCH Health care for the Homeless US Department of Housing and Urban Development White house office of faith based
Private sector resources
{} National Coalition for the Homeless (NCH)
The National Center on Family Homelessness
National Coalition for Homeless Veterans
National Alliance to End Homelessness
National Center for Homeless Education
Commission on Homelessness and Poverty, American Bar Association
Homes for the Homeless
National Low Income Housing Coalition
What do we need to clarify within ourselves about homelessness, mental health, poverty, and addiction
Our own bias and how we feel
Nurses provide care to marginalized and _______.
Disenfrachised or person lacking rights
What is essential for client nurse relationship in the marginialized and disenfranchised?
trust
Primary prevention
Primary prevention
Advocating for affordable housing, employment
opportunities, and better access to health care
Financial counseling (money management); assistance in locating sources of legal or financial aid to prevent eviction; assistance in accessing social services, temporary housing, or health care to avoid a housing, health, or family crisis
Health education: positive parenting skills, violence prevention, anger management, coping skills, healthy eating, principles of basic hygiene, and immunization programs
Secondary prevention
Assessment of client needs for housing, health care, education, social services, and employment
Screening for communicable diseases Assessment of barriers to accessing services
Tertiary prevention
Tertiary prevention
Provide rehabilitative care
Support clients already homeless
Treating complications of advanced disease
Case management: seamless delivery of services as people transition from one level of care to another
Advocacy: development of innovative modes for response to homelessness; advocate at each level of prevention for positive change
