Homelessness Flashcards
Define Homelessness.
a household has no home in the UK or anywhere else in the world available and reasonable to occupy (not just people who are sleeping rough)
A person is legally defined as homeless if:
(7 marks)
Ø they have no accommodation available in the UK or abroad
Ø they have no legal right to occupy the accommodation
Ø they have a split household & accommodation is not available for whole household
Ø it is unreasonable to continue to occupy accommodation
Ø they are at risk violence from any person
Ø they are unable to secure entry to their accommodation
Ø they live in a moveable structure but have no place to put it
Examples of homelessness:
- rooflessness
- houselessness (w a place to sleep but temporary, in institutions or a shelter)
- living in insecure housing (insecure tenancies, eviction, domestic violence, or staying w family & friends known as ‘sofa surfing’)
- living in inadequate housing (in caravans on illegal campsites, in unfit housing, in extreme overcrowding)
CHRONIC homelessness…
…characterised by mental & physical ill health & substance misuse
Define ‘rough sleeping’?
(2 marks)
- People sleeping, about to bed down or actually bedded down in the open air (such as on the street, in tents etc).
- People in buildings or other places not designed for habitation (such as stairwells, barns, sheds).
What is not included in the definition of ‘rough sleeping’?
(4 marks)
- people in hostels or shelters
- people in campsites or other sites used for organised protest
- squatters
- travellers
List STRUCTURAL factors causing homelessness/rough sleeping
(5 marks)
1) poverty
2) inequality
3) access to housing & affordability
4) unemployment / insecure employment
5) access to social security
List INDEVISUAL factors causing homelessness/rough housing
(8 marks)
1) poor physical health
2) mental health conditions
3) experience of violence, abuse & neglect
4) drug & alcohol problems
5) relationship breakdown
6) experience of care or prison
7) bereavement
8 refugees
List the risks of homelessness to health
(7 marks)
+ Poor living conditions,
+ Poor hygiene
+ Inadequate nutrition
+ Substance misuse
+ Stress
+ Trauma & accidents
+ Poor access to health services
There are stark health inequalities of the population between the homeless & general population. What is the most notable one?
People who sleep rough over a long period of time face a higher likelihood of dying prematurely & dying from injury, poisoning & suicide.
Average age men die: ~76 yrs
- homeless men die ~44 years
Average age women die: ~81 yrs
- homeless women die 42 years
What are the BARRIERS to improving oral health services for homeless people?
(7 marks)
1) Difficulties in maintaining daily oral hygiene
2) Neglect due to substance mis-use
3) Low oral health expectations
4) Attitudes of dental teams
5) Lack of mobile phone, limited access to internet
6) Travel issues
7) Assumptions that a fixed address is needed to access services
General health professional attitudes towards treating the homeless:
-ve attitudes: fear of aggression & cross infection concerns.
+ve attitudes: recommend working with the homeless as they found the work rewarding due to helping those in need’ & ‘relieving pain’.
Least rewarding aspects were being unable to complete treatment & missed appointments.
Summarise the ‘Integrated Health & Social Care for People Experiencing Homelessness’ NICE 2022 guidance:
1) Models of multidisciplinary service provision (health, housing, social care, voluntary sectors & peer advocates)
2) Role of peers in delivering & designing service
3) Improving access to & engagement w/ health & social care
4) Assessing individual needs (health & social care w emphasis on safeguarding)
5) Intermediate care (those discharged from hospital - ‘step-down care’ & those at risk of hospitalization / deterioration - ‘step-up care’)
6) Transitions between different settings
7) Safeguarding (needs a designated lead)
8) Multidisciplinary long-term support
9) Staff support & development (understanding the needs, duty of care & training in trauma-informed care)
What ways can we make dental services accommodating?
(4 marks)
○ Flexible appointments
○ Friendly staff
○ Working within the benefits system
○ Service provision for homeless &/or hard-to-reach pts needs to be proactive w/ outreach
List 5 facilitators of access to health services for homeless people:
1 - Homeless person ready to ‘move on’ out of homelessness
2 - Reducing or ending substance mis-use
3 - Concerns about appearance of teeth
4 - Need for oral health information
5 - Taking first step to resume regular dental attendance
