Vulnerable populations Flashcards
List some specific ACP considerations for LGBTQI populations
- ensure same sex partner is a formal agent (if preferred)
(will have limited / no rights if unmarried, family non-acceptance etc.)
Psychosocial considerations for LGBTQI patients
- unique social support circles (lavender families)
- EOL can be a time of reunion and reconciliation (estranged family)
- unresolved grief, loss, abandonment due to sexual orientation
(determine relationship with biological family) - disenfranchised grief in partners (unrecognized relationship)
- ask open ended questions (use patient’s terms as a guide) and use inclusive language
define akathisia
extrapyramidal symptom
feeling of uncomfortable inner restlessness
distinguish acute vs chronic EPS
acute - dystonia, akathisia (reversible)
chronic - tardive dyskinesia (irreversible)
key DDX of akathisia
delirium (attention and awareness affected)
RLS (circadian pattern, more chronic nature)
mania (racing thoughts and pressured speech)
what is the acute treatment for akathisia?
anti-cholinergics
diphenhydramine
benztropine
Which typical AS has a lower risk of EPS
Which atypical AS?
Typical - chlorpromazine
Atypical - quetiapine
(olanzapine slightly less than risperidone and aripiprazole)
what are social determinants of health?
social, economic, and environmental factors that influence health (individual and population level)
what is structural vulnerability
a concept that recognizes effects of social determinants of health on health outcomes
beyond individual behavior to socioeconomic, cultural, political hierarchies
what is trauma?
an experience that invokes fear, helplessness, or horror, and overwhelms a person’s ability to cope
Trauma is associated with poor health outcomes and …
incr. mortality
list 5 challenges SVP’s face in accessing palliative care?
- de-prioritization (focus on day to day survival)
- many do not see themselves on “dying trajectory”
- challenging identifying those with needs (care received outside of formal medical systems)
- safety concerns on part of healthcare providers
- siloed healthcare systems
what colonial impacts are relevant to acknowledge when caring for the indigenous
- trauma
- dispossession (separation from culture, land, family)
- racism / discrimination
What social determinants of health are relevant in immigrant / refugee populations?
- language
- social support
- faith / religion
- finances
- housing
- trauma
should refugees be screened for trauma?
not if they are doing well (risk of harm - re-experience)
look out for s/s PTSD and depression
