Vulnerable Populations (wk 5)

Question 1

What are the characteristics of a vulnerable population?

Answer 1

• Marginalized
• Easily hurt, marginalized bc low edu/ poor/ precarious housing/ food insecurity/ discriminated
• Increased susceptibility to risk factors–> increased risk of poor health outcomes

Question 2

Who are considered vulnerable?

Answer 2

Poor (low SES)
Discriminated/ stigmatized/ not tolerated
Marginalized (i.e. denied HR)
Victimized (blamed)

e.g. Women, LGBTQ, Ethnic minorities, Indigenous, homeless, OA, Immigrants

Question 3

Poverty (def)

Answer 3

No universally accepted definition

Experience of sustained/ chronic deprivation of resources necessary to achieve an adequate standard of living and rights

Question 4

T/F Poverty is man- made

Answer 4

T–> man made–> not natural–> can be eradicated

Question 5

Approaches to poverty

Answer 5

Basic Needs Approach
Market Basket Measure (MBM)
Low Income Cut Off Measure (LICO)

Question 6

Basic Needs Approach to poverty

Answer 6

Poverty = lacking the material resources to ensure physical well being (shelter, food, clothing)

Question 7

Market Basket Measure (MBM)

Answer 7

Lacking resources to ensure physical wellbeing (food, shelter, clothing) + essentials (undefined, i.e. transportation, entertainment, etc.)

Question 8

LICO

Answer 8

Low Income Cut Off Measure (LICO)

• Poverty = like MBM (no physical needs + essentials ) + taking into consideration family size and location
• spending > 70% of family income on physical needs (food, shelter, clothing)

Question 9

Define “the working poor”

Answer 9

Those who work F/T min half of the year but live below poverty levels

Question 10

Define Homelessness

Answer 10

not having permanent, appropriate stable housing and lacking the immediate ability if acquiring it

Question 11

Types of homelessnes

Answer 11

Unsheltered
Emergency sheltered
Provisionally sheltered
At risk of Homelessness

Question 12

Refugees living in shelters would be considered Provisionally sheltered T/F

Answer 12

F

Emergency sheltered

Question 13

Exampled of unsheltered

Answer 13

Living in public/ private places never meant for living

e.g. under bridges, attics, garages, cars , tents (Tent City), shacks sidewalks, vacant buildings

Question 14

Examples of provisionally sheltered

Answer 14

living w friends, couch surfing, motels/ hotels, rooming houses (i.e. sharing kitchen/ bath w 4 other ppl)–> insecure transitional housing

Question 15

Examples of emergency sheltered

Answer 15

In case of violence (e.g. women), natural disaster, fire, etc.

Question 16

Who is “ at risk for homelessness?”

Answer 16

Divorced/ separated
Facing eviction and no \$\$
No affordable housing
Children and conflict w caregivers--> kicked out
Addictions, mental illness

Question 17

Barriers to HC for the Homeless

Answer 17

• Stigmatized by HCPs–> lack trust
• Transportation difficult
• Lost OHIP
• Low literacy
• Not able to keep appointments
• Low adherence to tx (no $ to buy meds, disorganized/ do drugs- forget to properly adhere to tx)
• Competing priorities (i.e. may have to choose btw spending resources on food/ going to the doctor)

Question 18

Where do nurses work w vulnerable populations?

Answer 18

Shelters, churches, ED Hospital, Storefront clinics
Outreach:
- Street nurses
- Multidisciplinary mobile bus
- Home visits
- Phone appointments

Question 19

What are the nursing strategies to be used when working homeless/ poor ppl?

Answer 19

• Reflect on own values and put them aside–> destigmatize, humanize
• Establish relation of trust: listen to their stories (health clues), validate them, show respect and compassion, respect personal space (maintain safety), meet them on their turf (e.g. go to the streets); follow up w promises
• understand they have competing priorities and understand their SDOH
• start w what they consider priority
• “one stop shopping”/ coordinate services and providers
• provide direct care (wound care, DM feet, etc) and provide frequent screenings (TB, STI, pregnancy)
• focus on today, not the future
• preventive education (where to get condoms, needle exchange places)
• find cases and give referrals of homeless ppl to organizations/ shelters/ card finding
• advocate to political leaders, organization and general public to increase support programs/ funding/ > shelters
• e.g. Housing First Initiative: initiative that FIRST finds permanent and independent housing for the homeless, THEN works on providing needed services for them
• e.g. support at risk pregnant women (e.g. homeless, result of prostitution, drug users)
• e.g. Needle exchange programs (NEPs): non profit program where injecting drug users (IDUs) bring their used syringes and needles and receive an equal # of sterile needles and syringes, in addition to addictions counselling (if possible); WHO supports NEPs bc evidence strongly supports that it reduces the risk factors of contracting HIV, without evidence of exacerbating drug use
• use technology and social media as a way to engage, connect, refer and support the homeless

Question 20

What are the 5 groups that are at risk for low income? What does this mean?

Answer 20

1. Recent immigrants (< 10 years)
2. Indigenous living OFF reserve
3. Lone parents
4. Unattached individuals 45- 64 y.o.
5. Disabled (mentally/ physically)
   If the main household earner is part of this category–> family is at high risk of low income.

Question 21

A refugee housed in a temp. housing for refugees is what type of homeless?

Answer 21

Provisional homeless

Question 22

People living in group homes (e.g. LT care, for mentally/ physically disabled in need for support) are considered what type of homeless?

Answer 22

Provisional homeless