Disabilities, Veterans, Homelessness, Rural Health, Mental Health (N475)

disability

limitation in carrying out a major life activity

ex. breathing, walking. hearing, seeing, learning, etc.

developmental disability

insufficient development of the brain, resulting in some level of cognitive dysfunction or impairment

ex. cerebal palsy, autism, down syndrome

impairment

loss of body function or structure

activity limitation

difficulty encountered by an individual in executing a physical activity

ex. POTS, heart disorders

handicap

physical accomodation

functional

there are four stages of the "disabling" process:

1. pathology
2. impairment
3. limitation
4. disability

increases

disability prevalence and severity levels (increases/decreases) with aging

ADA

Americans with Disabilities Act

prohibits discrimination against a person with a disability relating to employment

work

in order to a disabled person to qualify for social security, subsidized housing, food stamps, etc., the person must not be able to _ and must be disabled for a long period of time (>12 months?)

grieve

parents may over the loss of an idealized or expected child

this is a normal response; redefine their image of expectations for the child and themselves

communicate

health care problems in PWD are frequently unrecognized and untreated

this is often because they are unable to __ their symptoms/pain

ask

the nurse and or caregiver should always the PWD if they needs assistance; don't just assume they always need help!

knowledgeable client

a person who lives with a disability commonly becomes an expert at knowing what works best for his or her body

intersystem model?

knowledgeable nurse

the nurse who has information about the disability and the available community and governmental resources

PSDA

patient self-determination act

act that requires health decisions to be communicated and protected; patient is asked if they have POA or advanced directive

active duty

active duty vs. national guard and reserves

• full time personnel
• overseas deployment = 6-15 months
• long work days and hours

national guard and reserves

active duty vs. national guard and reserves

• part-time
• serves no more than 39 days a year

veterans health administration

division under the veterans administration that provides all types of healthcare in every setting

noise

which is the biggest health risk for veterans and is the leading cause of disability?

tinnitus and hearing loss

PTSD

anxiety attacks, hallucinations, nightmares, irritability, sleeplessness, and CVD and gastrointestinal disorders are symptoms of which disorder in veterans?

moral injury

veterans

rates of suicide among _ are significantly higher than those who are not veterans

especially women: female veteran suicides are 92% higher than non veteran female suicides

military sexual trauma

sexual harassment that occurred while the veteran was on active duty

heavily unreported

polytrauma

two or more injuries sustained in the same incident (veteran health risk)

results in chronic pain

orange

veterans in the Vietnam War had high exposure to agent __, a herbicide used to kill vegetation that provided cover to the enemy

chronic multi-symptom illness

illness prevalent in veterans from the 1991 Gulf War

unexplained symptoms: fatigue, dizziness, HA, cognitive dysfunction, musculoskeletal pain, respiratory problems, rashes, diarrhea

5

veterans make up around ____% of the homeless population

50% is apparently cap

1

it is recommended that veterans should prepare for the transition into civilian life about ____ year(s) prior to separation from the military

social

homelessness has 3 domains:

1. physical
2. _
3. legal

ETHOS = European Typology of Homelessness and Housing Exclusion

rooflessness

not living in a building

ex. car, street, tent

houselessness

unstable living environment in which the individual does not actually own and live in their house

ex. staying at friends' houses

insecure housing

housing threatened with severe exclusion due to insecure tenancies, eviction, domestic violence

ex. not having enough money to pay rent and then being kicked out

inadequate housing

housing that is inadequate for living; unsafe living conditions

ex. no utilities

literally homeless

category 1 of huid's definition of homelessness:

individuals or families who lack a fixed, regular, or adequate nighttime residence

imminent risk of homeless

category 2 of huid's definition of homelessness:

individuals or families who will imminently lose their primary nighttime residence

homeless under other federal statutes

category 3 of huid's definition of homelessness:

unaccompanied youth or families with children

fleeing domestic violence

category 4 of huid's definition of homelessness:

individuals or families who are fleeing domestic violence, sexual assault, stalking, or other life-threatening conditions

students

homeless __ include children and youth that:

• share housing with other people ("doubling up")
• abandoned in hospitals
• waiting for foster care placement

higher risk of bad things that i don't feel like typing, like bad nutrition, academics, etc.

runaway

a _ youth is a person under 18 who flees from home without permission

homeless

a _ youth is a person under 18 in need of services and is without a place of shelter

point in time

a _ ___ _ (PIT) counts sheltered homeless people at a specific time/day

continuum of care (CoC)?

5

1 in ____ homeless people are children under the age of 18 years old

no

is it illegal for children (under 18 years old) to be homeless?

as long as they are fed/have shelter… no one aint doing anything about it

6

chronically homeless causes a high risk for death if homeless for ____ months or more, OR with one of:

• >3 hospital ED visits/year
• >3 ED visits in previous 3 months
• 60 years or older
• liver cirrhosis
• ESRD
• hx of frostbite, immersion foot, or hypothermia
• HIV/AIDS
• co-occurring psychiatric, SUD, and chronic medical conditions

survival sex

swapping sexual favors for food or shelter; must exchange sex in order to survive

prevalent in the homeless youth

acute

rural populations have more disabilities resulting from conditions

higher rates of obesity, drugs/alcohol abuse, mental health condition prevalences, unintentional injuries, etc.

2500

a rural community has less than people

OR <45 people/square mile

firearm

intentional injuries in rural areas are most often caused by _ usage

unintentional injuries

what is the leading cause of death of individuals in rural areas?

ex. cars, fishing, hunting, tractors, farming, etc.

farm

migrant and seasonal _ workers have the poorest health of any aggregate in U.S.

high risk of chronic respiratory conditions

migrant

individual that migrates to find work or employment

seasonal

type of worker that resides permanently in one place and works locally when farm labor is needed

diabetes

migrant/seasonal worker populations have a high prevalence of _; it is 3-5 times greater than the general population

golden

individuals in rural environments often cannot receive emergency medical treatment within the _ hour because of distance, terrain, etc.

volunteers

rural EMS systems mostly consist of ___ and are usually short staffed

health

mental (health/illness) refers to the absence of mental disorders and includes emotional, psychological, and social wellbeing

illness

mental (health/illness) consists of major disturbances in an individual's thinking, feelings, or behavior that reflects a problem in mental function and causes distress or disability in social, work, or family activities

severe mental illness

any adult diagnosed any time during past year with a mental, behavioral, or emotional disorder with moderate, severe, or extreme functional behavior in a specific lifestyle area (this makes no sense)

closed

community mental health centers act (CMHCA) deinstitutionalized inpatients and _ down mental institutions

emotional

children with severe _ disorder (SED) have large disparities to healthcare

abandoned, mistreated, etc.

secondary

IS PATH WARM is an example of a level intervention for depression

look at photo

assertive

_ community treatment allows healthcare workers to serve the community and those with mental illnesses

provides supportive therapy, meds, mobile crisis, education, etc.