Reflective Memo for Fundamental of Nursing
Homelessness as a social phenomenon is common to mankind for the throughout its existence. Usually its high point comes at the periods of social upheaval: war, famine, environmental local catastrophes, earthquakes, floods, various crisis processes, etc. Now it is inherent in both developed and underdeveloped countries.Reflective Memo for Fundamental of Nursing
In modern society, reasons which aggravate the problem of homelessness are
- Poverty, growth of housing prices
- Reforms in the health care system, when it was decided to keep mentally ill people in settlements instead of public psychiatric hospitals. However, due to lack of funds for housing programs, many patients became homeless. So, in 1955, state mental hospitals of closed type kept 559 thousand people out of a total population of 165 million people. In 1998, state mental hospitals kept 57 151 people when the population was about 275 million. The number of places occupied in the US state mental hospitals declined from 339 per 100 thousand of population to 21 per 100 thousand population (Lamb, 2001)
- Complex housing legislation, which impedes the possibility of building low-cost housing
- Nearly half of children living in foster homes and institutions of public care, become homeless after they turn 18 years old (Piasecki, 2006)
- Natural disasters, depriving people of property.
Many believe that people themselves lead such a way of life that they become homeless, especially this concerns teenagers who allegedly want more freedom and independence. In fact, very rarely homelessness is a conscious choice. Life on the street is dangerous and difficult, thus it often ends in tragedy. Homeless people depend on the others almost in everything; aggression, neglect and cold are against him.Reflective Memo for Fundamental of Nursing
Homeless people are very vulnerable because they are not able to take care of themselves even basically, ie wash and change clothes. When a person is badly dressed and dirty, he loses his dignity, which is very hard psychologically.
In the United States, homeless people constitute a large social group. According to the report prepared by the Department of Housing and Urban Development at the beginning of 2013, there were 610,042 homeless in the USA. Of these, only 65% used the services of shelters and centers of temporary stay. 35% of homeless did not have any shelter. Children under 18 make up nearly a quarter (23%) of the total number of homeless people in the United States. This is 138,149 people (Meghan, 2013).
Every US state has different situations with the homeless. The number of homeless people is changing from year to year. For example, in 2011, there were more than 50,000 homeless in Maryland. In 2012, this number was 7 % less (Health Care for the Homeless, 2013).
Various factors can make homeless people vulnerable to many medical problems. At the same time, receiving services for prevention and treatment of disease is the most difficult for this group of population. Homeless people generally suffer from various health problems, morbidity and mortality among them is much higher than among general population. For example, HIV prevalence among homeless people is very different and depends on the subgroup to which one belongs, but in general, HIV is found among homeless people more often than among general population. High prevalence of HIV in this case is accompanied by limited or no access to HIV treatment and poor living conditions, which leads to the fact that AIDS has become one of the leading causes of death in this group.Reflective Memo for Fundamental of Nursing
A study in San Francisco showed that the spread of HIV among homeless adults in this city is 10.5%, which is five times higher than among the whole population in San Francisco. On the one hand, for people with HIV the risk of becoming homeless is much higher due to discrimination in employment, the cost of medical care and other problems. On the other hand, for homeless people there is an increased risk of HIV transmission (San Francisco HIV Foundation, 2014).
Homeless people live in unstable circumstances and often in disadvantaged communities with a high incidence of disease. Thus, their risky behavior often leads to infection. Homeless people are more likely to suffer from abuse of drugs, alcohol and mental health problems than the general population. According to research conducted in 2000, 88% of homeless men and 69 % of homeless women suffered from all three problems at the same time (Statistic Brain, 2014). Moreover, approximately every fourth homeless man has a constant and sufficiently severe mental disorder.
It is known that the average life expectancy of a homeless person is 47 years for men and 43 years for women, compared to 77 years for the rest of the population (Crisis, 2012). Causes of death of homeless differ from causes of death of the rest of population. The main causes of death of homeless are diseases and drug and alcohol abuse (one-third of all cases). Researchers note that often these factors act as both causes and consequences of the loss of homes. Previous research has shown that four out of five people are starting to take at least one type of drug after becoming homeless.Reflective Memo for Fundamental of Nursing
Homeless people are also nine times more likely to commit suicide than other people, and three times more likely to die as a result of road accidents. Their risk to die due to infection is twice higher and the risk of dying from a fall is three times higher (Do Something.Org, 2014).
The US government understands the problem of a large number of homeless people and tries to resolve it by conducting various assistance programs for homeless people. A lot of governmental and non-governmental organizations help American homeless community in various ways. The assistance of non-governmental organizations consists of advocating and giving physical and financial aid. The work of government agencies is to realize programs and policies, recognize the fact of homelessness, give help to the homeless, and prevent further increase of the homeless population.
A lot of governmental programs that are created to assist homeless people have incorporated some type of housing programs for their clients. All types of housing program (transitional, permanent and emergency) provide the assistance for a very low cost or even for free.
One of the helpful government programs is Healthy People 2020 that provides science-based, state goals and objectives together with 10 -year targets created to conduct national health promotion and illness prevention efforts to improve the health of all American citizens. The program Healthy People 2020 consists of about 1,200 objectives in 42 Topic Areas intended to be the framework for improving people’s health, including homeless in the state.Reflective Memo for Fundamental of Nursing
The government of the country tries to solve the problem with homeless people creating new policies. There are several policies dealing with homelessness. Everything started in 1980 when the government decided to start giving financial support to the homeless, but it didn’t work until 1984 when those shelters were built to accommodate and provide food to them. Later, in 2002, the Bush Administration announced a national goal of ending chronic homelessness by 2012. That initiative of a 10 -year plan to finish chronic homelessness in the USA started as a part of a 10 -year plan to end homelessness in general which was adopted by the National Alliance to End Homelessness in 2000. The last achievement was made in 2009, when the President of the USA, Barack Obama, signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009.
Homeless population is a social group that is very vulnerable since the homeless people are at an increased risk for adverse health-related and other outcomes. Understanding the nature of homelessness and the relationship between resource availability, relative risks, and health status is critical for nurses to diagnose and treat health-related problems in this vulnerable population (Strehlow, 1999).
The government understands the problem that has arisen with the homeless and tries to solve it adopting new laws and implementing programs. Our society uses different forms and methods of social work with homeless: night stay houses; “hotlines” for the homeless and vagrants; shelters, canteens and showers with laundries; social centers, etc. Homeless people are very vulnerable in the modern world and this situation should be changed.Reflective Memo for Fundamental of Nursing
References
Crisis. (2012). Homelessness: A silent killer – A research briefing on mortality amongst homeless people’ London: Crisis. Retrieved from
http://www.crisis.org.uk/data/files/publications/Homelessness%20-%20a%20silent%20killer.pdf
Do Something.Org. (2014). 11 facts about homeless teens. Retrieved from https://www.dosomething.org/actnow/tipsandtools/11-facts-about-homeless-youth
Health Care for the Homeless. (2013). Clinicians’ Network. Third Edition. ADAPTING YOUR PRACTICE. Treatment and Recommendations for Unstably Housed Patients with HIV/AIDS.
Lamb, R., & Bachrach, L.L. (2001). Some Perspectives on Deinstitutionalization // Psychiatric Services 2001, 52, 1039-1045.
Meghan H., Cortes, A. & Morris Abt Associates. (2013). The 2013 Annual Homeless Assessment Report (AHAR) to Congress. Part 1. Point-in-Time Estimates of Homelessness. The U.S. Department of Housing and Urban Development. Office Of Community Planning and Development. Retrieved from https://www.onecpd.info/resources/documents/AHAR-2013-Part1.pdf
Piasecki, J. (2006, June 22). Throwaway kids: Thousands of area foster children leave county care for a dangerous and desperate life on the streets, Pasadena Weekly.Reflective Memo for Fundamental of Nursing