What did you learn about this population that can be implemented into your practice today?

Within your discussion response, include the following points. Most can be answered in one to two sentences but should be substantive and clear. Use of scholarly sources with correctly formatted citations and references is expected for each point. •Share why you chose to explore caring for this population. •What did you learn about this population that can be implemented into your practice today?•What was most surprising to you and why? From the Module Five Evolve course content, select one of the following case studies that resonates the most with you. Include the following: (1) Describe the problem and (2) Share how a public or community health nurse can provide therapeutic, professional nursing care for this population. •The Challenge of HomelessnessConsidering the population and disease on which you will focus in your Community Health Teaching Presentation. (ELDERLY COVID-19). Is this population considered vulnerable in any way? If so, how? How might this need to be addressed through your teaching?Nies, M A., & McEwen, M. (2019). Module five: Vulnerable populations. Community/public health nursing online for Nies and McEwen: 7th edition. [Evolve online course]. Retrieved from https://evolve.elsevier.com/Homeless Individuals in the ParkIt was a warm day, and many families were enjoying picnics in the park. The tennis courts were occupied with several individuals playing both singles and doubles, the swimming pool was active with many young families enjoying the sunshine, and an impromptu game was underway on the softball diamond. Summer was a great time to enjoy the beautiful park in Centerville.People of all walks of life enjoyed this park. On any given day there would be older couples walking along the river or sitting on benches to enjoy the view. Families of all sizes gathered at the park for picnics and recreational activities. Many teens worked as lifeguards at the swimming pool—a pool filled with children and adults of all ages. Tennis lessons might be given on the courts; several soccer matches were underway on the soccer fields; and people were riding bicycles on the trail. It was a busy place to be.New Visitors to the ParkRecently there had been some new visitors to the park. These visitors were not local families but strangers to the community. They did not participate in the activities, but instead isolated themselves from everyone else. Some could be found sleeping on a blanket near the edge of the trees or resting on the benches along the river. Some were seen picking through the trash bins after the dinner hour, apparently looking for food that had been thrown away.Several families had reported the park’s strangers to the local authorities. Panhandling was illegal in Centerville, but no complaints had been made so far about the individuals asking for handouts. Where did these people come from? What were they doing at the park? Were the children safe from these strangers? When the park closed at dark, where did these people go? Many questions were being asked about these visitors, but no one seemed to have the answers.Is Homelessness Only a Big City Problem?Centerville had never had a problem with homeless individuals. That had always seemed to be a big city problem. When the residents of Centerville visited the nearby city, they would often see homeless individuals hanging around parks in the downtown area. Sometimes they would see individuals just sitting on the sidewalk, looking lost and alone. One might even see a couple sitting at an outdoor eating establishment counting their money on the table to pay for a meager meal of a basket of day-old bread and a cup of soup.It was very hard to determine how many people were homeless in the nearby city. The city had established food stations and shelters for the homeless. Individuals who worked at those shelters reported an increase in the number of families who were homeless, and they often had to turn away requests for shelter when the weather turned colder. The largest group of single individuals was males, with more minorities represented than Caucasians.Factors Contributing to HomelessnessTo combat some of the main factors that contribute to homelessness, the city had implemented several policies to address the issue. People who live at or below the poverty level often cannot afford housing. They may be unable to get employment, or they may have a job that does not provide enough money for their family to rise above the poverty level. The number of people living below the poverty level has continued to increase, with an even larger increase in the number of people in extreme poverty (below half of the poverty level).The city surveyed the community to try to identify housing that was affordable for low-income families. When sufficient housing was not found, the government established a subsidized housing program to help make housing affordable. Individuals who could prove their income level was below a certain level qualified for subsidized housing. Unfortunately, the need for such housing far exceeded the demand.Many people who suffer from physical or mental disabilities are unable to obtain or keep a job. Individuals with limited assets or resources may need additional support to meet the demands of a work schedule. The city needed to increase support services such as affordable childcare, transportation, or appropriate vocational training for these individuals to help them become productive members of society.Health Needs of the HomelessIf a family is struggling to put food on the table and a roof over their heads, health care is no longer a priority. It is no wonder that research has found a direct correlation between income and health—the poorest people usually have the most health problems.Sometimes a major health problem taxes a family’s resources to the point that they cannot make rent or mortgage payments. As a result, they eventually lose their home. Then they must address the additional needs of finding shelter, storing medications, and meeting appointments when there are conflicting priorities. It can become a vicious cycle.Individuals who rely on community resources for shelter and food often have major health issues consistent with the poorest populations, such as tuberculosis, AIDS, malnutrition, and severe dental problems. Still other individuals face the complications associated with alcoholism, mental illness, diabetes, hypertension, and physical disabilities.Individuals who do not have regular housing might also fall prey to parasites, frostbite, infections, and violence. Most health care is obtained through the emergency room or at urgent care centers, but only after the illness has reached a serious level. Very few resources are put towards preventive care.Public Health Nurses Get InvolvedThe Riverside County Public Health Nursing Service was notified of the strangers in the park. After several conference calls with the civil authorities, the nurses offered to help the homeless individuals with resources that already existed in the community.Using Maslow’s hierarchy of needs as a guide, Nancy and Cheryl worked to meet the basic needs of food, shelter, and safety. Nancy and Cheryl knew that unless basics needs are met, it is nearly impossible to address the health care issues and other problems confronting homeless individuals. They decided to tackle housing first, then food and clothing. Health and safety issues would be integrated throughout.Housing was the first need to be filled. The community had recently built several new apartments that were eligible for federal subsidies for low-income individuals and families. A few apartments were available for rent, so arrangements were made to use these apartments to house the homeless individuals. County tax dollars were used to pay for the first month of housing. Applications were made for additional funds through state and federal housing subsidies.Housing Provided in Subsidized ApartmentsTwo apartments were reserved for three individuals, one male who lived alone and two sisters who would live together. They had all hitchhiked to Centerville when competition for space became a premium in the nearby city. For their primary living area, the three of them had joined forces and created a “tent” out of cardboard adjacent to a barn on the outskirts of town.During the day they would sleep near the barn or in the park; at night, they would wander the streets looking for discarded food. They felt safer being awake at night to avoid confrontations with police or other individuals; however, a local security officer had found their temporary tent near the barn.One of the apartments went to a family that consisted of a mother and three young children. They had been spending days at the park and nights sleeping in an old automobile—their “home on wheels.” The mother would move the car to a different part of town each day and had been doing that most of the summer.A Group Home in the CommunityTwo other male individuals refused the apartment housing. These men had limited mental capacity and qualified to live in a group home recently built when a small house near First Community Church was put up for auction.Several concerned citizens interested in providing a group home for individuals with physical or mental disabilities bought the small home at an auction. The home was too small for a group home, so the individuals contracted with the local community college to build an addition to the home through the home construction class. This contract allowed the home to be built for the cost of materials—the labor was provided as part of the class project. The concept is similar to the donated labor for a Habitat for Humanity-built home.The group home hired a head resident to live there, organize and supervise the preparation of meals within the home, and help the individuals get to work projects at the sheltered workshop. A van provided the residents with transportation to the workshop. The group home provided a supervised setting, but in a home-like environment. Many people flourished in this environment.Resources to Address the Needs of the HomelessThe next needs to be addressed included food and clothing. A community senior meal site had been providing lunch meals each day during the week for a minimal fee. Donations to cover the cost of additional meals for the homeless would be sought to provide at least one good meal a day for them.All of the adults were given the opportunity to select two sets of clothing, appropriate outerwear, and personal items from local second-hand stores. The stores also offered to provide clothing and toys that were safe and developmentally appropriate for the children. Arrangements were made with the health department so there was no charge for the clothing chosen by the homeless individuals.Local dental offices worked together to donate toothbrushes, floss, and toothpaste for all individuals, and they offered dental check-ups through a free dental program similar to the one started by the Indiana School of Dentistry.Using the Community Free Clinic for Health CareAll individuals were offered a complete physical exam at the Community Free Clinic during the weeks following their relocation. An anonymous donation was made to the clinic to cover the cost of these physicals and any related follow-up work. The health problems experienced by these individuals were typical of the problems seen in people who experience homelessness.One of the males seen at the clinic suffered from depression and talked about experiencing symptoms of chest pain and shortness of breath in the past month or two. The symptoms he described were consistent with a heart attack but, with no medical records, that finding could not be documented. He still experienced fatigue upon exertion, but had limited his physical activity to avoid the chest pain. The other two males both suffered from high blood pressure. One was a borderline diabetic and needed further evaluation of his nutritional needs; the other was dealing with alcoholism.The two sisters were relatively healthy in a physical sense, but both suffered from mental health issues. Tracing their medical history was difficult, but both had been diagnosed with schizophrenia and had a long history of medical noncompliance. They had always lived together and refused to be separated for any length of time.Health Needs in the FamilyThe homeless family was seen at the clinic. Although the mother was a relatively healthy thirty-three-year-old, her two older children (ages 5 and 7) suffered from asthma and needed regular medication. Neither child had attended school during the past year, so plans were made to enroll them immediately in a summer childcare program similar to Head Start. The toddler was treated for eczema and a severe diaper rash—the mother had been washing out the disposable diapers and reusing them as long as possible.Nancy and Cheryl, two of the public health nurses, decided to add the new clients to their caseloads for continued follow-up. It was especially important to monitor the treatment and medication compliance for the children’s asthma. The nurses would continue to follow the children as long as it was deemed necessary.Once Basic Needs Were Met…Once the basics of food, shelter, and safety were met, Nancy and Cheryl could help the individuals focus on becoming productive members of society. All of the adults were evaluated by the vocational rehabilitation center for their work skills and job potential. Recommendations were made for personal and professional counseling sessions. Any adults who had limited social and physical skills could work at the sheltered workshop in the community.The sheltered workshop provided assistance to several local businesses by contracting for services. Some of the services included simple jobs such as:•putting multiple paint chip samples together on a chain for a regional paint company,•sorting nuts and bolts into varying sizes for a tool and die manufacturing company,•weaving rag rugs from clothing discarded from the sheltered workshop clothing store, and•sorting cans and recyclable materials collected from several recycling centers around town.The young mother and the male in the apartment complex both had potential for the vocational rehabilitation training program. They were enrolled in the program, which was paid for by the government, and they received a living subsidy to cover rent and meals for the duration of the training. The program had arrangements with several area employers to provide internship opportunities and eventual employment for graduates of the vocational rehabilitation program.Addressing Homelessness in the Long TermNancy and Cheryl had helped these seven individuals become more productive members of society by using the resources already existing in Centerville. Nancy and Cheryl attended several city council meetings where the problem of homelessness was the topic of discussion.Cheryl shared the stages and level of assistance that had been provided to help these individuals, and she stressed that additional resources would be needed if the number of homeless individuals continued to rise. Nancy stressed that health care would not become a priority issue for them until basic needs of food, shelter, and safety could be met. Lack of basic necessities has a direct impact on the individuals’ health and vice versa—it is a vicious circle.Insufficient income sources, unaffordable housing, and lack of support services for vulnerable individuals are often considered some of the main factors that contribute to homelessness. Until these issues are confronted and addressed by communities as a whole, the problem of homelessness will continue to be a challenge to public health officials and government agencies. This problem cannot be addressed by one segment of society, but must be addressed in a collaborative effort. Public health nurses will continue to be involved as long as the citizens’ health is at risk.