NURS11162: Nursing- Healthcare Consumers- Assessment Answer

Nursing Assignment

Assignment Task

The task requires you to write a essay about 2 (two) types of healthcare consumers. You will need to choose one type of healthcare consumer from Group A and one type of healthcare consumer from Group B as follows:

Group A

• A person with a physical disability confined to a wheelchair
• A person with intellectual disability
• A person with vision impairment requiring a guide dog

Group B

• A person who identifies as belonging to the Lesbian Gay Bisexual Transsexual and Intersexual (LGBTI) group
• A person who is homeless
• A person who is an injecting drug user

In order to complete the task, you are to address the following criteria for each of your chosen type of healthcare consumers.

Consider these concepts, together with the supporting literature, when addressing the following 3 (three) criteria:

1. Critically examine access barriers to quality health care

2. Discuss potential issues affecting health literacy

3. Critically discuss the impact of policies on promoting inclusion in accessing quality health care

Introduction

Much has been done to improve the community healthcare delivery system in Australia, but there is still requirement of improvement in the delivery system for the people with intellectual disability and developmental disabilities. Addressing the healthcare needs of the people in Australia is an important step take by the government, but these people still find the lack of necessary resources, which could change their healthcare condition.

In most of the developed countries (Australia, USA, Canada), homeless has been emerged as the major social issue. Being homeless is not just a simple issue of living without a home, but it is more complex issue, which includes various factors that contribute to homeless condition of an individual. The first part of the essay is going to present the key concepts of healthcare delivery for people with intellectual disability emerged through the interview of Rikki. Thus, second part of the essay is going to present the various factors affecting the healthcare delivery for the homeless people in Australia through the interview of Chris. It will also review the barriers and potential issues affecting healthcare literacy with the discussion of healthcare policies for homeless. The essay will focus on the healthcare needs of intellectually disabled and homeless people in Australia.

Group A- Healthcare Facilities for People with Intellectual Disability

Consumer Interview

Disability is seen the people of every age, sex, race and gender, but the people suffering with disabilities, but people with disabilities are not considered as the priority population in the public health policies. The prevalence of disability is very high in Australia, but the health care evidences for these people are sparse. The evidences developed from the Australian and international resources, have shown that people with disabilities have the sever health conditions (Ervin et al, 2014). The medical conditions associated with the causes of disability have been widely documented in the medical literature, but the health differences documented are mainly the socially determined rather than being associated with healthcare facilities (Emerson et al, 2011). According to the video of Rikki, she is suffering from intellectual disability and her mother is the care giver for her. Her mother informed the interviewer about the unsatisfactory services they received at the hospitals. Rosaline (Rikki’s mother) informed that Rikki requires separate room whenever she is hospitalized to have comfortable environment. She also requires a person to stay with her all the time. Rikki is not able to eat her food by herself, and need her mother’s assistance.

Intellectual disability is the condition, where an individual has severe limitations to complete their daily activities. The people with intellectual disability use the healthcare services on the higher rate, but the healthcare access is still limited and insufficient to meet their needs. The mental health of the people with intellectual disabilities, does not allow them to complete their daily task without support of care givers.

Barriers to Access Sufficient Care

The first barrier in accessing the quality healthcare by the intellectually disabled people is the diagnostic overshadowing, which refers to the tendency of the healthcare professionals. Under this tendency the healthcare professionals ignore the unrelated illness and consider it under the diagnosis of the intellectual disability. For example, a person suffering with intellectual disability may have been diagnosed with some kind of mental disorder or illness (Ervin et al, 2014). The symptoms of such illness are often thought to be related to intellectual disability rather than being considered as secondary illness. The overshadowing diagnosis also explains the higher rate of undiagnosed illness.

People with intellectual disability have unique and primary needs. To fulfill these needs, these people require tailored approach in the delivery system of the healthcare in Australia. The access to the quality healthcare can be defined in two ways, the first is the physical access to the healthcare service, and second is the access of quality care from the service providers (Ervin et al, 2014). The available services are often unresponsive to the unique needs of the consumers, which can become a major barrier to access sufficient care. The lack of knowledge and skills of the healthcare providers is also a barrier in access to care. People with intellectual disability often receive care from the service providers and practitioners, who are not appropriately trained to access the physical and medical concern of such people (Ali et al, 2013). The healthcare systems mainly focuses on the acute medical conditions and not on the chronic conditions, and remain poorly equipped to fulfill the needs of intellectually disabled people.

Issue Affecting Healthcare Literacy

There is wide array of literature available for increasing the ability of the people with intellectual disability. The healthcare literacy helps them to manage their own health. But, health literacy is the topic which is overlooked and poses inequalities in healthcare for these people (Ali et al, 2013). The people with intellectual disability have reported dissatisfaction, as the healthcare professionals fail to provide health information to intellectually disabled people (Chinn, 2014). There is a lack of communication among the professionals and consumers, as the professionals could not explain the medical procedures to these people, and also they are unable to make trustful relationships with care recipients. The people with intellectual disability are excluded from the benefit of critical health literacy (Chinn, 2014). Lack of skills in the health care professionals, and lack of communication, results in inappropriate care and treatment.

Impact of Policies

The United Nations Convention on the Rights of People with Disabilities was ratified by Australia in the year 2009. This includes all the international standards and obligation to provide equal fundamental and human rights to the people with disabilities. According to the law, making discrimination against intellectually disable people is unlawful, still many inequalities persist in various domains. But, there is lack of awareness towards the existing policies for intellectually disabled people. It is very important that existing policies must specifically refer to the needs of people with intellectual disabilities, and more targeted and wider policies must be developed. If necessary, new policies must be developed for the inclusion of specific needs of these people. The inclusion must also consider and determine the level of negative impacts that they can pose to the health of intellectually disabled people. Systematic review of the policies will help the professionals to understand the proper implementation and to achieve reasonable positive results (Robertson et al, 2011).

Group B-Healthcare Facilities for People Who are Homeless in Australia

Consumer Interview

For the purpose of discussing the inequalities and problems associated with healthcare delivery for homeless people, the interview of the homeless consumer is included in the study. Chris is a homeless person, who lives in terrible condition, without healthy environment, employment and quality food resources. Developed nation like Australia, the profile of homeless people has also changed. Now the young people and people like Chris are homeless. According to the census of year 2011, 0.5% population of Australia is homeless, in which 60% people are below age of 35 years. The fundamental aspect behind homeless is the lack of connectedness with friends, family members and lack of controlled living environment, as in the case of Chris. Many human rights are associated with the condition of homeless people. Poor health is another problem, which is associated with low living condition of these people. These people are more exposed to severe chronic diseases and require effective healthcare facilities (Bywood, Katterl, & Lunnay, 2011). The high rate of mortality, metal diseases and injuries are found in these people in comparison to general population.

Barrier to Access Quality Care

Despite of high prevalence of morbidities and mortality, homeless people face many financial and non-financial barriers for accessing quality healthcare services. The homeless people are mainly unemployed and financially deprived. Lack of health insurance is the major barrier, which deprives them from accessing quality healthcare services (Australian Human Rights Commission, 2008). The non-financial barriers includes, giving priority to access food and shelter, long waiting time in healthcare services, lack of transportation for physical access (Bywood, Katterl, & Lunnay, 2011), and feeling of stigma. These are the barriers that contribute to further deterioration of health in homeless people (Lamb and Joels, 2014).

Thus, it would be correct to state that mental and physical health needs of the homeless people are not adequately managed in the primary healthcare. These people are found to be more addicted (Alcoholism or substance abuse), have high risk behavior (sexually transmitted diseases), and severe mental health disease, for which they may require expensive secondary care (Argintaru et al, 2013). Thus, the barriers to access quality healthcare are lack of identity proofs that does not allow them to register with GPs, fear of being denied for ill health, problem in communicating their health needs, lack of support, discrimination, low self-esteem, stigma (Bywood, Katterl, & Lunnay, 2011) and lack of healthcare literacy (Lamb and Joels, 2014). According to the report of Bywood, Katterl, & Lunnay (2011), Homeless people have described the unmet needs of the primary healthcare services, and due to lack of early intervention, their health problems become worse.

Healthcare Literacy

Health literacy is very important for the professionals working under primary healthcare delivery system. The lack of healthcare literacy can be a major issue for providing quality treatment and care to the patients. The inflexible model of the service delivery, which is appointment based and require financial aid are difficult for homeless people (Campbell et al, 2015). Health literacy can be defined as the situation, where people perceive knowledge about understanding the healthcare information and how they use this knowledge to apply in their lives. Individual health literacy is important so that a person can acquire skills, knowledge, and could motivate others also (Australian Commission on Safety and Quality in Health Care, 2014). Health literacy is very important for the service providers as well as the service recipients. Homeless people are often unable to make positive relationships with their healthcare providers due to stigmatization and it affects their healthcare literacy.

Health literacy is also coming up as a major issue in Australia. Approximately 60% of the Australian population has low health literacy, which does not allow them to make effective choices about their healthcare decisions. Thus, the formal involvement of the homeless people is affected due to low health literacy. For providing safe and high quality healthcare improvement in health literacy are important.

Impact of Policies

There are many policies in Australia for the homeless people such as The National Affordable Housing Agreement (NAHA),The National Partnership Agreement on Homelessness (NPAH) and Going Home Staying Home (GHSH) (Costello, Thomson, & Jones, 2013). But, the main issue with these policies is that they mainly focus on providing home for the homeless people, instead of including provisions for effective healthcare services. Homelessness is considered as the human right issue, but main focus is on providing affordable homes, preventing risk of becoming homeless again and improving social housing arrangements. the Australian Government released a White Paper on Homelessness: The Road Home: A National Approach to Reducing Homelessness, it also mainly focuses on the funding and providing home to these people. With universal healthcare system also, people who are homeless have reported unmet needs of primary healthcare due to various financial and –non-financial reasons (Tuffrey-Wijne et al, 2014). Thus, policies require inclusion of new approaches towards the health of homeless people. The policies must specifically focus on the primary healthcare needs of these people.

Conclusion

Intellectual disability is highly prevalent in Australia. There are limited policies and procedures to meet the needs of these people. The essay reviewed the barriers for sufficient access to healthcare services. Often these people are denied their right to have health related education and literacy from the professionals. It is required that new policies must be developed that can specifically target the population suffering with intellectual disabilities.

Homelessness is also a major social issue for Australia. Many people are homeless in a developed nation like Australia. The lack of support, unemployment, and low education has greatly contributed to the low living conditions of these people. The essay provided the discussion of the major barriers among effective delivery of primary healthcare service for homeless people and people with intellectual disability. The discussion is also provided for the affects of low health literacy and ineffective policies for intellectually disabled and homeless people.