Calgary Drop-In & Rehab Centre A Picture of the Health of a Homeless Individual
2006 All Rights Reserved Calgary Drop-In & Rehab Centre
The Calgary Drop-In & Rehab Centre (Calgary Drop-In) provides services of food, shelter, and clothing, counselling and basic medical attention to all those in need. In operation since 1961, the Calgary Drop-In & Rehab Centre now sleeps 1100 nightly, and provides meals to 3500 people daily. Providing health services to the complex medical problems faced by the homeless are one of the challenges providers struggle with. This presentation is an examination of the breakdown in the continuum of care. ABSTRACT
Objective: A data collection study was completed to meet the following objectives:
· to obtain a snapshot picture of the current health of Drop-In clients. · to determine which medical services are used by clients · to examine gaps in services and providers
The Calgary Drop-In & Rehab Centre, an emergency shelter located in Calgary’s downtown core, has approximately 950-1100 individuals using the shelters services on any given night. A noticeable trend has emerged, as the numbers of shelter users have grown; clients have increasingly more complex medical conditions. As a result of these complexities, there is a need to provide appropriate, integrated care. A study was completed in-house asking clients about the length of time they have been homeless; their impressions of their health; where they seek medical services; the types of medical conditions they currently live with; the types of medication they have been prescribed and are currently taking; and how they pay for their medications. A sample of one hundred fifty-one (151) clients were surveyed, approximately 15% of the CDIRC’s sheltered population. METHODOLOGY Procedure Method:
· Self Reporting Questionnaire of 151 Drop-In clients; about 15% of the population. · length of time homeless · impression of health · where they seek medical attention · medical conditions they live with · types of medication prescribed · how they pay for prescriptions
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Demographics of population surveyed
Location of demographic surveyed
· Intox: 75% male / 25% female · Emergency: 91% male / 9% female · Transitional: 87% male / 13% female
Types of sleeping services offered at the Calgary Drop-In & Rehab Centre:
1. Intox beds: are for individuals under the influence of either drugs or alcohol. 2. Emergency beds: are for sober individuals on a first come, first serve basis. 3. Transitional beds: semi-permanent housing to facilitate the move from shelter to independent living.
2006 All Rights Reserved Calgary Drop-In & Rehab Centre
Intox Shelter Clients - Age Range Intox Shelter Clients - Length of Time living on the streets or in a shelter.
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Intox Shelter Clients - Right now, how would you rate your overall health? Intox Shelter Clients - Where do you usually go for medical treatment?
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Intox Shelter Clients - Please list any medical conditions or concerns?
8 - feet and leg problems4 - hypertention3 - siezures
1 - bipolar1 - cyatic nerve1 - manic-depressive
Intox Shelter Clients - Have you ever been prescribed ongoing medications? Are you taking the above regularly?
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Emergency Shelter Beds - Age Range Emergency Shelter Clients - Length of Time living on the streets or in a shelter.
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Emergency Shelter Clients - Right now, how would you rate your overall health? Emergency Shelter Clients - Where do you usually go for medical treatment?
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Emergency Shelter Clients - Please list any medical conditions or concerns?
Total of 66 Clients interviewed - 15% of population
Emergency Shelter Clients - Have you ever been prescribed ongoing medications? Are you taking the above regularly?
4 - Cost2 - Cut Off1 - Only when required1 - Does not work
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Transitional Shelter Clients - Age Range Transitional Shelter Clients - Length of Time living on the streets or in a shelter.
Total of 53 Clients interviewed - 15% of population
Number of Respondents
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Transitional Shelter Clients - Right now, how would you rate your overall health?
Total of 53 Clients interviewed - 15% of population
Number of respondents Transitional Shelter Clients - Where do you usually go for medical treatment? ponde s e 20 r of R e b m 15
2006 All Rights Reserved Calgary Drop-In & Rehab Centre
Transitional Shelter Clients - Please list any conditions or concerns? Emergency Shelter Clients - Have you ever been prescribed ongoing medications? Are you taking the above regularly?
4 - Cost2 - Cut Off1 - Only when required1 - Does not work
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Observations · Female respondents perceived their health as very poor to average as compared to the male respondents whose perceptions ranged from very poor to very good. · Respondents living in Intox and Transitional housing were older and longer on the streets than those living in emergency shelter beds. · Respondents living in emergency shelter beds have a perceived health from poor to very good, however the longer the respondent lived on the streets a decline of perceived health was reported. · No matter where a respondent resided in the shelter system, they reported their health as Average, even if they reported more than 2 medical conditions or concerns. · The primary service provider was 8th &8th Medical Centre, followed by CUPS. Almost 60% of respondents stated that they will not go to another medical service provider as a secondary service provider. · 71% of the respondents did not have a family doctor · Majority of respondents paid for their medications either by cash or through Social Services. Our Conclusions
· Homelessness affects the health and well-being of an individual. The longer they are on the streets, there appears to be an inconsistency between the observed health of the individual and the individual’s personal perception of their own level of health · As one’s housing becomes more stable, their perceptions of their health become more realistic and their overall health and well-being appear to improve. · There is a need for a continuum of care for the homeless population. · An integrated care model would benefit this population’s diverse medical needs including addictions and mental health. Discussion
Survival is this population’s primary struggle. The medical needs of the homeless do not meet the criteria of any one medical service provider, therefore an integrated care model would benefit this population’s diverse medical needs including addictions and mental health. Most homeless people suffer from one or more chronic conditions, yet our delivery systems are focused on the episodic treatment of chief complaints at a given moment in time. Readily accessible, consistent, and continuous care from a known, trusted clinician is not always available for many people experience homelessness. For an agency that offers services to more than 1100 individuals a night, an on-site medical clinic would be of great benefit to meet their medical needs. * Survey and data all conducted November 2005 by Calgary Drop-In Staff.
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Comments on “BIOIDENTICAL HORMONES” - March, 2009 Below is an article that was published in the Wall Street Journal on Mar 16th, 2009. Two of my patients have been kind enough to give me a copy of the article, to warn me of what’s out there. My comments are dispersed throughout the article. This type of article is exactly why there is so much “confusion, ignorance and misinformation”