Question 1

Mr. Hall is a 78-year-old Veteran who is homeless. He is most likely to fit into which category of homelessness?&#10;A) Chronic&#10;B) Transitional&#10;C) Episodic&#10;D) Not at risk for homelessness

Accepted Answer

Homelessness has a temporal dimension. The three basic temporal categories of homelessness are chronic, transitional, and episodic. The causes and stressors are different for each type of homelessness, as are their intervention needs. People who are chronically homeless tend to be older, unemployed, and often mentally ill and/or physically disabled. Although a small percentage of the homeless (10%), these are people who have been homeless for a year or more. Those who are transitionally homeless tend to be younger and become homeless because of some catastrophic event, such as a house fire or job loss. They use the shelter system temporarily before transitioning into more stable housing and represent the largest percentage (80%) of the homeless population. The episodically homeless (10%) are typically persons who are chronically unemployed, often due to medical, mental health, and substance abuse disorders. They may stay with family and friends intermittently and frequently move in and out of homelessness. The episodically homeless are at risk for becoming chronically homeless if the issues that caused their homelessness are not resolved (National Coalition for the Homeless [NCH], 2018).

Question 2

A structural issue related to homelessness is:&#10;A) Mental illness&#10;B) Affordable housing&#10;C) Chronic medical conditions&#10;D) Education status

Accepted Answer

Homelessness is the result of a complex interaction of structural factors, personal characteristics and vulnerabilities, and cultural influences (Petrenchik, 2006). Structural factors emerge from the social and environmental conditions in which people live, such as a lack of affordable housing. Personal vulnerabilities, such as mental illness, place individuals at greater risk for homelessness. A holistic understanding requires consideration of the various structural factors and personal characteristics that precipitate homelessness and their interactions.

Question 3

In order to address homelessness, one strategy is to advocate for which aspect of structural support?&#10;A) Mental illness treatment programs&#10;B) Medication assistance therapy programs&#10;C) Increased social welfare funding&#10;D) Employment programs

Accepted Answer

An important structural factor that increases the rate of homelessness is cuts to social welfare programs. According to Petrenchik (2006), as state governments in the United States seek to conserve limited resources, funding for welfare programs is often the first to be reduced, resulting in less spending on programs intended to benefit the poor. In particular, funding for Medicaid, low-income housing, food stamps, and child welfare programs is often targeted by these efforts, further weakening the protections they provide. Petrenchik (2006) notes that education spending is also a frequent target, with cuts to elementary, secondary, and higher education directly affecting homeless children, who are already at a disadvantage. Some of the school-related programs that are targeted by budget reductions and affect low-income and homeless children include meals, transportation, and other special services. According to Blank (2010), the reduction of entitlement programs-for example, Medicaid and the Supplemental Nutrition Assistance Programs (food stamps)-is particularly detrimental to families in the United States, where eligibility for social support may be contingent on employment. This makes it increasingly difficult for low-income families struggling to find employment to benefit from these support systems. Without these benefits, families that are already facing uncertainty are made even more vulnerable, with even a slight decrease in aid increasing the odds that they will experience homelessness.

Question 4

Greg is a 17-year-old transgender individual recently kicked out of his family home. Due to his new homelessness, Greg is now vulnerable to developing which chronic condition?&#10;A) Pneumonia&#10;B) Bipolar disorder&#10;C) Diabetes&#10;D) Substance abuse

Accepted Answer

Substance use disorders have been found to predict risk for first-time homelessness (Thompson et al., 2013). Substance abuse can also result from having experienced homelessness. Among the homeless population of Melbourne, Australia, Johnson and Chamberlain (2008) found that 34% of people reported having developed an alcohol-use or other drug-use disorder before becoming homeless, whereas 66% of those surveyed had developed a substance-use disorder during or after a period of homelessness. The authors attributed this difference to substance use as a form of coping, as well as a homeless subculture that promotes drug use. They also noted that people who first became homeless as teenagers were more than three times as likely to develop a substance use disorder compared with those who first became homeless as adults (Johnson & Chamberlain, 2008).

Question 5

The average homeless family consists of:&#10;A) Transgender youth&#10;B) A mother and young children&#10;C) A Veteran couple&#10;D) Teenage siblings

Accepted Answer

On average, a homeless family consists of three people, most frequently a single mother with two children, often under the age of six. The mothers often have low levels of education, are unemployed, and are without adequate transportation. Many of these women are survivors of intimate partner violence (IPV) who fled a dangerous home situation. Women who have been subjected to IPV are four times more likely to experience housing instability than those who have not. Not surprisingly, they have disproportionately high rates of anxiety, depression, and posttraumatic stress disorder, and many self-medicate their distress with alcohol and other drugs (Bassuk, DeCandia, Beach, & Berman, 2014). Homeless women and adolescents may also be victims of the sex trade, exchanging sex for money to obtain food, shelter, and other basic needs (Nooe & Patterson, 2010).

Question 6

Morgan is an 8-year-old who frequently misses school. You discover she is homeless. Morgan is at risk for experiencing which of the following that puts her at risk for future mental illness?&#10;A) Hunger&#10;B) Illness&#10;C) Adverse childhood experiences&#10;D) Poor sleep patterns

Accepted Answer

Children in homeless families are often hungry, sick, and worried about where and when they will eat and sleep again. Many of these children are frequently absent from school and need to repeat grades, if they do not drop out of school entirely. In addition, children experiencing homelessness experience high levels of stress and recurrent exposure to violence, which have significant mental health consequences. Adverse childhood experiences (ACEs) are correlated with social, emotional, and cognitive impairments in children and adolescent risk-taking behaviors. ACEs are defined as "stressful or traumatic events, including abuse and neglect" (Substance Abuse and Mental Health Services Administration [SAMHSA], 2018a, para. 2). Many runaway and homeless youth (60-80%) are victims of emotional, physical, and/or sexual abuse in the home environment. Additionally, the loss of safety, privacy, possessions, friends, pets, and routines creates a life-altering experience, inflicting deep and enduring emotional scars on these individuals and families (Bassuk et al., 2014).

Question 7

A significant number of homeless youth identify as:&#10;A) Straight&#10;B) Mentally ill&#10;C) Homeless&#10;D) LGBTQ

Accepted Answer

According to the USDHUD (2016), youth who are lesbian, gay, bisexual, or transgender, or who are questioning their sexual orientation or gender (LGBTQ), are disproportionately represented in the homeless population. Comprising 7% of the general youth population, they represent nearly 40% of the youth experiencing homelessness. Rosario, Schrimshaw, and Hunter (2012) suggest there are two pathways to homelessness among LGBTQ youth, the first being sexual abuse, and the second being an earlier age of sexual development. LGBTQ youth often leave home after being rejected by family members (Cochran, Stewart, Ginzler, & Cauce, 2002; Kipke, Weiss, & Wong, 2007), and they are more likely to have been sexually abused prior to becoming homeless (Nolan, 2006; Rosario, Schrimshaw, & Hunter, 2012).

Question 8

An emerging group at risk for homelessness is:&#10;A) Older adults&#10;B) Single mothers&#10;C) Veterans&#10;D) LGBTQ individuals

Accepted Answer

As the median age of the U.S. population shifts upward, the number of older adults living in poverty and experiencing homelessness is also increasing. The demand for housing for low-income older adults exceeds the supply. The mortality rate of older adults who are homeless is three to four times higher than for those living in safe housing (Nooe & Patterson, 2010). A cross-sectional study by Brown, Kiely, Bharel, and Mitchell (2012) found that common geriatric conditions were more prevalent among older homeless adults than others in the general population who were in their same age group. Of 247 homeless adults between the ages of 50 and 69 years old, 30% reported experiencing difficulty performing one or more activities of daily living (ADLs). Participants were more likely to have experienced urinary incontinence (49.8%), major depression (39.8%), and vision loss (30.0%) compared to their population-based cohorts. Other common conditions among the homeless adults were hearing loss (29.7%) and cognitive impairment (24.3%). Of the older adults studied, 53% had experienced a fall in the prior year (Brown et al., 2012).

Question 9

A structural factor impacting the homelessness of Veterans is:&#10;A) Posttraumatic stress disorder&#10;B) Difficulty transferring military job skills to the civilian workforce&#10;C) Addictions&#10;D) Limited family and social support networks

Accepted Answer

All of the structural factors previously described-poverty, lack of affordable housing, and an unlivable federal minimum wage-have an impact on Veterans. In addition, Veterans contend with the lingering effects of posttraumatic stress disorder (PTSD) and substance-use disorders, and often have limited family and social support networks. Fifty percent of Veterans who are homeless have serious mental illness, 70% have substance abuse problems, and 51% have service-connected disabilities (predominantly traumatic brain injury). A history of military sexual trauma is a predisposing factor for homelessness, particularly among female Veterans. Furthermore, military training and job classifications do not always transfer to the civilian workforce, making finding and securing positions that pay a living wage difficult (NCHV, n.d.).

Question 10

Which intervention enhances the likelihood that individuals and families will maintain housing stability?&#10;A) More shelters&#10;B) Trauma-informed care&#10;C) Educational and employment opportunities&#10;D) Family and social support networks

Accepted Answer

Providing educational and employment opportunities enhances the likelihood that individuals and families will be able to maintain housing stability. Job skills training, job placement assistance, childcare, and transportation are required for parents, particularly mothers, to obtain and maintain employment. Stable housing and related supports are prerequisites for social and community participation (Petrenchik, 2006).

Question 11

Angela is a 15-year-old transgender female who was raped while homeless. Angela would benefit from which intervention?&#10;A) Housing&#10;B) Trauma-informed care&#10;C) Educational and employment opportunities&#10;D) Family and social support networks

Accepted Answer

The answer of Angela is a 15-year-old transgender female who...

Question 12

The most common location for occupational therapy direct service provision for a homeless population is:&#10;A) Emergency shelters&#10;B) Food pantries&#10;C) Transitional housing&#10;D) Homeless shelters

Accepted Answer

The answer of The most common location for occupational therapy...

Question 13

Which of the following is an example of a systems-level occupational therapy intervention for the homeless population?&#10;A) Program needs assessment&#10;B) Group intervention&#10;C) Life skills training&#10;D) Vocational training

Accepted Answer

The answer of Which of the following is an example...

Question 14

Mr. Anderson is a 56-year-old Veteran who is homeless. As an occupational therapist, you know most individuals who are homeless focus on occupations related to survival. During an occupational profile, Mr. Anderson will most likely identify which daily occupation as a priority?

A) Employment training
B) Securing food
C) Life skills training
D) Obtaining housing

Accepted Answer

The answer of Mr. Anderson is a 56-year-old Veteran who...

Question 15

Which of the following occupations for the homeless population supports the need for social participation?&#10;A) Caring for a pet&#10;B) Securing food&#10;C) Life skills training&#10;D) Obtaining housing

Accepted Answer

The answer of Which of the following occupations for the...

Question 16

A homeless shelter with guidelines and rules can lead to which of the following impacts on homeless individuals?&#10;A) Temporary housing&#10;B) Access to showers for hygiene&#10;C) Life skills training&#10;D) Occupational deprivation

Accepted Answer

The answer of A homeless shelter with guidelines and rules...

Question 17

In the Model of Occupational Empowerment Occupational Deprivation, poverty is an example of which component of the model?&#10;A) Disempowering environments&#10;B) Occupational deprivation&#10;C) Learned helplessness&#10;D) Occupational empowerment

Accepted Answer

The answer of In the Model of Occupational Empowerment Occupational...

Question 18

Children who experience homelessness should be screened for which of the following?&#10;A) School absenteeism&#10;B) Developmental delays&#10;C) Learned helplessness&#10;D) Infant mental health

Accepted Answer

The answer of Children who experience homelessness should be screened...

Question 19

A group of women who are homeless due to domestic violence would benefit from which occupational therapy intervention?&#10;A) Employment training&#10;B) Developmental delays&#10;C) Life skills training&#10;D) Marriage counseling

Accepted Answer

The answer of A group of women who are homeless...

Deck 20: Addressing the Needs of the Homeless Introduction