The longer a person is homeless, the more complex and chronic their health needsare likely to become. Homelessness increases the risk of death, injury and illness –physical and mental. Living on the streets exacerbates existing problems and increases the risk ofdeveloping new health problems, especially those associated with drug or alcoholabuse, mental illness and the occurrence of accidents and assaults, particularlythose resulting in brain injury. These issues coupled with their early childhoodexperiences and adult life there after paints a vivid picture. A professional, comprehensive NP Assessment is a key to understanding the impactof these factors on an individual’s cognitive functioning and on the nature andextent of his or her possible deteriorating cognition and decision making capacity. Armed with this information, a case worker is able to determine a housing solutionand a support arrangement that best meets the specific needs of each client.Furthermore, the assessment have become an invaluable resource for supportworkers in preparing a care plan with specific, realistic and measurable outcomes.
We are an inclusive service with peoplefrom diverse ethnic backgrounds, ages andgenders. Our clients are; Long term homeless Drug and Alcohol Mental Health Domestic Violence Incarceration Self Harm Family breakdown Physical emotional and sexual abuse
History Homeless for approximately 12 years. He had been living in a boarding house for the past 4 years. Hygiene is lacking in areas of oral hygiene, bathing and grooming. Has a long history of substance abuse which spans over a 30 year period. Has expressed a desire to discontinue or reduce his illicit drug use. Has a diagnosis of schizophrenia and is compliant with medication. He is prone to being financially exploited by other individuals to whom he lends or gives away money. Has three children who are currently under the care of his sister who is their legal guardian. Has several significant physical issues, the most debilitating being a broken ankle. Has injuries were sustained when he was hit by a car.Results The results of the completed report from ANTs indicated that Mr A He was not fit to live independently. History provided suggests a possible acquired brain injury. Low average to borderline pre-morbid intellectual functioning Possible brain injury acquired in childhoodRecommendations He would benefit by living in Supported Accommodation preferably near his family. He would require daily support, in a maintained well organised environment. A financial guardian is sought.The outcome An application for full guardianship was lodged and his sister attended the hearing. She was appointedguardian to make decisions about his accommodation and services provided to him. The Tribunal appointed the NSW Trustee as his financial manager. He had surgery to his foot which wentwell, however as he didn`t continue with physiotherapy it eventually mended back into the same positionas before. Due to the clients age the process of the ACAT assessment took sometime. After the assessment wascompleted the client was placed in a specialized aged care service that accommodates clients withCo-morbid issues. This is a permanent placement.
Navigating the service system. Lack of psychosocial history, difficult toknow where to start. Barriers to overcome / opening doors Once we have completed theneuropsychological assessments, whatnow.
What shaped this persons life A greater level of empathy Improved knowledge of services The types of supports required. Navigating systems, the steps Training requirements. Collaborations with other services A future guide and bigger picture.
Trust through sharing their story Acknowledge their actions. Structure through therapies, Better housing options available. Family supports are still there Stabilization and access to their children Safety and security with financial structure Improved health
STAFFClients presentingbehavioursSituation EscalatesNo coherenceService doesn’tunderstand theclients issues andhas no planClients presentingbehavioursSituation escalatesStaff are preparedService recognizesthe situation andimplementsstrategiesdeveloped in planClientleavesClientStaysBEHAVIORAL STRATEGIES FLOWCHART
Insight and management plans aroundbehaviour Transparent and detailed referrals Suitable long term outcomes Ending the cycle of homelessness for avulnerable client group Valued service relationships A sense of hope