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Homelessness Among Special Populations - Elderly, Incarcerated, Rural, and Transgender Individuals

Aging and Housing Instability: Homelessness among Older and Elderly Adults

1. Lack of stable housing has been associated with increased Emergency Department utilization.

A. True

B. False


2. All of the following factors among older patients are associated with making at least four Emergency Department visits in the past 12 months, except for:

A. Male sex

B. Alcohol problems

C. Executive dysfunction

D. Sensory impairment


3. Physicians are largely the preferred decision-makers for end-of-life matters for unstably housed adults due to trust in their expertise and lack of family/social support available for the surrogate decision-maker role.

A. True

B. False


4. Research has identified which of the following clinical implications to consider?

A. Focus should be placed on modifiable factors prevalent among older and elderly adults without stable housing.

B. To reduce avoidable Emergency Department utilization and improve health status, it is recommended to routinely screen and counsel for alcohol abuse, risk factors for falls, and eye glasses, hearing aids, and housing needs.

C. Due to negative perceptions of advance care planning, staff should approach clients with great sensitivity and assess their unique views of death and dying, while also addressing their basic and immediate needs.

D. All of the above.


Incarceration & Homelessness: A Revolving Door of Risk

5. Although incarceration and homelessness are mutual risk factors for each other, incarceration often precipitates homelessness.

A. True

B. False


6. All of the following sub-groups within the homeless population have a more widespread incarceration history, except for:

A. Individuals with mental health issues

B. LGBT

C. Veterans

D. Youth


7. Upon release, sudden discontinuation of medications and services, paired with lack of access to services, puts previously incarcerated individuals at risk to cycle among the streets, shelters, emergency rooms, and criminal justice system.

A. True

B. False


Gender Minority & Homelessness: Transgender Population

8. Transgender individuals are defined by their gender identity, how they present themselves, and their sexual orientation.

A. True

B. False


9. Which of the following contextual factors is the most common cause of homelessness amongst transgender youth?

A. Family rejection and/or conflict.

B. Running away from or aging out of the foster care system.

C. Institutional discrimination such as schools, housing, and workplaces.

D. Substance use disorders and psychiatric illnesses.


10. All of the following statements are true regarding LGBT, except for:

A. Violence/victimization is both a consequence and a contributing factor of homelessness amongst LGBT youth.

B. A large portion of transgender individuals experiencing emotional, physical, and/or sexual abuse, do so in their homes at the hands of people who they know, resulting in many choosing homelessness or seeking shelters as a safer alternative.

C. Substance abuse and psychiatric illnesses are both a consequence and contributing factors to homelessness.

D. Experiences of homelessness and transgender identity have been associated with the same rates of psychiatric illnesses, trauma, and HIV infection compared to the general population.


11. Desire to transition or receive gender-confirming treatments can add to the emotional stress and mental instability (depression, anxiety, and suicidal ideation) of transgender individuals, especially in cases of limited access to treatment.

A. True

B. False


12. Reticence to disclose gender identity out of fear of rejection and compromising safety, internalized transphobia, and perceptions that providers lack transgender-specific knowledge, is an example of which category of barriers to service access for the transgendered population?

A. Personal

B. Structural / systematic / legal

C. Provider education

D. Financial


Rural Homelessness: Identifying and Understanding the “Hidden Homeless”

13. Recognition of rural homelessness is limited for all of the following reasons, except:

A. Rural landscapes camouflage homelessness through expansive geography with low population density.

B. Unstably housed individuals reside in less visible locations than in urban areas.

C. There are not enough rural service workers to adequately assess the homeless situation.

D. Cultural norms deny that homelessness can exist in the idealized rural setting and aim to rid communities of this “social problem.”


14. Methods used to enumerate the urban homeless are also effective in rural areas.

A. True

B. False


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