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WGU HLTH 2320 D396 Evidence-Based Practice for Health and Human Services - WHM1 Task 1 Evidence-Based Practice Process to Serve Clients

Scenario and Research Question

In this case scenario, the client is an 85-year-old male who has been experiencing frequent falls. He is currently homeless, has no source of income, and has limited access to healthcare. His only known family member is his 50-year-old daughter, who has brought him to his medical appointment. Both the client and his daughter are immigrants from Central America and have been in the United States for less than a year. They face challenges related to health literacy and language barriers. Additionally, they reside in a rural area where healthcare resources are limited.

Research Question:
What evidence-based strategies can be utilized to support elderly individuals experiencing homelessness and financial insecurity?

Evidence-Based Practice Process

To address the research question, the PICO (Population, Intervention, Comparison, Outcome) framework was used to structure the inquiry, along with the Five A’s (Ask, Acquire, Appraise, Apply, and Assess) to implement evidence-based practice (Western Governors University, n.d.).

PICO Analysis:

  • Population (P): Elderly individuals experiencing homelessness and financial insecurity.
  • Intervention (I): Facilitating access to healthcare services by assisting the client in applying for Medicaid and securing stable housing through a shelter or nursing home. A study has demonstrated that Medicaid coverage is associated with improved health outcomes, including increased access to routine checkups and screenings (Liang, Tao, & Shi, 2023).
  • Comparison (C): While accessing food pantries and staying in a homeless shelter could offer some benefits, placement in a nursing home with government assistance would provide more stable living conditions and consistent healthcare access (Shaw, 2021-a).
  • Outcome (O): By enrolling in Medicaid and securing housing in a nursing home, the client can receive essential healthcare services, adequate nutrition, and stable living conditions.

Five A’s Framework:

  1. Ask: The client is an elderly immigrant who is homeless, has no income, and lacks access to healthcare services.
  2. Acquire: Evidence was gathered to examine how Medicaid enrollment and nursing home placement could benefit elderly homeless individuals (Shaw, 2021-a).
  3. Appraise: The data was evaluated, and it was determined that the evidence was relevant and applicable to the client’s situation.
  4. Apply: A decision was made to implement an evidence-based practice intervention by assisting the client with his Medicaid application and referring him to a government-supported nursing home.
  5. Assess: The effectiveness of the intervention will be evaluated based on the client’s ability to secure stable housing, access healthcare services, and improve his overall well-being.

Impact of Client’s Location, Background, and Circumstances

Several factors may influence the effectiveness of the proposed interventions for the client. His location in a rural area, combined with his immigrant status and limited family support, presents additional barriers to receiving medical care. If he is successfully enrolled in a government assistance program, he will have greater access to healthcare services. However, his limited English proficiency and unfamiliarity with healthcare navigation may make it more difficult for him to access services independently.

Once placed in a nursing home, the client’s limited family involvement may negatively affect his mental health. Family visits are known to provide emotional support and contribute to a sense of belonging, and in this case, the client may experience loneliness due to infrequent visits from his daughter. Feelings of isolation and depression are common among elderly individuals in institutional settings, particularly those with chronic illnesses. However, studies indicate that consistent healthcare and social support can enhance both physical and emotional well-being, improving overall quality of life and fostering stronger interpersonal connections (Shaw, 2021-b).

In summary, the client is currently facing multiple challenges, including homelessness, financial insecurity, and health concerns. The recommended interventions—placement in a nursing home and enrollment in government programs—have proven successful for similar clients and are likely to improve his circumstances. Although some challenges, such as social isolation, may persist, ensuring access to healthcare and stable living arrangements will significantly enhance his well-being.

References

Liang, H., Tao, L., & Shi, L. (2023). The effect of Medicaid eligibility on utilization of services and access to care among health center patients: A regression discontinuity design. Health & Social Care in the Community, 1-14. https://doi.org/10.1155/2023/9102639

Shaw, G. M. (2021-a). Medicaid and Medicare: A Reference Handbook. ABC-CLIO. Retrieved from https://eds.p.ebscohost.com/eds/ebookviewer/ebook/bmxlYmtfXzI3MzMwNTdfX0FO0?sid=23ae02ad-2446-463e-8a1f-45971ba19f9f@redis&vid=3&format=EB&rid=7

Shaw, G. M. (2021-b). Medicaid and Medicare: A Reference Handbook. ABC-CLIO. Retrieved from https://eds.p.ebscohost.com/eds/ebookviewer/ebook/bmxlYmtfXzI3MzMwNTdfX0FO0?sid=23ae02ad-2446-463e-8a1f-45971ba19f9f@redis&vid=3&format=EB&rid=7

Western Governors University. (n.d.). Section 1 Lesson 3.1: Evidence-Based Practice Steps. Retrieved from https://apps.cgp-oex.wgu.edu/wgulearning/course/course-v1:WGUx+OEX0160+v01/block-v1:WGUx+OEX0160+v01+type@sequential+block@ff1934c836bd466bbf5a405dd6c94a41/block-v1:WGUx+OEX0160+v01+type@vertical+block@b72b79c6f1554217bbfaac3188164014

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