Vulnerable Population and Self Awareness

Vulnerable Population and Self Awareness

Vulnerability is defined as susceptibility to physical or emotional injury, open to attacks, censure, and criticism. To live, to exists, means we are open to vulnerability and vulnerability requires that we make ongoing changes in our lives (Hillis, 2003). All human beings are vulnerable, that degree of vulnerability varies with time and circumstances. Vulnerability is essential to personal growth and development and, sometimes forces changes in our lives (Mitleton-Kelly, 2004). Vulnerable populations are those at risk for poor physical, psychological, or social health. These populations include those who are physically or mentally disabled, blind, hard of hearing, cognitively impaired, or mobility challenged. Included in this group are, the elderly, non -English speaking or does not speak English fluently. Remoteness, isolation, medical or chemically dependent, limited diversification, poverty and limited capacity are factors that characterize communities as vulnerable. Anyone can be vulnerable at any given point as a result of life circumstances or response to illness or events (Aday, 2001). The purpose of this paper is to elaborate on the vulnerable population, focusing on the elderly.

Older population, persons sixty five years and older numbered 38.9 million in 2008 (latest data available). They represented 12.8 % of the U. S. population, about one in every eight Americans. By 2030 there will be about 72.1 million older persons, more than twice their number in 2000. People 65+ represented 12.4 % of the population in the year 2000 but are expected to grow to be 19 % of the population by 2030. Nearly 4.2 million senior resides in the

State of Florida, almost 25% of the States total population (U.S. Census Bureau, 2007-2008) Many are now in their 80's, 90's and 100's and this age group is most at risk for nursing home placement. Older population in Florida is among the vulnerable that experiences limited resources and consequent high relative risk for morbidity and premature mortality. Frequently the older population is doubly vulnerable as they experience more than one factor that diminishes their autonomy (Moore, 2001). Initiating autonomy among the elderly presents unique and difficult challenges. The elderly often suffers a variety of losses, including economic stability, self sufficiency, physical or cognitive function, or the support and care of loved ones due to illness. The elderly may be vulnerable by virtue of their financial circumstances or geographic location. These factors can present obstacles to obtaining needed health care and can result in increased exposure to health risks. Those who disproportionately experience access problems include those whose income and health insurance status place them at increased risk for encountering barriers to accessing needed services and those who live in certain rural or inner-city areas that have a shortage of qualified health care professionals and community services. The dependence of the elderly on others resulting from the loss of physical or cognitive functioning, and loss of power and control over personal and functional resources have been found to be associated with caregiver abuse and neglect and, sometimes become victims, to those in charge of their well being. Efforts to prevent poor health are of equal importance to the elderly population and should focus on restoring maximum function for those who already have serious and psychological, and social health problems. Services should be designed to inhibit the onset of problems initially to restore a person who is affected to maximum functioning, treatment services and minimize the deterioration of functions for people with non-curable problems, long

term services. Programs and services should be made available to support the continuum of care for the elderly and should include primary prevention services related to community resource development, public health programs and services, long term care and community base programs and services. Barriers to access can lead to a lack of continuity, delays in obtaining care, and limited choices about where and from who care may be received (Newacheck, Hughes, & Stoddard, 2005). These patterns of utilization can contribute to adverse health care outcomes, including higher rates of preventable hospitalizations (Billings et al., 2008). Poverty and lack of insurance can result not only in decreased access to health care but also increased risk of poor health. Any of these factors can magnify exposure to environmental risk and lack of infrastructure supports such as educational services that contribute to an increased burden of poor health. Vulnerability can in some cases be attributed to limitations in the ability to communicate with providers and other disciplines in the health care system. Communication difficulties may be associated with a person's