Patient Care Challenges and Long-term Care Issues

Optimal care for patients with special challenges requires modifications in communication, assessment, treatment, and transport.
Approximately 17.7% of children aged 3-17 in the U.S. have one or more developmental disabilities, including ADHD and autism.

In 2016, over 7.1 million patients received care in long-term settings, correlating with increased EMS calls for transport to acute care.
Many life-sustaining therapies, such as mechanical ventilation and IV medication, are increasingly managed outside hospitals by families and patients.

Over 11.8% of U.S. residents live in poverty, affecting healthcare access and leading to health disparities.
Patients may prioritize basic needs over medical care, leading to interruptions in necessary medications.

More than 500,000 individuals are homeless daily in the U.S., with a higher prevalence of physical and mental illnesses in this population.
A 2017 study indicated 27% of homeless participants tested positive for Hepatitis C and 4% for HIV.

Federal law requires emergency departments to stabilize patients regardless of their ability to pay, stressing resources and increasing wait times.
Care and treatment for patients experiencing homelessness are frequently complicated by lack of access to chronic healthcare.

Caregiver abuse and neglect complicate patient care; recognition of signs and symptoms is critical.
Emotional, legal, and regulatory concerns often surround cases of suspected abuse, particularly in dependent individuals.

Physical Abuse: Intentional acts leading to physical harm, including hitting, burning, or placing individuals in dangerous situations.
Neglect: Failure to provide necessary protection and care, often harder to identify than physical abuse.
Sexual Abuse: Involvement in unwanted sexual acts, with a very high percentage of child abuse cases reported as sexual.
Emotional Abuse: Causes significant changes in behavior or emotional state through ridicule, threats, and isolation.
Abandonment: Harm to a child or vulnerable adult due to a caregiver’s failure to maintain contact or supervision.

Healthcare providers must recognize and report suspected abuse or neglect, with potential civil, criminal, or regulatory penalties for failure to do so.
Documentation is crucial, requiring objective descriptions of findings and timelines that may substantiate abuse suspicions.

Reports are typically submitted to state social services, with investigation rates varying by state.
Law enforcement roles include intervening in immediate threats and conducting investigations into suspected abuse cases.

EMS personnel may require emotional support after encountering cases involving suspected abuse or neglect to cope with the psychological impact.

Modifications in communication, assessment, treatment, and transport are essential for optimal care of patients facing special challenges.
Approximately 17.7% of U.S. children aged 3-17 have developmental disabilities, including ADHD and autism.

In 2016, more than 7.1 million patients utilized long-term care settings, correlating with a rise in EMS calls for acute care transport.
Many life-sustaining therapies, such as mechanical ventilation and IV medications, are increasingly managed at home by patients and families.

Over 11.8% of U.S. residents live in poverty, affecting access to healthcare and contributing to health disparities.
Patients often prioritize fundamental needs, such as food and shelter, over necessary medical care, leading to adherence issues with medications.

More than 500,000 individuals experience homelessness daily in the U.S., with a notable prevalence of physical and mental health issues in this population.
A 2017 study found that 27% of homeless participants tested positive for Hepatitis C, while 4% tested positive for HIV.

Federal law mandates that emergency departments must stabilize patients regardless of their ability to pay, putting a strain on resources and increasing wait times.
Patients experiencing homelessness often face additional obstacles in accessing chronic healthcare, complicating their treatment in emergency departments.

Caregiver abuse and neglect present significant challenges in patient care; recognizing the signs is vital for effective intervention.
Cases of suspected abuse often raise emotional, legal, and regulatory concerns, particularly concerning dependent individuals.

Physical Abuse: Intentional actions causing physical harm, such as hitting or burning.
Neglect: The inability to provide necessary protection and care, often more subtle than physical abuse.
Sexual Abuse: Involvement in unwanted sexual acts, with a high percentage of child abuse cases classified as sexual.
Emotional Abuse: Alters behavior or emotional state through ridicule, threats, or isolation.
Abandonment: Harm resulting from a caregiver’s failure to maintain contact or supervision of a child or vulnerable adult.

Healthcare providers are mandated to recognize and report suspected abuse or neglect, facing potential penalties for non-compliance.
Accurate documentation is vital, including objective descriptions and timelines to support suspicions of abuse.

Reports of abuse are typically directed to state social services, with investigation rates differing by state.
Law enforcement is responsible for addressing immediate threats and conducting investigations into suspected abuse.

EMS personnel often require emotional support after encounters with suspected abuse or neglect cases, as such incidents can have significant psychological effects.