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Community Assessment Paper Amy Miles Scotia Nutt Michelle Groundwater PNR 315 October 7th, 2019

Running Header: COMMUNITY ASSESSMENT PAPER 2 Introduction Our patient Ms. Cassandra Peters is a 25-year-old who is expecting her first child, she currently has limited family support and is in search of answers for her hyperemesis gravidarium. Ms. Peter’s hyperemesis gravidarium is a complication due to her pregnancy, it is a complication that tends to involve severe nausea, vomiting, and an imbalance of electrolytes [ CITATION Ame16 \l 4105 ]. She currently resides in a house just off of the intersection at Baldoon road and MacNaughton Road. (Appendix A, for the neighbourhood location). Our chosen community is the more Northern area of Chatham, between the areas of McNaughton (East) and Oxley road (North). This area has a high rate of couples and families with one young child (60% of homes have children), this specific neighbourhood has a split of 64% of owners, and the last 36% is renters [ CITATION Nex \l 4105 ]. During the walk through, it was clear that there were young families, due to the toys on the front lawn and the buses going through on a Tuesday morning. It is important for visiting nurses to do a community survey, to help understand the population and growth in the community we are serving. Understanding our patient’s lifestyle and desires help us to diagnose and treat our patients with the care that best suits them. We also get to acknowledge the majority and minorities (sex, age, decent, and hobbies) that could cause diseases, injuries, or conditions. Nurses can use this survey to benefit themselves and their care towards their patients in new and adaptable ways such as; a patient struggling to lose the weight, a nurse could describe or list off some walking trails in the near by community, or gyms. Small community nurses help make care for patients a constant learning curve, and a way to better connect and personalize each patient’s visit to the clinic/hospital!

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Community Assessment History In this area of Chatham, a majority of the houses were actually built in the 1980s, although the residence isn’t typically the elderly. In fact, 33% of this neighbourhood is over 55 years of age, the rest are 54 and younger [ CITATION Nex \l 4105 ]. I briefly stopped and talked with an 11 year old boy who was walking, I asked him how long his bus ride is and how many of his neighbours get picked up in this area: “the bus takes 10-15 minutes depending on the stops, and there is 8 of my us that get on the bus at the same spot.” (unknown, 2019). Many people were out during my walk through the neighbour hood on Friday evening, cutting grass, cleaning the yard, sitting on the porch, and biking. The overall “windshield Survey” came off as a very safe, family-oriented, busy little neighbourhood. An elderly couple sitting on their porch willingly socialized with me and described their neighbourhood that they have lived in for the past 40 years. They stated that the overall crime was low in this area, and they enjoyed watching families come and go as they grew. The only downfall of this specific area of Chatham is the busy roads, which are always filled speeding cars (Joyce, 2019). Demographics: The majority of people in this area ranged from middle aged younger families to a few homes with elderly individuals or couples. There were minimal homeless people in the neighbourhood, but a few older people that were hanging out behind the Rexall’s Pharmacy. Everyone I witnessed, or talked to were from Caucasian decent, and many of the families had kids under the age of 14. The families seemed to have similar interests and lifestyles, many of them were just starting out, and the parents both worked and typically were home in time for the

Running Header: COMMUNITY ASSESSMENT PAPER 4 bus at the end of the day. One of the more common things I noticed while driving through this community during the day was the pets, many cats lounging on porches or window sills, and multiple chains outside for dogs. That being said, I could not see many backyards, but the yards did look larger for pets and children— the ones I could see had a nice deck and patio set, with lots of trees and gardens. Ethnicity: In all of Chatham-Kent the mother tongue ranges from English (88.6%), French (2.4%), other (7.8%), lastly multiple languages (1.1%),[ CITATION Unk18 \l 4105 ]. I found this very interesting considering I saw maximum one individual who was not speaking English, unfortunately I could not follow the conversation and am not even sure if they were living in this are of Chatham. According to a 2016 statistic on Chatham’s population, multiple families were actually born in another country. In fact, out of 42,080 people 3,890 of them were not born in Canada— the majority actually originate from Europe (2,270) the next largest country Chatham citizens originate from is Asia, than America, Africa, and lastly with 10 people (from 2016 statistics) are from Oceania [ CITATION Unk18 \l 4105 ]. I did not witness any festivals or areas that multicultural people can attend, but I did see different flags hanging at houses other than the Canadian flag. Values and Beliefs: Fortunately, there are many areas for people to practice their religion and beliefs. There are actually ten Churches all within the 3km distance to this community. There are two Presbyterian churches, a Christian Community, Gregory Drive Alliance, Evangel Community, St Agnes, Congregational Church, and Emmanuel Baptists. All these facilities for worship carry a

Running Header: COMMUNITY ASSESSMENT PAPER 5 variety of diversity in the community that are available and help promote diversity and change within the Chatham-Kent area. Due to the close proximity I was able to travel by all ten of these areas, they all were well kept, and many had signs that changed each week (that I noticed) which provided reassurances that the facilities cared about the people and promoted acceptance. Few of these properties had their own flowers, but many had picnic benches and trees that provided natural vibes within their property. Physical Environment: The community did look clean and well-kept, some of the houses were more tired looking than others such as; needing a fresh coat of paint on the porch. Many houses had full gardens with many metal garden décors on fences and porches. Like I mentioned, many cats and dog belongings on front lawns and in drive ways. A lot of the houses had large beautiful oak trees growing that looked to be quite big, providing natural shade and amazing fall colors when the seasons hits. The water quality was reported good, with some notes of lower water pressure. As for air quality residence said when they first arrived the factory smell was quite irritating, however it has become part of their everyday living. The houses were built quite close to one another, but that is something expected in city/town living. Chatham is a total of 2,458km2 and the community that we were assessing takes up a rough estimate of 250km. Health and Social Services: There has been no sign or research of any shelters in this community, however there are many agencies and clinics that are readily available to not only just this community, but to Chatham as a whole. Mental health is on the rise therefore, having access to therapies are very important luckily under 5km from this community is two therapies: Paddy Newman is a Family

Running Header: COMMUNITY ASSESSMENT PAPER 6 Counsellor and Paul Szeps is a private practice who focuses on individuals, couples, and family therapy [ CITATION Mee \l 4105 ]. Not only are therapies important for mental health, but the right facilities for mental health education is vital. Thankfully, Chatham as many facilities to support individuals with mental health: Mental Health Clinic, Canadian Mental Health Association, Family Service Kent-Services, and two others. There is minimal clinics, and hospitals directly in the community, however it is not too far from Chatham-Kent Health Alliances. Emergency departments are also with the CKHA hospital which is in the closest proximity to the community. On the other hand, there are plenty of nursing homes in the area: Copper Terrace, Revera Chatham retirement, Meadow Park, and three others which are all within 7km of the community. One of the most important facilities within this specific area of Chatham is the distance of Rexall’s Pharmacy. Economy: On average the household income is about $69,986, but only about 48% make 50K150K, and 45% make 50K or less. That being said, to look at what people are making and working at we have to look at their education level, only 46% of these individuals gave went to university or college and the other 54% have just received a high school education [ CITATION Nex \l 4105 ]. Many of these homes are filled with young families and I believe that the community has to be thriving because soon these children will be teens looking for a job. In 2018 a statistic shows that the unemployment rate was at an all time high, at 7.1% in March of 2017 [ CITATION Stu18 \l 4105 ]. There are many mini marts, Rexall’s, and home hardware shops in this specific area, which allows for employment opportunities. There were no known food banks in this area of Chatham, but many schools do fundraise and help families out especially in small

Running Header: COMMUNITY ASSESSMENT PAPER 7 areas. About 5k out of this community is Walmart and Food Basics to allow for grocery availability. are wheelchair assessible, and all public transits are promoted for disability users. Protective services include: EMS, Hospital Emergency, Fire department, Ontario Provincial Police, Chatham-Kent Police and Protective Child Services. Community and Government Findings: One of the most valuable community findings for Ms. Peters, is the Prenatal Classes. These classes are free for Chatham-Kent residence and can be done in-class or on-line! Ms. Peters would benefit from these classes as they teach new/previous mothers about: active living, smoke/alcohol-free, eating well, stress-relief, environmental hazards, labour, newborn care, oral health, and different jobs that help throughout the pregnancy! There are six classes for the prenatal series that are offered regularly for her [ CITATION Hea19 \l 4105 ]. It is believed that prenatal classes, help new moms find “mom-friends”, answer questions that mothers did not know they had, and enhance their education on the process they are enduring [ CITATION Par19 \l 4105 ]. Along with prenatal classes there is a drop-in time at the YMCA in Chatham for pregnant mothers every Wednesday (1430-1630) that is called Building Healthy Babies, this drop-in time is another educational period that discusses nutrition for pregnant women. It offers support and knowledge in areas such as: nutrition, breast feeding, and infant care. Nutrition is the main topic that our patient should take advantage of, with the amount of fluid and electrolytes she loses through her hyperemesis periods the nutrition courses may help find some relief. Not only will understanding the importance of her nutrition benefit her and the baby, she may meet another mother experiencing this problem as well [ CITATION HUB15 \l 4105 ]. The last

Running Header: COMMUNITY ASSESSMENT PAPER 8 resource found through Chatham-Kent Public Health was Mother’s Advocate, it’s a printable booklet that has multitude of chapters that help new mothers chose their birth plan with an openeye to all different births, feedings, and routines [ CITATION Unk11 \l 4105 ]. Lastly, I think an important resource for Cassandra to have is child care, being a single parent with minimal support is going to be a big adjustment for anyone let alone a 25-year-old. She is may experience Post-Partum Blues which can be quite difficult to go through with a new born and no one to step in for you when you need time to “re-coop”. The best provider for her would most-likely be looking into the YMCA infant room, they except 3-month-old babies, which will allow Cassandra the time to be away from the new born, and perhaps even find a new support class in parenting. These infant rooms are actually built to help increase sensory, auditory, and musical aids in a new born, and help the transition of being away from the parents [ CITATION Unk19 \l 4105 ]. These references will help Cassandra feel more confident and prepared to face the obstacles she will face as a young, single mother with Hyperemesis. The prenatal class series will help her understand her body changes, fetal development, and what to expect up to her time of delivery. The Building Healthy Baby sessions will hopefully allow her to accept her condition and maybe make some good connections with other moms facing this challenge, and perhaps new techniques to help relieve some side effects. The online book is more up-to-date with technology, a great resource, and super handy to download onto her phone to allow time and choices to plan out a delivery she wants. Finally, the YMCA Infant room will hopefully give the young mom time to catch a breath and feel that her new addition is in safe hands— which would help ease her mind and enable her to do things that a single mom sometimes does not have time

Running Header: COMMUNITY ASSESSMENT PAPER 9 to do, she can find these contacts and locations close to home that will help provide the information she needs (See Appendix B for list of contacts).

Transportation/Safety: With the population of Chatham being 43,550, many people are needing transportation daily, and roads can become busy during rush hours (Brinkhoff, 2016). Fortunately, when it comes to transportation in Chatham, driver’s licences are not a necessity as there are many services available. Sidewalks and bike lanes are frequently used in this community as commutes are short and most commodities are within walking distance. CK Transit is a commonly seen form of transportation around this community. There are five conventional transit bus routes available throughout Chatham, with the price being $2.50 to ride and buses arriving approximately every 30 minutes (Unknown, 2019). Another well-known transit company that is private, is Helping Hands Community Services. Services that they provide are rides to medical appointments and errands that are within Chatham-Kent and surrounding areas (Unknown, 2019). While surveying the area, I spotted many Chatham-Kent Police vehicles throughout this community. As stated on their site, the mission statement for the Chatham-Kent Police is: “dedicated to making Chatham-Kent the safest community in Ontario” (Unknown, 2019). I was able to talk to a 36-year-old woman, who explained that: “she feels safe, as she walks to work everyday, which is about a 10 minutes walk” (Peggy, 2019). Politics/Government:

Running Header: COMMUNITY ASSESSMENT PAPER 10 Currently in Chatham-Kent elections are underway with voting coming up shortly. While driving through the community, I noticed that most homes in this area did not have a sign in their front lawn for the election. I was able to spot a few signs, those of which were for David Epp. Right now, David Epp is running of the conservative party, whose goal this election are: “introduce a universal tax cut which aims to lower the tax rate for residents who fall under the lowest-income tax bracket (under $47,630), they also plan to make maternity leave tax free, and provide tax credits for kids’ activities” (Vega, 2019). As Chatham is constantly growing in population and family sizes are getting bigger and bigger. Many parents and soon to be parents are leaning to vote for Epp, as his goals will directly affect them. Communication: Unfortunately, this community does not have any common areas directly in it but within five kilometers there is the Downtown Chatham Center. When walking through the downtown center there are many shops, drug stores, hair salons, and a Fit4Less. The newspapers that is commonly seen in the stands is the Chatham Daily News, which you are also able to locate in the Downtown Center. When doing my drive by I noticed that most people had at least one tv in there home, that I was able to spot. Most homes had one to two vehicles in the driveway, meaning almost all homes had at the minimum one radio on their property. Many people in this generation use informal communication, rather than formal, as people are always on some type of device. Whether it be a cellphone, laptop, or walkie-talkies because it is the most efficient way to get a hold of someone fast. Education:

Running Header: COMMUNITY ASSESSMENT PAPER 11 Within 10 kilometers of this community there are two schools, one Catholic and one Public, both of which can be accessed without entering busy areas. While driving by Tecumseh Public School, it appeared that they had recently updated their parking lot and landscaping outside, making the school look more approachable. Tecumseh Public School supplies monthly newsletters to parents/guardian’s regarding any upcoming events and opportunities. Which gives parents the opportunity to participate in their child’s schooling by joining the Home and School Council (VanDenBossche, 2019). I was able to stop and talk shortly with an 11 year old boy that goes to school at Tecumseh, I asked him what kind of sports and after school activities they offered: “we have a lot of sports at our school such as basketball, soccer, cross country, volleyball, track & field, and tennis, and we also have after school clubs.” (Unknown, 2019). Unfortunately, there is not a library directly in this community, but Chatham does offer a public library located downtown, about 5 km away. At the Chatham Library they offer a library card with proof of identification, this allows you to borrow books, movies, and cd’s for short periods of time. Recreation: This community unfortunately does not have any recreational buildings directly in it, but there are many resources within a 10 km radius. The YMCA being a main spot in Chatham, as it offers a variety of activities for people of all ages to participate in. the YMCA offers monthly memberships at $60.00, which allows access to all areas of the building including the swimming pool. Chatham offers an array of opportunities to explore and stay healthy. While driving through this community, I noticed that there were plenty of parks around where children were playing, a main park where children were at was Kingston Park. Kingston offers a splashpad, play

Running Header: COMMUNITY ASSESSMENT PAPER 12 equipment, pavilions, and several pathways. I was able to stop and talk to a mother of 3, who’s kids were playing at Kingston at the time and ask her how she liked the park: “I really enjoy this park, as it offers a variety of different activities for the kids. My kids especially enjoy playing in the splash pad in the summer.” (Unknown, 2019) The Residents: The residents in this community were very polite and approachable to talk to. While conversing with an older man who has lived in his home for 15 years about his neighbourhood, he stated that, “I love this community, I wouldn’t change a single thing. Strengths that this community has would be: everyone helps one another, we keep our lawns well maintained, and there is a variety of resources within 10 km of us.” (K.Brown, personal communication, September 29, 2019). Mr. Brown seemed to be pleased with the people who live around him and enjoys living there. I was also able to talk to a young mother who was walking with her child, and that also lives in this community, she explained: “I just moved here not too long ago from London, as I was offered a new job. Coming here at first was scary as I knew nobody and was unfamiliar with my way around Chatham. But once I was all settled in, I realized that the commute is nothing compared to London and the neighbours made me feel right at home.” (T.Chauvin, personal communication, September 29, 2019). Overall, the residents in this community truly enjoy where they live, and they care about the people that live around them. Your Perceptions: Overall the com...