Health for Community and People Across Lifespan - Essay Example

Health for community and people across lifespan Introduction The importance of an expert possessing both moral and professional obligation to meticulously carry out his/her duties are self- evident and should never be undermined. In the view of this, nurses are bound by ethics which guides them in the dispensation of their profession to the best of practice obtainable (Diamond 2008). Nurses should take every responsibility when having knowledge and creating principle of conduct that maintains both the patient and support other professionals as a whole (NMC 2008). In life there are some main life events that make life predictable and at times unpredictable. People are influenced by a variety of life issues and circumstances. It was highlighted that some are predictable or might be chosen at the same time some are unpredictable. In a situation where life became suddenly changed there will be consequences that might be out of control and an individual becomes stressed. Both ideas involve broad view, for an instance issues like redundancy or divorce may be predictable while other people are not expecting to lose their job or divorced. Nevertheless, life changing events frequently involves positive learning also risk of stress (Aldworth et. al2010). Page: 159, Situation Analysis This assignment deals with health needs in the community in order to meet the provision across lifespan, the perspective of people regarding inclusion, access to choice, and disengagement of services. Also, factors affecting access to health care of an individual from the perspectives of social, health and behavioural science theory. Also the role of a nurse within the multi-disciplinary team will be explored in the delivery of holistic care. And it relates to an individual in decision making. In the scenario, it is very evident that social exclusion is present and it will reflect on this assignment. However, a recommendation and advice will be made for the individual on how to promote health, wellbeing and lifestyle (University of Bedford). The main focus of this essay is Gladys a 51 year old lady. She parted from her husband soon after the delivery of Joshua and presently divorced. At present, she lives with her two sons, her granddaughter and her father in-law in a 4 bed roomed house through the housing association. Presently, she is a full time carer for her granddaughter and her father in-law. She does smoke roll-ups, but unable to afford a car (University of Bedford). She was separated from her husband right after the birth of Joshua, which shows her tendency towards the postnatal depression. Postnatal depression is the condition of a mind in which a womans loss her confidence after giving birth to a child, as she thinks that she will be unable to look after her child and take the responsibility of a full time carer in the form of a mother. Postnatal depression is very common in the residents of the United Kingdom, i.e. in every ten out of fifteen women this sort of depression is strongly expected. The major symptom of this disease involves the loss of confidence in the patient and the patient will also exhibit low mood, social exclusion, and fatigue Insomnia (Bertram and Stickley. 2005). The number of informal carers in England and Wales has been increased by 600,000 and reached to 5.8 million since 2001. Such a high number of increases have been reported due to the emphasis put by the local society and norms regarding the relatives and their personal bonds. The informal carer is much better than the formal one because of the presence of trust between the patient and the carer, as an informal carer must be a person’s relative or friend. Due to the presence of an informal carer the person shows an ability to remain at home and continues to enjoy the home environment and the company of the relatives. An informal carer also reduces the financial burden over the patient that would otherwise be paid by him for the provision of services of a formal carer (Levitas, 1965). However, beside these advantages the potential disadvantage with the informal carer is that they may not possess high skills and expertises like a formal carer do. This will put the health and wellbeing of the patient at high risk. The nurse plays an important and integral role in the healthcare institution all around the world because they are the only employees, who have a direct contact with the external stakeholders, i.e. the patients and the rest of the society. Historically, the nurse is considered as a formal caregiver because they are always paid for their services either by the state departments or by the client individually. Whereas, the informal caregivers are those nurses, who take care of their family members and not required to be paid on a periodic basis under a contract or an agreement. In the United Kingdom, the caregivers are known as a carer, who may be formal or informal, but due to the increasing concern of families, every 1 out of 10 carers are informal now and the number is increasing day by day (Ons.gov.uk, 2014). This is a positive sign because an informal carer can provide better care and attention to the patient as compared to the formal one due to the factor of love and affection. Research shows that a formal nurse is often reluctant to provide in home healthcare services to a patient because the family members usually treat a nurse as their servant or reluctant to make any close relation with them. This is the basic reason behind the withdrawal of most of the nurses from their duties as an in house service provider (Salin, Kaunonen and Åstedt-Kurki, 2013). Social inclusion was defined by Bertram and Stickle, (2005) is a virtuous circle of improving right of access to the social and economic world, recovery status, range of opportunity, and reduced impact of disability. It means that everyone should be ready to help out the community and work for the betterment of the individual and social welfare of the community. Everyone has a right to get supported by the society and equally contributes toward the achievement of the common goals of a community. The concept is used to reduce the impact of disability and provide a number of opportunities to the potentially underrepresented communities to grow and participate in the development of their community. Ruth Levitas (2010) is referring to Duffy (1995) and the Social Exclusion Unit (1997) contends that the meaning of social exclusion is ambiguous, however alludes to conceivable definitions as the powerlessness to take an interest viably in financial, economic, political and social life, alienation and separation from the standard society. Also as shorthand mark for what can happen when people or territories experience the ill effects of a blending of joint issues, for example, unemployment, poor attitudes, low livelihoods, poor lodging, high wrongdoing situations, awful wellbeing and family breakdown (Bertram and Stickley. 2005). In the scenario for Gladys it is very evident that social exclusion is present because she has been refrained from joining a job elsewhere and she was deprived from buying a car due to her bad financial conditions. She has been prevented from participating in the other events of life due to her responsibility of a full time informal carer for her father-in-law and granddaughter. She is also unable to participate in the social events and has been deprived of her fundamental rights, i.e. right to earn a better living standard and right to participate in different social events (Lareau and Horvat, 1999). Being a lone mother, her responsibility to take care of her children becomes more difficult and problematic because her financial conditions are also not healthy and she is not able to work as well. Research shows that the key element that lead a person’s to social exclusion is poverty, because people will perceive that he/she is not capable to participate actively in different events of the society. In the case of Gladys, her social exclusion is also caused by her unfavourable financial conditions and her inability to make her future bright by doing some reasonable job (Barigye et al., 2010). Gladys is a lone mother; this is the type of parent whereby the mother raised the children in the absentia of the father (Duncan and Edwards 2003). In this case Gladys must be the only parent raising her two sons. Children from divorced or separated family are at greater risk of negative outcome, such as health related problem, poor nurturing resources and poor housing. Gladys, two sons and the granddaughter might be experiencing some of the negative characteristics analysed above. Even a family transition can have a huge impact on child such as neighbourhood, school and moving house (Bowlby, 1969). Nevertheless, children living with both parents can also experience bad situations such as violence, parental conflict, poverty and poor parenting style, while on the other hand children from broken homes may not experience and become more productive than children from unbroken families (Department for Children, Schools and Families 2009). Report from Poverty and Social Exclusion (2014) pointed out that 650,000 lone parents are not in paid work. These types of workless environment always have a negative impact on children, such as poor academic performance, which might make them leave school at a younger age. Although there was no clue about the two sons’ educational performances they might be struggling with their education. The scenario highlighted that Gladys cannot afford a car which might be as a result of not in a paid job, which can be linked with her financial crisis, which is an evidence of poverty. Poverty is said to be the lack of appropriate resources in term of physical needs in order to have what you want, this might have a huge impact on Gladys and the two sons not been able to live a good life or living in a deprived area. From the above analysis, Gladys and the household are exposed to multiple deprivations. Deprivation is being categorised as lack of opportunities and assets, which are associated with employment, education, health, low income, access to services, crime and living environment (Communities and Local Government 2010). In England there are 15 per cent informal carers in households, 60 percents are female carers and out of 100 percent 3 percent are taking care of three or four persons in a household (Health & Social Care information Centre 2010). In order to appreciate this essay, it will explore informal carer as an individual looking after a relative, family or friend, unpaid care by giving special assistance to someone with a disability, sickness, elderly or frail conditions. They assist the people with this condition to live within the family instead of living in institutional care. There are two types of informal carers, those living with the recipient and those coming from their house to look after their loved ones. The main focus is the informal carer living with the recipient. The above statistic showed that Gladys is one of the carers being a woman and looking after two sons and doing full time care of granddaughter and the father-in-law within the household. Gladys works more than 50 hours per week, the majority of her time is being spent in looking after and providing care for the household as a bedrock of support and care. This might have a negative impact on her lifestyle, quality of life, living standard, and health (Deeken et. al 2003). Reports indicated that an individual working more than 20 hours is at risk of some mental health related problem such as depression and anxiety and during the first year of such a routine, there is a possibility for distress level to increase (Research Findings from the Social Policy Research unit 2001) Gladys carer`s role might have a huge impact in the near future both on her physical health and well-being. Moreover, from the face value of the scenario there is a need of divided attention in Gladys`s house because everyone might need attention, which might be a big stress on the whole household and this might be affecting their behaviour. This will be resulted in the form of negative effects over their lifestyles and the outcome they might contribute to the society. Gladys might have been working round the clock, as the bedrock of relief and support. Health professionals see this type of people as partners in care because it saves NHS lots of money and it helps people to live outside residential care (British Medical Association 2009). Although it saves NHS lots of money, but the needs of the individuals, who taken up the responsibilities are yet to be met, Alzheimer Society (2001) underlined that informal carer’s requirements are not met. It is a significant fact that caring is costly and demanding, many are in financial crisis because they have bills to pay with limited resources. Gladys cannot afford a car which might be due to the caring role, although carers are entitled to £61.35 per week, which normally have an effect on other benefit as compared to when they are in full time employment (Departments and Policy 2014). Another report supported that the informal carers needs must be evaluated in order to address their needs because of their significant role (European for Palliative Care 2009). However, since caring is said to be rewarding, demanding and tiring, there are some provisions for the carers in case they need to go on holiday or break, such as the respite care, but many carers find it difficult to go on break, which might be due to lack of trust, financial aspect or other dependant in the family (Malin, 1999). Based on Gladys situation, it is also difficult for other members of the house to arrange a break or holiday tour because it will put an extra burden over her financial conditions. Having a break is said to be a good suggestion for a carer and also the recipient, the recipient might need a change of routine, meet other people, a change of scene. The carers as well might have new ideas and be more relaxing from day to day activities, fresh energy as well, it might even be a group of carers to exchange ideas (Malin, 1999). Another aspect of life, which should be put into consideration, is Gladys smokes roll ups, Department of health, social services and public safety (2001) analysed that 40 per cent of carers living with the recipient were heavy smokers; heavy smoking is common among the female carers. Although the scenario did not show us how much she smoke, but being a carer living with the recipient there is a possibility she is a heavy smoker according to the report. Smoking is attached to highest premature death and illness in England, which claimed 86,500 people in a year. People`s health involves government and people`s input because not everyone has the capacity or opportunity to make such decisions alone, which are healthier for their own health. While some people preferred to be healthy, independence and active as much as possible (Department of Health 2006). In order to promote Gladys health, there is a need to enlightened her and educate her about the consequences of smoking, and for this purpose she is required to attend a number of seminars and workshops. Other people within Gladys house are at a risk of being passive smokers, who are directly exposed to the dangerous and harmful carbon particles in the smoke. They are the people who are closely associated with her, i.e. her two sons, and granddaughter and father-in-law. The father-in-law and granddaughter of Gladys are at higher risk because being a full time carer, she has to spend the major portion of her day with them. Research shows that every 6 out of ten persons are exposed to the lung cancer due to passive smoking, because in active smoking the smoker filters out the hard tar particles from the smoke, but the passive smokers are directly inhaling these particles and can be at higher risk as compared to the active one. Another negative aspect of the Gladys smoking is the extra financial burden over her financial health because she has very limited financial resources; therefore she should try to eliminate her smoking habit to improve her financial and social health (Hershey, Eisenbud, and Angoff. 1978). As the family of Gladys is unable to provide a separate bedroom to every member of the family, i.e. total numbers of members are five and they are living in a four bedroom apartment, therefore they are also facing a problem of overcrowded households (Council, 2012). Research shows that about 1.1 million households, which form 4.5% of the overall household figure of the country is overcrowded and the figure is increasing rapidly with the passage of every next day. It has also been observed that a major portion of the overcrowded households is living in the rented houses, i.e. 8.7% and 8.6% in socially and privately rented houses respectively (Ons.gov.uk, 2014). However, on the other side about 16.1 million households are under-occupied and the larger portion of the under-occupied households are reported in the owner’s occupied houses, i.e. 82.7% (Ons.gov.uk, 2014). This had made the life of poor people very difficult and deprived them from the basic necessities of life. Public health is a very complex and important field of practice that requires the professionals to get engaged in a number of research activities to determine possible solutions for the changing health demands of the population at a larger level (Lareau, and Horvat. 1999). According to the research work of the Canadian Institute of Health Research (CIHR), behavioural and social sciences is one of the four important pillars of the public health. The scientific task here is to comprehend and clarify the nature and components of the individual, societal and institutional conditions and constraints that focus upon well-being status, health related conduct, and the association, procedure and results of the public health as a set of practices for anticipation and mediation. (Hershey, 1979) The most significant and successful public health projects and activities are focused around an understanding of health practices and the connection in which they happen. Therefore, intercessions enhance health behaviour could be better planned with an understanding of pertinent theories of behaviour change and the capacity to utilize them skilfully (Strecher and Rosenstock. 1997). Theories that gain recognition in a particular field are useful in defining the nature and scope of the practice and helps in understanding the capabilities of the professionals regarding the training and socialization of their profession. (DiClemente, Salazar and Crosby, 2013). Gladys has a very tough job to look after and give appropriate time to all the family members and being a carer she has to determine and fulfil the needs of two different aged people, i.e. her granddaughter and her Father-in-Law. In order to evaluate the position and responsibilities of Gladys, the work of John Bowlby will be very effective and appropriate. He states that attachment is an integral part of the human nature from the cradle to the grave. (Lifespanlearn, 2009). He further states that attachment can be proved as a strong connection between the carer and his patient to improve the chances of survival and recovery. In the initial stage the carer will be required to make a connection or bond of affection with his patient, which is provided as a six week time period. In the second phase the carer will develop a permanent bond of affection and love with his patient and ensure him that his condition is improving day by day and one day he will be capable to lead his life as a normal competent person. The overall phases of attachment will last from 6 months to two years, which is a considerable time for developing healthy relationships and a sense of confidence with the patient (Bowlby, 1969). In the given scenario Gladys should treat her granddaughter as a subject for her attachment because of her immature mind and innocent nature; she will be capable to make a relation of trust and confidence very soon. On the other hand, she should give an appropriate time and attention to her Farther-in-law as well in order to ensure that she is performing her responsibility very well irrespective of the fact of her divorce from his son. This will help her in developing a sense of confidence and trust with her father-in-law as well (Malin, 1999).  The Health Belief Model was developed with a purpose to help the people in understanding that why they did or did not use the preventive healthcare services that were offered by the public health departments in the late 1950’s, and evolved a number of new approaches and concerns towards the prevention and detection techniques that could be used in the public health sector, i.e. Influenza Vaccines and mammography screening, etc... It also helps the individuals in understanding different lifestyle behaviours, i.e. the injury prevention and sexual risk behaviour (Becker, 1974). This theory states that people usually have different beliefs regarding different things that whether or not that particular thing is a risk for a health problem or disease and once they perceive a risk from anything, they would take action to avoid them and this shows the readiness of their actions. This theory is basically used in those circumstances where the major concern is related to the prevention of a disease, i.e. early detection or prevention of cancer and the earlier screening of hypertension before it results into any sort of major loss such as brain ham ridges or heart attack (Cerkoney and Hart, 1980). In the given scenario, the Gladys smoking habit is required to be eliminated on time because this habit will be a potential cause for lung cancer in the other members of the family and also put her own life at risk. Though, research shows that about 40% of the informal nurses are smoking addicts because of their tension full life and unfavourable financial conditions, but this habit is harmful for the other dependents and the patient’s health. Therefore, they should either use different sorts of antidepressant drugs or Alcohol to release their tension instead of smoking because these two ways have no negative affect over the surrounding environment. They should also try to engage their selves in other social activities, i.e. organizing small parties and get together at their homes, which will minimize their tension and also release her sense of deprivation (Barigye, at .el 2010). Conclusion and recommendation On the basis of the above analysis and from the critical evaluation of different academic contents, it has been concluded that nursing and community healthcare culture is the most important factor in the development of the public health department of any country. It is also observed that the informal carer faces a number of problems in their lives while providing wellbeing services to the patients throughout their lifespan. This is because of the fact that informal carers get very low income from the state departments and they are not only supposed to take care of the concerned patient but also to look after themselves and fill their social and economical needs. It is also evaluated that beside the social and economical constraints to the informal carers, they are also exposed to some of their negative habits, i.e. the smoking habit of nurses. After evaluating all the aspects of the given scenario and the general discussion related to the topic, it has been recommended that government should establish a proper legislative and recognize the importance and contribution of the informal carers to the public health departments and the society as a whole. They should provide them appropriate financial support, so that they cannot feel excluded and deprived in the society (Ons.gov.uk, 2014). In the above scenario, it is advised that Gladys should try to manage her tension through other healthy ways instead of smoking and should focus upon her health as well because if she become ill then who will look after and care the entire family. She should also try to start a part time job, whether a home based job or a job in the neighbourhood to earn some easy financial means for herself and her family. Which will help her in overcoming the disadvantages related to the bad financial conditions and her son’s will become capable to get better education. References Becker, M. (1974). The health belief model and personal health behaviour. 1st ed. Thorofare, N.J.: C.B. Slack. Hershey, J. (1979). Formalization of the health belief model. 1st ed. Philadelphia: National Health Care Management Center, University of Pennsylvania. 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