In today’s world, health promotion is imperative in the control and prevention of diseases. The concept of integrating health promotion in all aspects of life has resulted from the high prevalence of diseases and conditions that are preventable. Promotion of healthy lifestyle has taken momentum in the last few decades thereby enhancing the process of maintaining health and delivery of quality healthcare (Naidoo & Wills, 2000). As a person becomes older, he/she becomes predisposed to many conditions that are usually associated with various factors. While some conditions occur naturally due to old age, majority of these diseases and conditions are usually brought about by the sedentary lifestyles that have become the norm in modern times.
Consumption of fatty foods combined with limited physical exercise results in development of cardiovascular disorders while predisposing the person to severe debilitating conditions such as stroke. More importantly, the social and economic impacts of these conditions are enormous to the family and to especially in the developed world. Community assessment acts as a major avenue for understanding the occurrence of health conditions while providing ways of managing them depending on the prevailing circumstances. The adoption of the sedentary lifestyles has impacted negatively on healthcare with an ever increasing budgetary allocation going towards meeting the cost of treatment for these patients. This report will discuss the state of elderly people in Australia with regard to epidemiological and demographic variables and the various national policies safeguarding their rights. In addition, a community assessment of the health needs of the elderly people will be described.
Demographic and epidemiological data
The elderly forms a substantial component of the larger population in most parts of the world. The figure is further expected to exponentially increase due to the witnessed life expectancy brought about by economic development in many regions, world wide. For instance, the number of elderly persons (60 years and above) is expected to increase from about 670 million to almost two billion by the year 2050 representing a threefold increase. About 60 % of the elderly people residing in the developed world where majority of them are housed in nursing and elderly homes (World Health Organisation, 2003). In addition, it is estimated that the population of the most elderly persons (over 80 years) will increase from about 40 million in 2005 to more than 275 million in 2050 (World Health Organisation, 2003). Furthermore, the baby boomers of the 1970s have reached their retirement age and are expected to add a considerable proportion of the elderly population particularly in the developed countries. This is as a result of the advanced health systems and the everyday emerging better diagnostic techniques. In fact, the nursing homes are expected to be overburdened by the increasing number of elderly people in the next few years (World Health Organisation, 2003).
Although the number of Australians that have more than 65 years of age has constantly increased over the last few years, variations have occurred with respect to the rural, urban and regional fronts. The Australian Bureau of Statistics (2010) denoted an increase of 3% in the population with over 65 years. This represented 85800 people. More importantly, the population of the elderly population has recorded a marginal increase from 11.0% to 13.3% in the last decade, with a projected leap to 26% of the population in 2051 (Australian Bureau of statistics, 2005). In comparison to other OECD countries, Australia is ranked 13th with Japan experiencing the highest number of elderly people at 26%. Recent studies indicate that Australian men live longer when compared to their compatriots in the other OECD countries.
The incremental loss of living partners and independence occasioned by development of disabilities impact negatively on elderly people’s health especially those suffering from chronic illnesses (ABS, 2006a). However, there were variations in population growth of people aged 65 years and above in that period. The northern territory experienced the highest growth at 7%. Population dynamics depicted more women in this category thus denoting higher life expectancies for Australian women. The population aged above 85 years and above increased by 5.8 % in the previous year. More interestingly, an increase of 167% in this category compared to 30% in the general population in the last twenty years was reported thereby denoting an improvement in living conditions hence resulting higher life expectancies. The number of elderly people living in cared accommodation increases with age while receiving influence from disability. In addition, 28% of aged persons live alone in households as a result of such factors as loss of life partners (ABS, 2004).
Long-term health conditions become more prevalent as age progresses. More often, majority of these people complained about loss of eyesight, musculoskeletal and oral disorders. Gender differences were reported in conditions such as osteoporosis with women being affected four times as many as men (ABS, 2006b). Mortality was more pronounced in men than in women with circulatory disorders. Malignant neoplasm was reported as the main cause. Sizeable number of the deaths is caused by diabetes and arthritis. More so, a high level of psychological distress has been reported in the last few years as compared to 2001 figures. In fact, the level of stress in elderly people (13%) was higher when compared to that in younger persons that had 9% (ABS, 2004).
The indigenous population of Australia forms the smallest proportion of the elderly persons because of the significant impact of high fertility and fatality rates (ABS, 2005). The disparities persisted in Australia with indigenous people having more than 40% likelihood of developing a system that limits disability hence requiring assistance in executing specific core activities (ABS, 2006b). More worrying were the statistics on lifestyle behaviours that predisposed the elderly people to poor health. The statistics indicated that about half of the elderly persons residing in Australia are overweight; this is similar to the figures in the younger age groups. Sedentary levels ranged from 36% and 63% with increases in the level directly proportional to the age. A tenth of the elderly population were involved in smoking, although the figures were lower compared to those of younger age group. Management of health conditions were carried out using different approaches with about 40% of the elderly people regularly visiting doctors, 74% receiving vaccinations and embracement of lifestyle changes receiving special attention (ABS, 2006b).
With the changes in modern times, majority of governments have embarked on an aggressive campaign to market health promotion as a way of reducing morbidities and mortalities among specific vulnerable groups. Likewise, the general population has increasingly become informed about the benefits that come from learning the aspects of health promotion and eventual replication in their individual or community life. According to World Health Organization (1986), health promotion mainly refers to the comprehensive process that entails the political and social aspects. In addition, the process embraces all concerted actions aimed at strengthening the capacity of individuals while equipping them with action oriented skills that play a vital role in modifying the external environment. In fact health promotion entails execution of changes in the environmental and economic fronts and largely from the social aspects thereby enhancing the improvement of the overall health at the individual and societal level.
The Ottawa charter further noted that health promotion acts as a process upon which people are empowered with vital and relevant knowledge hence making them have increased control over their overall health through acquiring thorough knowledge on the management of the determinants of health. Incorporation of strategies in health promotion has become important since it enhances the creation of basic conditions for health (World Health Organization, 1986). Advocacy is essential since it plays a major role in informing the concerned stakeholders about the essential conditions that enhances the access to health. The incorporation of social actions that are usually complemented with individual effort is imperative in order to achieve political commitment while also ensuring support for policies and the embracement by the targeted individuals and systems. According to World Health Organization (1995), advocacy is carried out by individuals and social groups with the sole aim of achieving better terms for the society in areas of healthcare delivery and lifestyles. More importantly, there is need to enable the achievement and enjoyment of full health potential while acting to mediate amongst the various forces and concerned groups in the society.
Terminally ill people have variations in the health needs and care. In fact, the longer the people live, the more dynamic their needs become. The prevailing circumstances with respect to the place the senior citizens live, whether in the community or residential facilities, determine the needs of the elderly. The needs of the elderly people depict the extent of support networks they need (Stuck et al, 2002). In addition, an increased propensity of confinement to residential facilities occurs owing to the fact that majority of the relatives and friends overly supersede them. Majority of the essential health needs are dictated by the ability of the elderly to live active lives, regardless of the decline in resources. The extent of adaptability to changing circumstances in the social environment determines the success and satisfaction of the elderly persons (Stuck et al, 2002). Significant increase of accidental falls in elderly people as compared to younger men has been reported.
Taking into account of the cultural values of the westerners, the number of elderly persons in the nursing homes is expecting to shoot up. The fact that majority of the people in the developed world do not value their families will result in an increased need for more nurses and social workers in the geriatric facilities. More importantly, the inception of preventive programs targeting all walks of people has taken place with the intention of reducing healthcare costs. The initiation of such programs at the institutional level serves to justify the urgent need for maintenance and improvement of the overall functional abilities and largely the well being of the geriatrics. In fact, governments in various developed countries have integrated the care of elderly persons into national policies thereby offering clear guidelines on the management of old age centres (Byles, 2000). The main reason for the embracement and integration is to lower the propensity of functional impairment occurring at later stages of life (Byles, 2000).
Continued advocacy and calls for emphasis on need for dementia care and largely pain management in the senior citizens has occurred in the recent past. Previously, people suffering from dementia have failed to access palliative care despite there being an increased need for it. In fact, a myriad of challenges in receiving pain management exist. Little is known about the overall process of pain management in elderly people particularly those suffering from dementia and terminally ill patients. The incorporation of the various domains of palliative care is imperative in order to enhance the full enjoyment of health (Fillit, Rockwood & Woodhouse, 2010).
Oral health care for the ever increasing elderly residents living in the nursing and elderly homes have continuously proved challenging for the caregivers who are overly required to offer the necessary support in terms of daily health maintenance. Previous studies have depicted that the commonest problems facing the institutionalized people include poor oral hygiene.The poor oral health status results from the fact that oral tissues have the propensity to be affected due to changes in body metabolism and functioning brought about by advancing age (Lamy et al, 1997). Other several studies have indicated poor oral health and limitation in accessing dental care in the elderly mainly residing in the nursing homes (Berg & Morgenstem, 1997). While majority of the people continually maintain their teeth to old age, the onset of old age ushers the era of dependency and increasing need to seek regular dental care in the elderly home setting (Fillit, Rockwood & Woodhouse, 2010).
Community assessment has become a useful tool in guiding the implementation process of policies in the community level. Community analysis follows a systematic approach that ensures the reinforcement of the required strategies hence enhancing the achievements of the analysis (Robinson, 2006). Identification of community needs is an important step that will allow for the utilization of the community empowerment model in addressing them. The community empowerment model is viewed as a viable methodology that will enhance the achievement of the health for all. It forms the core competencies that have defined the paradigm shift of nursing practice from the institutional based to community oriented approach. In addition, the active involvement of the community in the overall decision making process forms an essential component that leads to an effective healthcare that is also affordable and acceptable to the people. The need to empower the citizen to take charge of their health has compelled the nursing fraternity to embrace community health as an indispensable, approach that enhances collaboration and better partnership between the community and the health professionals (World Health Organization, 2001).
To ascertain the knowledge and overall understanding of matters pertaining to care of elderly persons, a survey within the establishment is required. Data collection through questionnaires is important since they enhance the depiction of the knowledge levels and understanding of old age care (World Health Organization, 2001). Recruitment of respondents is carried out systematically to enhance the validity and reliability of the collected data. The accuracy of data collection serves as a key resource material for supporting policy decisions. After candid reflection on the findings, a clear cut path to address the knowledge gap on the policy and implications to the healthcare must be devised at all times. More importantly, the shortcomings in the practice where the community and the healthcare staff failed to implement the policies are outlined in the guidelines. Before conducting a rigorous sensitization campaign, the findings from the study were compiled to enhance the development of a holistic curriculum, which is vital in health promotion drives. The sensitization would be carried out in two phases; community and the hospital setting. In view of the different roles and understanding of the policy guidelines, both groups will be sensitized separately with much emphasis on the healthcare staff (Shrestha, Shrestha & Deepak, 2009). The functioning of each group with regard to best practices will receive wide acknowledgment in the training session. In fact, the applicability of the policy in every day life and practice is stressed to ensure the transfer of the knowledge to practice (Robinson, & Eklan, 1996).
On the implementation of policy, the government, relevant stakeholders and the community leaders consult widely on the most effective way of carrying out the task. In tandem with the guidelines and concerns raised during the data collection, the supporting frameworks will be given first priority Education of the community and nursing home staff on the best practices of handling and treatment for the elderly people will be carried out simultaneously (Wagner, 2001). The supporting frameworks entails provision of friendly infrastructure, wheel chairs, recreational facilities, dedicated staff and ensuring their concerns are overly attended to. Elderly people should be supported at the community level by ensuring support in accessing basic amenities. People with learning and cognitive disabilities must be accorded necessary support and encouraged to learn basic things. In addition, psychological help must be given in abundance to improve their self esteem. The old age persons will overly receive due attention and care when accessing healthcare. To enhance the achievement of the objectives set in the policy guidelines, both groups together with the elderly persons require undergoing sensitization and trainings on the utilization of the various special facilities in order to avoid inconveniencing others while avoiding the occurrence of injuries or any form of harm of the patients (Badger, Gagan, & Mcniece, 2001; Wagner, 2001).
Evaluation of the adherence and success of the process is mainly conducted after six months interval. Evaluation entails the observation and interviewing of the elderly persons to assess their views with regard to access of healthcare and basic amenities. Importantly, observation will come in handy in ascertaining the treatment and social interactions within the community with a view of instituting programs to improve the situation. Evaluation will be based on set standards such as high level of interaction with the staff and community with special attention given to them. More importantly, understanding and applying best practices with regard to the management of elderly persons must be exhibited within the community and staff with the former well conversant with their rights (World Health Organization, 2001). To this end, rating of the success of the implementation will be done and remedial measures taken.
National policies on elderly persons
The involvement of the non medical staff particularly in residential facilities and households becomes inevitable in the care of terminally ill people. Their incorporation in the daily support of the elderly people is usually carried out in order to ensure the maintenance of coordination in delivery of care. The coordination of care between the health providers and the community has received recognition through adoption of policies at the state and at national levels. The key policy documents at the national level include the National Action Plan for Improving the Care of Older People across the Acute-Aged Care Continuum that has highlighted a wide range of initiatives with regard to the health of the older population. The National Health and Hospital Reform Commission provided the Australian people with the best chance to examine the healthcare delivery in relation to the achieved outcomes. Although there are many plans in place to preserve the lives of the Australian population, the Health Service Framework for Older People 2009-2016 is a comprehensive one.
The strategic plan under utilization in South Australia is based on several principles that are imperative in promoting healthy living (South Australia Department of Health, 2009). The plan acknowledges the independence of the older people in selecting the treatment options while achieving high levels of respect. The plan also advocates for provision of services aimed at optimizing capacity towards healthy lifestyle. Recognition and support of the carers to ensure that is emphasized as it forms the core of the community empowerment. More importantly, it recognizes that the planning and delivery of healthcare services require basis on viable and long term collaboration and sometimes partnerships. Appropriate response to needs of the indigenous populations and other groups that require special considerations is emphasized. More so, providing alternatives and observing accessibility is imperative in enhancing the quality of life (Government of South Australia, 2009).
The concept of integrating health promotion in all aspects of life has been informed by the high prevalence of diseases and conditions that are preventable. The elderly forms a substantial component of the larger population and the figure is expected to significantly increase due to the witnessed life expectancy brought about by economic development in many parts of the world. Terminally ill people have variations in their health needs and care. In fact, the longer people live, the more diverse their needs become. Community assessment has become a useful tool in guiding the implementation process of policies in the community level. The coordination of care between the health providers and the community has received recognition through adoption of policies at the state and national levels. It is therefore important to adopt a holistic framework in health promotion that encompasses all health stakeholders, community, supporting frameworks and conceptual models to enhance improved health in the elderly people.
Health promotion booklet
Taking into account of the current trends in healthcare, it has become increasingly popular to note that the future in healthcare will be dominated by high cases of chronic disorders. Utilization of concerted efforts has resulted into reduction of infectious diseases in the recent decades. In fact the plummeting of the epidemic infections in the 20th century has been counterbalanced by skyrocketing cases of non communicable diseases which are chronic in nature. Majority of these conditions are brought up by the important changes witnessed in the lifestyle of the public. Ben-Shlomo & Kuh (2002) and Janssen & Kunst (2005) noted that the development of these conditions is usually as a result of an accumulation in a myriad of risk factors particularly over a long period of time. Considering the enormity of factors responsible for causing the diseases, it is becoming impossible to point onto one problem that is responsible for causing the disease. Although there is an ever growing body of research on healthy living that aims at postponing the occurrence of these conditions, the fact remains that the conditions will still sky rocket in the future owing to demographic increases and changes in the social environment.
It is estimated that about a quarter to half of all young people in Europe will develop a long standing problem during their later days of life owing to the factors that they are exposed to in the social environment (TNS Opinion & Social, 2007). The development of multiple chronic conditions at older ages is becoming a nightmare to the health sector in the developed world with at least two thirds of pensionable persons suffering from one or more of these conditions in Australia. With the health system employing the traditional approach of treating the major ailments, the policy makers have been put into task to create proper mechanisms of addressing the care process targeting the chronically ill patients. The linkage of chronic diseases with disability has impacted negatively on the lives of the elderly people. Disability complicates the lifestyle of the elderly occasioning their dependence particularly on executing basic tasks.
During the past few decades, an increasingly level of societal interest has been observed from several quarters in the United States and Australia. A striking similarity is the embracement of programs aimed at changing individual behaviours with the single motive of preventing the development of disability. More importantly, the management of the chronic diseases has taken centre stage owing to the increasing knowledge of their impact on the economic and social fronts. The Australian government has intensified efforts to address the overall management of the chronic diseases. Buoyed by support from the private sector, the government has embarked on a spirited fight to carry out health promotion and the prevention of chronic diseases. Health promotion efforts usually target the social determinants in addition to the environmental influencers. While the social determinants are mainly blamed for the high level of chronic diseases, other determinants have also been found to have significant role in perpetuating the occurrence of the diseases. It has therefore brought in to fore the need to direct efforts not only on modifying the lifestyles but also on encouraging the maintaining appropriate conditions in the environmental and physical environment.
Taking into consideration of the data from the Australian Bureau of Statistics on the health status of the elderly people in Australia, there is urgent need to educate them on the management of chronic diseases. A large segment of the population in this category is at high risk of developing one or more of the chronic diseases with specific attention on the cancers and diabetes (ABS, 2006). High levels of smoking and sedentary levels are causes for worry due to their relationship with the development of cardiovascular disorders. The fact that more than half of the elderly people are overweight is another factor that occasioned the development of this booklet. Although the health seeking behaviour was found to be consistent with accepted norms, the manner under which the elderly people went on with their lifestyle left a lot to be desired. In view of the existing loopholes in understanding the management of chronic illnesses among the elderly people in Australia, this booklet will provide remedial and risk reduction measures. The booklet will incorporate several approaches of promoting health in order to achieve high success rates.
In fact, the wide range of remedial measures to be integrated on the management of the health disorders will bring into fore the need to utilize several interventional approaches. More importantly, to enhance the development of long term solutions to the chronic disorders, a holistic approach that will entail the incorporation of behavioural and social change coupled with educational interventions will be required. To enhance the uptake and sustainability of the interventions, conceptual frameworks will be utilized to reinforce the concepts behind them. The ecological model for health promotion provides the best conceptual framework to ensure all the components of the intervention are satisfactorily addressed. The fact that the model focuses on individual in addition to the social environmental factors makes it the right one for aiding in the intervention. Furthermore, the model addresses the underlying importance with regard to the changes in interpersonal and organizational levels. It also seeks to find answers on community and policy at local and national levels while addressing the broad range of factors that perpetuate the unhealthy behaviours. The models has its premise in that initiation of appropriate changes targeting the social environment will ultimately result in pivotal changes at the individual level while also denoting that support conferred by individuals within the population is important in executing changes in the environment (McLeroy et al, 1988).
Approaches in promoting health in elderly people
Taking into account the dynamic nature of the problem, several approaches will be included; education, behaviour change, medical, community empowerment and social change.
The medical approach is aimed at lowering the burden of diseases while ensuring fewer deaths occur among the elderly people in Australia. The fact that the elderly suffer from one or more chronic diseases means that the medical model has wide application in this scenario. In fact, the various facets of the medical model confer undue advantage that enhances the success of the program. The Integration of the three strategic approaches in prevention not only serves to reduce the number of persons who will require care in the long term. The three approaches include: primary, secondary and tertiary prevention.
This usually entails the application of concerted efforts to prevent the occurrence of diseases mainly through risk education. Primary prevention through immunizations and participation in physical exercises helps in averting the occurrence of long term debilitating conditions. The elderly people and the community at large need to be equipped with the necessary knowledge regarding the management of the risk factors in the long term. In view of this, there is urgent need to educate them on the harmful effects of smoking and largely alcohol taking in a bid to dissuade them. The integration of drug control programs such as alcohol anonymous and support groups would go a long way in lowering drug abuse hence resulting in lower morbidities due to cancer. Encouraging healthy eating is imperative. The elderly people and their carers require an understanding about the benefits of eating balanced diets. This will ensure the adherence to strict diets that has lower levels of cholesterol. Incorporation of light or slightly heavy physical exercises depending on the state of the elderly person is also imperative. It is therefore important to consider workouts in the daily activities to enhance blood flow and other body system functions. Actually, physical exercises like jogging, swimming, walking and press ups go a long way in preventing the occurrence of musculoskeletal disorders. Therefore, application of drug control, physical exercise and healthy feeding habits not only helps the individual to prevent the development of majority of the chronic illnesses (Nutbeam & Harris, 1999; Tones & Green, 2004).
Secondary prevention in terms of early detection and treatment of health conditions is vital in curtailing the development of the disease within the body system. Embracement of screening in combination with other methods of early diagnosis such as medical checkups needs emphasis particularly in cases where disease development takes a lengthy period. Taking into account majority of the conditions in the elderly people are cancer and diabetes, this approach would provide a useful avenue for their early detection. Early detection not only brings increased awareness about the medical condition but also helps the individual to embrace appropriate lifestyles behaviours. Avoidance of cholesterol rich foods in favour of whole meal cereals confers the elderly people with better immunity against further development of the disorders. Colon inspections and testing for common cancers and diabetes are not only helpful but also added advantage of living longer (Breslow, 1999).
Tertiary prevention programs have proved to be the most important particularly in the management of nursing homes. That majority of the clients suffer from terminal diseases makes this strategy an important approach in helping the patients recover from their debilitating conditions. The combination of medications and physiotherapeutic techniques in the management of elderly clients offers a viable option that results in quick recovery of the clients. Home visitations have also started taking root, although little empirical evidence exists on its efficacy and viability (Nutbeam & Harris, 1999). The successes of the various approaches have depicted different rates of success. The success of programs is pegged on the demographic characteristics of the populations and the manner of application. Empirical evidence denotes that extended ambulatory evidence had become an effective program when compared to other programs targeting elderly clients in the nursing homes. The reduction of the extent of disability through rehabilitative approaches such as physiotherapy and physical workouts is important in enhancing independence and strength in the individuals.
More importantly, patient education about the need for consistency in treatment procedures and rehabilitative approaches goes a long way in enhancing recovery. Patient education coupled with regular physiotherapy and inner strength is required to ensure the condition does not recur. Palliative care in the nursing homes and households forms an integral component in tertiary prevention. The community and the carers in specific require special training on palliative care with regard to counselling and communication of the eventuality of the end of life. In addition, the elderly people require spiritual guidance to help them understand and embrace their past life while reconciling their creator. Communicating vital information about the chronic disorders is important to strengthen the contribution of the patient in the recovery process (Tones & Green, 2004).
Behavioural change approach
Behaviour change approach depicts that alteration in the individuals’ cognitions is imperative if any meaningful change is to occur in an individual’s behaviour. The approach is premised on the assumption that humans are usually rational decision makers who value the mass media as the source of credible information regarding the potential health risks and largely hazards in the environment. In this case, health promotion largely takes the form of health education. Owing to its notion of empowering the individual on the causation and management of illnesses, the approach was hence forth referred to as “information giving model” (Aggleton et al, 1989, p. 76). Through health education, individuals will receive knowledge on the various aspects that constitute healthy lifestyles in order to help them make informed decisions. The benefits and harmful effects of embracing physical exercises, appropriate feeding habits and avoidance of drugs need to be shared with the individuals. Persuasion plays a major role in enticing the elderly people to appreciate the merits offered by the intervention strategies while encouraging them to overlook the negligible demerits and inconveniencies. Motivation techniques are integral in the achievement of intended behaviours, hence the nurse should integrate them during the facilitation of health education. In tandem with the top down approach concept, the nurses need to utilize understandable language and disseminate the information while contextualizing the information to fit the local setting (Egger, Spark & Lawson, 2005). To ascertain the efficacy of the approach, evaluation of the intended interventions should be carried out after a specific period. The evaluation is carried out in order to enhance the development of better intervention strategies that are line with the particular group cultural values and preferences (Green & South, 2006).
Taking into account of the current trends in healthcare, it has become increasingly popular to note that the future in healthcare will be dominated by high cases of chronic disorders. The ecological model for health promotion provides the best conceptual framework to ensure all the components of the intervention are satisfactorily addressed. The fact that the model focuses on the individual in addition to the social environmental factors makes it the right one for aiding in the intervention. In view of this, the application of drug control, physical exercise and healthy feeding habits not only helps the individual to prevent the development of majority of the chronic illnesses. The community and the carers in specific require special training on palliative care with regard to counselling and communication of the eventuality of the end of life. In addition, the elderly people require spiritual guidance to help them understand and embrace their past life while reconciling their creator. Communicating vital information about the chronic disorders is important to strengthen the contribution of the patient in the recovery process. Persuasion plays a major role in behavioural approach thereby enticing the elderly people to appreciate the merits offered by the intervention strategies while encouraging them to overlook the negligible demerits and inconveniencies.
The need to ascertain the level of understanding of students and scholars has occasioned the development of reflective journals. Reflective journals serve to present the findings of a certain scholarly material and offering the researcher a chance to evaluate, critique and give his/her own views in comparison to other studies. Reflective journals are imperative in learning since they help in the assessment of the understanding of the student while also enhancing their development by allowing them to critically analyze the articles. In this case, the reflective journal will discuss the health promotion report with an aim of critically analyzing and offering a personal assessment in relation to past experience and studies.
The health promotion report describes the community assessment of the specific problems facing the elderly people in residential facilities and households in Australia. The advent of old age comes with several health problems, majority of which are preventable through the embracement of healthy lifestyles. The fact that majority of the elderly people exhibit large extent of risk factors make the elderly people at high risk of developing one or more of the chronic illnesses. The demographic and epidemiological information regarding this category of the population is presented with a view of understanding the extent of the health problem. The report further gives a detailed breakdown of the various aspects of health status with regard to the chronic illnesses. The hazards and risk factors associated with cancer, diabetes and heart disorders are presented in the study, in addition, the distribution of the population of elderly people in Australia is highlighted while the relationship between chronic illnesses with healthy lifestyle, physical exercises and drug abuse are presented (Brockbank & McGill, 2007).
A review of past findings on the management of chronic illnesses and other heath problems affecting the elderly people in other settings are presented in the report with an aim of enhancing understanding of past and current trends in the world. In order to effectively manage the development of chronic illnesses, community assessment is carried out to ascertain the extent of the problem and suggest the most amicable solutions to the community. Utilization of the community empowerment model helps in equipping the target group and the community at large with necessary knowledge and skills in implementing interventional strategies aimed at management of chronic illnesses. An evaluation of the various interventional strategies is imperative to help ascertain the efficacy of the interventions put in place. More importantly, the report sheds light on the national policies and plans under application in Australia particularly those that affect the lives of the elderly and aged people. The national policies were mainly replicated in all states of Australia either as whole or with little amendments (Brockbank & McGill, 2007).
Health promotion acts as a very important intervention particularly in control of illnesses that can be managed through healthy lifestyles. The fact that health promotion employs facets such as advocacy and theoretical models makes it widely applicable at the community level. Models utilized during the community analysis offer the most effective platform under which the extent of the health problem is ascertained. In fact, it enhances the determination of the various aspects of the problem and the various ways it affects the concerned individuals. Models of health promotion not only enhance the multidimensional understanding of the causation but also of the management. Literature reviews offer the readers a clear perspective of what they want to achieve. Incorporation of the literature review also enhances the creation of an image that depicts the strategies and approaches to be embraced during the community assessment. A look at the policy frameworks in the Australian society denotes a country where the rights of the elderly people are respected. The societal values depict that the individuals need be cared of depending on the specific qualities and circumstances under which they find themselves.
The distribution of the policies governing the care of the chronically ill people is instrumental in offering a holistic view that ensures people’s rights are respected across all aspect of life. While the policies may have significant implications to the management of the aged, the Australian society appreciates them while upholding their dignity by ensuring they enjoy their lives (Liimatainen et al, 2001. Furthermore, the representation of the demographic and epidemiological data on the health status depicts a worrying trend where risky behaviours are inherently becoming prevalent in the aged unlike in normal situations where they are found in the younger segments. Although the values of the Australian aged people are respected, this trend may denote an increasingly level of segregation of the elderly thereby resulting in high stress levels. That behaviour is learned over time means a high number of Australia in their middle ages indulge in drug abuse. Community assessments are the best approaches in learning the problems being experienced in a certain setting. In fact, it is only through interaction with a certain group that one becomes aware of their situations while empathizing with the affected individuals. In doing so, health promotion serves to instil the motivation and encouragement that gives the affected the energy and will to change the situation.
Health promotion entails the overall process where an increasingly tendencies of control is given to the people especially on their health and factors that determine their health hence resulting in the significant improvement in their health status (WHO, 2005). In a nutshell, health promotion occurs through concerted efforts that entail the development of a public policy with the main aim of ensuring the basic factors that dictate the full enjoyment of health are availed. Factors such as employment, housing, quality working conditions and fair income levels are vital to enhance the overall enjoyment of health (WHO, 2005). Community assessment entails a collaborative approach that brings together a group of individuals in data gathering with the eventual aim of implementing helpful strategies. The question that arises during community assessment revolves around the efficacy of the various approaches utilized during the assessment. In essence, their impact in influencing the outcomes should be given due care to avoid distortions of the figures. The involvement of the community as the main source of information regarding their shortcoming with regard to health needs may be affected by reliability owing to bias particularly when they learn about the expected benefits.
The report offers better approaches useful in providing solution to many health situations. Since health is intertwined with other factors in the environment, it becomes possible to extend the concepts to other aspects of life. Community assessment is a viable option in ascertaining the levels of poverty and their impacts on the overall access of healthcare delivery. Ascertaining the root causes of poverty can in turn help explain the health seeking behaviour since high poverty levels makes people to priorities access to basic commodities such as food and water. In this case, medical care is regarded as a luxurious commodity, the preserve of the rich and affluent. The implementation of health promotion of interventions in others settings such as prisons or informal settlements would greatly benefit from the approach. For instance, the integration of conceptual models in the community analysis would ensure there is systematic collection of vital data that would eventually inform the adoption of sound interventions (Liimatainen et al, 2001).
The fact that the prevailing circumstances in the area under study play a significant role in influencing the outcomes of the intervention, means that their consideration during replication of the study approach is vital in ensuring due process is followed thus resulting in better outcomes. Taking into account that the assessment relies on an in-depth analysis with due consideration of the diversity within a certain setting makes it an approach worth replicating in other community settings. The acknowledgement of diversity as a major influencer of health outcomes would serve as a premise of understanding the health outcomes in the prison settings. The utilization of multiple perspectives when assessing the needs of the community provides a solid foundation upon which conclusions on outcomes of each category is made. The understanding of the importance of linking the assessed needs with evaluation is as important as carrying out the whole process. Failure to create linkage will provide inconsistent results thereby affecting the effectiveness of the whole process (Baker, 1996).
Linking the concepts used in accomplishing the community assessment with student learning is beneficial since it allows for the smooth integration of knowledge coupled with skills. In fact, discussions regarding the health promotion report produced interesting insights that will have significant impact on the conduct of future expeditions. For instance, the incorporation of conceptual frameworks into the community analysis brought efficiency and reliability in the outcomes (Baker, 1996). With regard to the achieved efficiency, integration of more than one framework in the analysis was floated as a viable option that would enhance the production of reliable results. More importantly, specificity would be greatly enhanced hence the variables would due attention hence allowing the linkage of them with the health outcomes.
In view of the discussions, due consideration of specific demographic variables such as gender and age in relation to cultural, economic and largely ethnic background was stressed. The consideration of these variables in that context improved the accuracy and specificity in correlation thereby conferring better outcomes based on the evaluation (Baker, 1996). More importantly, further assessments would highly benefit from the relationship espoused above owing to the fact that assessment is based on specific issue affecting a particular group of people. Student learning largely benefited from the health promotion report since they were able to nurture knowledge on the process of carrying out an assessment. New insights on conducting the study based on set standards or benchmark in order to achieve a clear picture of the situation was devised. Analysis of data collected through questionnaires or interviews is then compared with specific benchmarks hence allowing understanding the deviation from the normal ranges. In such a case, conclusion can be easily be deduced mainly due simplicity offered in relating the various parameters under study (Brockbank & McGill, 2007).
In conclusion, the reflective journal helps in highlighting the major concepts discussed in the health promotion report while helping understand how the outcomes can be harnessed to improve student learning. Having delved on health promotion using the community assessment helps bring out its usefulness and superior advantages when compared to other methods. In fact, it is only through interaction with a certain group that one becomes aware of their situations while empathizing with the affected individuals. In doing so, health promotion serves to instil the motivation and encouragement that gives the affected the energy and will to change the situation. The involvement of the community as the main source of information regarding their shortcoming with regard to health needs may be affected by reliability owing to bias particularly when they learn about the expected benefits (Brockbank & McGill, 2007). The understanding of the importance of linking the assessed needs with evaluation is as important as carrying out the whole process. Failure to create linkage will provide inconsistent results thereby affecting the effectiveness of the whole process. Student learning largely benefited from the health promotion report since they were able to nurture knowledge on the process of carrying out an assessment. The concept of reflective learning should be embraced in learning owing to the advantages it offers to students involved in research studies.
Baker, C. (1996). Reflective learning: a teaching strategy for critical thinking. Journal of Nursing Education, 35(1), 19-22.
WHO. (2005). The Bangkok Charter for health promotion in a globalized world. Geneva: World Health Organization.
Brockbank, A. & McGill, I. (2007). Facilitating reflective learning in higher education. Maidenhead: Open University Press.
Boutilier, M., Mason, R. & Rootman, I. (1997). Community action and reflective practice in health promotion research. Health Promotion International, 12 (1), 69-78.
Liimatainen, L., Poskiparta, R., Karhila, P. & Sjögren, A. (2001).The development of reflective learning in the context of health counseling and health promotion during nurse education. Journal of Advanced Nursing, 34(5), 648–658.
Aged & Community Services Australia & National Rural Health Alliance. (2005). Older People and Aged Care in Rural, Regional and Remote Australia: National Policy Position. Canberra: ACSA & NRHA.
Australian Bureau of Statistics (2010) Australian demographic statistics, Dec 2009. Canberra: Australian Bureau of Statistics.
Australian Bureau of Statistics. (2005). Population Projections, Australia, 2004-2101, cat. no. 3222.0. Canberra: ABS.
Australian Bureau of Statistics. (2006a). National Health Survey: Summary of Results, Australia 2004-05, cat. no. 4364.0. Canberra: ABS.
Australian Bureau of Statistics. (2006b). Health of Older People in Australia: A Snapshot, 2004-05. Canberra: ABS.
Badger, T., Gagan, M. & Mcniece, C. (2001). Community Analysis for Health Planning With Vulnerable Populations. Clinical Nurse Specialist, 15(3), 95-104.
Berg, R. & Morgenstern, N. (1997). Physiologic changes in the elderly. Dental Clinics Nurses of America, 41, 651–668.
Byles, J. (2000). A thorough going over: evidence for health assessments for older persons. Australia and New Zealand Journal of Public Health, 24, 117-123.
Elkan, R., Kendrick, D., Dewey, M., Stuck, A. & Siu, A. (2001). Effectiveness of home-based support for older people. British Medical Journal, 323, 719-724.
Fillit, H., Rockwood, K. & Woodhouse, K. (2010). Brocklehurst’s Textbook of Geriatric Medicine & Gerontology. London: W.B. Saunders Company.
Government of South Australia. (2009). South Australia: Health: Health Policy for Older People 2010 – 2016. Canberra: GSA.
Lamy, M., Pharis, M., Geris, K., Gorse, M., Sur, H. & Cante, Y. (1997). Oral status and nutrition in the institutionalized elderly. Journal Dentistry, 27, 443–448.
Naidoo, J. & Wills, J. (2000). Health Promotion. London: Balliere Tindall.
Robinson, J. & Eklan, R. (1996). Health needs assessment: theory and practice. London: Churchill Livingstone.
Robinson, W. (2006). Community Analysis. Web.
Shrestha, S., Shrestha, K. & Deepak, S. (2009). A community assessment of poverty and disability among specific rural population groups in Nepal. Asia Pacific disability rehabilitation journal, 20(1), 83-99.
South Australia Department of Health. (2009). South Australia’s Health Care Plan 2007–2016. Canberra: Department of Health, Government of South Australia.
Stuck, A., Egger, M., Hammer, A., Minder, C. & Beck, C. (2002). Home visits to prevent nursing home admission and functional decline in elderly people: Systematic review and meta-regression analysis journal of American Medical Association, 287(8), 102-1028. Web.
Stuck, A., Siu, A., Wieland, G. & Rubenstein, L. (1993). Comprehensive geriatric assessment. Lancet, 342, 1032-1036.
Verbrugge, L. & Jette, A. (1994). The disablement process. Social Science Medicine, 38, 1-14.
Wagner, E. (2001). Meeting the needs of chronically ill people. British Medical Journal, 323, 945-946.
World Health Organisation. (1986). Ottawa Charter for Health Promotion. Geneva: WHO.
World Health Organisation. (1995). Report of the Inter-Agency Meeting on Advocacy Strategies for Health and Development: Development Communication in Action. WHO, Geneva.
World Health Organisation. (2003). The World Health Report – shaping the future. Geneva: WHO.
World Health Organization. (2010). WHO Oral Health Country/Area Profile. Geneva: WHO.
Aggleton, P., Gaffan, E., Leton, J., Gaffan, D., & Shaw, C. (1989). Learning about AIDS: exercises and materials for adult education about HIV infection and AIDS. Book/booklet/exercise pack. Edinburgh: Churchill Livingstone.
Australian Bureau of Statistics. (2006a). National Health Survey: Summary of results, Australia 2004-05, cat. no. 4364.0. Canberra: ABS.
Ben-Shlomo Y, & Kuh, D. (2002). A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology, 31, 285-93.
Breslow, L. (1999). From Disease prevention to health promotion. Journal of American Medical Association, 281(11), 1030-1033.
Egger, G. & Lawson, D. (2005). Health Promotion: Strategies and methods. (2nd Edition). Sydney: McGraw-Hill.
Green, J. & South, J. (2006). Evaluation. Maidenhead: Open university Press.
Janssen, F. and A.E. Kunst (2005), Cohort patterns in mortality trends among the elderly in seven European countries, 1950-99. American journal of epidemiology, 161(1), 52-61.
McLeroy, K., Bibeau, D., Steckler, A. & Glanz, K. (1988). An ecological Perspective on health promotion programs. Health education behaviour, 15, 351-377.
Naidoo, J. & Wills, K. (2000). Health Promotion Foundations for Practice. London: Balliere Tindall.
Nutbeam, D and Harris, E. (1999). Theory in a nutshell. A guide to health promotion theory. Canberra: McGraw-Hill.
Tones, K. & Green, J. (2004). Health promotion: Planning and strategies. London: Sage Publications.