Must Complete: Yes
Word Length: 2500 words
Notes: Project Report
This assessment relates to:
Learning Outcomes 4-5
Use the case scenario from your Project Presentation to:
Discuss the manner in which social determinants of health and ageing may impact on the current situation.
Provide a critical analysis of three relevant policies on ageing ensuring that you include the overarching frameworks of Person Centred Care and Active Ageing.
Demonstrate a developing capacity to analyse policy and practice frameworks regarding the prevention and management of complex and chronic diseases for the diversity of ageing populations in Australia
This report is focused on the life of 74 years old aboriginal Australian Jack Lawler, who lives with his wife Alice. All his children and grandchildren are living in the local areas. The successful motor mechanic is respected in the local aboriginal community and supports different parts of the local aboriginal youth by enlightening on cultural history. Currently, he is diagnosed with renal failure and type II diabetes for a long time. Purpose of the report lies in identifying influence (positive or negative) on health of aged people and describing suitable policy frameworks.Additionally, impact of biological and physical changes on attitudes and beliefs of people is critically examined.
The impact of social determinants of health and ageing on this current situation
The World Health Organisation has described the social determinants of health involved in every phase of human life. This is because to born, to grow, to live, to work and to age are shaped by the distribution of resources, power and money at the local, National and global level. The social determinants of health comprise of economic stability, education, physical environment and neighbourhood, food, Healthcare system and community and other social contexts. Some of these determinants affecting Jack in his current condition are:
Safe, secure and affordable housing is confined to better health that becomes highly impactful on the participation of people in fields like education and work. A gradient exists that explains the relationship between the quality of the housing and health. As the likelihood of residing in a precarious housing rises, health automatically worsens (Fisher et al., 2019). Aged people like Jack in the case scenario often panic with the thought of living precariously.
Jack lives in a rural and small town. For the current physical condition of Jack, housing may or may not positively impact on the health recovery. As he is living with his wife, he is happy for being with his partner with whom he can share his feelings and emotions with. On the contrary, she is also an aged woman who may not be able to provide proper healthcare support to Jack.
Browne et al., (2017) says that it is quite evident from previous research works that unemployed people or who have relatively lower-income suffers from disability and illnesses more. This is because of the psychosocial burden caused due to unemployment, which affects both mental and physical health along with the wellbeing. People with lower education tend to earn lesser compared to the ones having higher qualifications. So, Somerville et al., (2017) concludes that education is directly proportional to getting employed. Unemployment is a huge factor to cause severe health issues which are chronic and results in drastic sufferings of people. Together with this, it brings financial problems and psychological consequences in their lives.
It is a well-known fact that Jack used to be a motor mechanic but currently he is retired. He plays an effective role in maintaining his responsibility towards his community and family both as he is an aboriginal. His wife is successfully working in the local aboriginal medical service still the income is not sufficient to contribute to his health recovery.
This is a wide-ranging concept for describing lack of appropriate resources and social disadvantage. It also lowers skills participation and opportunities associated with people. As a result of stigmatization, unemployment, discrimination and several other factors like language culture prejudices and poverty, social exclusion occurs (Westrupp et al., 2019). Due to anxiety and long term stress from the psychological tensions, health may deteriorate in the individuals. Jack may suffer from such anxiety of not getting appropriate treatment belonging to the Aboriginal society.
Jack is successfully supporting the local aboriginal youth committee. He is also a respected elder of the local aboriginal community. At the local level, his popularity will help him to recover his health condition (Adler, Glymour & Fielding, 2016). Residential environment is highly impactful on the health equity by its influence over the local resources safety and behaviour. Neighbourhoods and communities which ensure access to the basic necessities and seems to be socially cohesive are quite required for aboriginals. Health Promotion communities which will protect and conserve the natural environment along with people is necessary for maintaining health equity.
Equal opportunity is not provided in terms of this aboriginal person which create great behavioural and environmental health risk factors. It has been identified that among the aboriginal people of Australia the health rate is lower than the other population. For instance, the data on cardiovascular disease in the general population of Australia has produced around 30% from the year 1991(Gwynn et al., 2015). When it comes to the aboriginal people, since the last 35 years, hardly any reduction of death rates for cardiovascular disease is identified.
Three children of Jack and nine grandchildren are living in the same small rural area. The support from his family is available for Zack even in his old age because of his large and compact family. In fact as her wife is successfully working in the local aboriginal medical service, the physical health issues in Jack can be monitored by her maintaining the strict diet and fluids regimes. His grandchildren can also help him during the travelling of 45 minutes for the local renal analysis centre.
The lack of infrastructure and transport system for the rural areas in Australia is creating difficulty for the old aged people. However, the distance of his house and the medical centre is deteriorating his current medical condition. Government should be responsible for the amenities of ambulances in emergencies and shall increase the count of health centres (Buckley, McCormack & Ryan, 2018).
In order to understand practices and policy frameworks within Australia for equalising rights of aboriginals to get equivalent air quality as other communities include some health regulations. Article 12 of ICESCR (International Covenant on economic social and cultural rights) provides right to every people for enjoying the greatest possible standard of mental and physical health that is attainable. Article 11 of the Covenant States about right of people irrespective of caste and creed to sustainable and sufficient living standard involving adequate food housing and clothing (Smylie & Firestone, 2016). Article 13 talks about equal rights to education in Australia. However, Article 2 of this Covenant projects on taking active steps for maximizing the available resources to the aboriginals and complete realisation of their rights shall be recognised by the government. According to the National Aboriginal Health strategy of 1989, indigenous Australians have clarified that their respective health statuses are interlinked with controlling over physical environment receiving justice and self-esteem as well as developing dignity (Snyder & Wilson, 2015). It is not about providing hospitals doctors medicines and any kind of incapacity towards them. Due to inappropriate or absence of the patient centred care, several aged people like Jack can suffer from illnesses.
Since 2008, the Australian government has been committing to provide aboriginals of Australia with equal health status as well as life expectancy. Anderson et al., (2016) discusses that within the year 2031 the commitment of Australian government in the context of a notion ‘closing the gap statement of intent’ shall create a platform for the national aboriginal and Torres Strait Islander people’ health plan. This plan framework shall provide an evidence-based and long-term policy framework in order to mitigate the gap between aboriginals and other communities. The health plan has been already signed in the year 2008 that was set out within the National indigenous Reform agreement (Canuto et al., 2017). The health plan has been built on different principles mentioned in the United Nations declaration over rights of the indigenous peoples. It basically adopts the strength-based theoretical approach for ensuring different programs and policies to improve social and emotional wellbeing together with health status. It will definitely and sure promotion of affirmative health behaviour and resilience. In order to provide aboriginals with an empowered and healthy life, a health plan is built on some existing planning Strategies and approaches. This health plan eventually aligns with distinct Strategies and plans of government that support improved health outcomes for the aboriginals with Torres Strait islander people. It brings out the national strategic framework for them as planned from 2003 till 2013 (Browne et al., 2018).
At the international level, the World Health Organisation has included the Global strategy action plan on ageing and health. According to this strategy, conceptualization of health benefits at ageing needed to be included. Besides that, they also focus on the functional ability of older people for the things they value. The ability of environment inhabited and intrinsic capability of an individual is also measured for societal action. Garg, Boynton-Jarrett & Dworkin, (2016) discusses that for promoting healthy ageing, WHO also focuses on the Dynamic Adaptive Compensation Policy which provides a positive spectrum to the delivery of care to the old people. The policies for personalized care approach at this international platform have identified the conventional ways for care delivery to Aboriginals.
Patient centred care
According to their perspective, recognising the elder person for care is not the only way for their health improvement. Empowering the old age person for participating in the process of decision making about the health also improves the personalised care. According to the part of these international policies, healthcare professionals in rural Australia need to focus on developing skills for maintaining the holistic health area of the old people (Jones et al., 2018). The biopsychological needs and capabilities of the older persons needed to be a significant part of the Patient Centred Care.
Regular focus on the age-related declines should be included as part of this personalized care treatment for measuring and mobilizing their abilities. For integrated or person centred care, specific short time requirements related to chronic and complex health needs should be measured with increasing age. The Healthcare system should be based on the people-centric health services, which can be considered as the primary care for the wider healthy population.
Black & McBean, (2016) suggests that for maintaining the old age population, the Australian government has introduced the National social policy committee. The various principles under this engaged are right to the employment, independency, exercise choice and control, personalized style of their choice, self-fulfilment related to cultural recreational sources in their community, treated with dignity and respect as well as supporting opportunity for pursuing health ageing lifestyle choices. The Australian government has announced “live longer live better” policy for the old population as well. In the year of 2012 in April, the framework has been announced by the government for “live longer live better”- an aged care policy (Kogan, Wilber & Mosqueda, 2016). This policy is known for providing home and community care, packaged community care, residential care and information, referral and assessment for the senior Australians. The regulation of this government policy has a new aged care financing authority. This authority is useful for maintaining the aged care services with proper monitoring system with care standards and acceleration agency. Both the Australian and National infrastructure of Australia provides some basic opportunities to the old age people like Jack. The identified principles and policies will provide a better way to improve his current health condition.
Policy and practise frameworks regarding the prevention and management of the complex and chronic disease for the diversity of the ageing population in Australia
In order to understand the depth of severity in chronic diseases, a model is highly required to be illustrated which refers to the CCM (Chronic care model). This is a practical approach for showing care towards people suffering from chronic diseases in primary care settings. Gammon et al., (2015) states that this particular system is based on population and also creates supportive practical and evidence-based communication among the activated and informed patient as well as a proactive and prepared practice team. Some of the essential elements are identified by the chronic care model in the Healthcare systems include community design of delivery system support of self-management clinical information procedures and decision support system. Health systems according to this model are responsible for creating a safe and care oriented environment for patients (Davy et al., 2015). This would definitely include patient centred care which is needed for people suffering from type 2 diabetes and renal failure. This is because they shall be dependent on the care providers most of the time. Community is another element which is essential because of mobilising the resources in order to meet the patients’ needs. Encouraging patients for participating in the community programs must be included in the policy approaches for aboriginals. It would make them realise about being in a secular community.
National strategic framework for chronic conditions will be effective for the prevention and management of the chronic disease. As per Brands et al., (2018), this framework is known for the national, state and local levels. The aboriginal population is already known as a misguided diversity in Australia. Therefore, maintaining the health care of this old age population can be possible with local responsible healthcare providers. This National framework of Australia focuses on various types of clinical conditions which are complex in nature. Clinical conditions have multiple causes. The prioritised populous areas wherein this National Framework is working, it is merely focusing on eliminating cultural and lingiuistic barriers. In the year of 2014-15, Australian Government has identified that 87% of older Australians are having different types of chronic conditions (Lacaze, Ryan, Woods, Winship & McNeil, 2017). Approximately, 50% of them have more than one chronic condition. The national report has also identified that the population suffering mainly from chronic and fatal illnesses age over 65 years (Marmot, 2018).
Depending on this condition, this National Framework has set up its first objective of prevention process for improving health care in Australia. The various priorities of this objective are to reduce risks and promoting health, overcoming critical life stages, establishing partnership for health and finally, appropriate and timely detection, diagnosis and intervention of the disease. The second objective is associated with providing efficient and appropriate care for supporting different groups of people with chronic conditions like Jack (Ponikowski et al., 2016). For this, focus has been given on optimising the quality of life. The priorities of the second objective are effective engagement, continuity of care, information sharing along with accessible health services and support systems (Sendall, McCosker, Crossle & Bonner, 2017).The final and third objective of this National Framework focuses on targeting populations with utmost priority. There are also strategic prioritised areas for targeting this population. For managing and preventing the Healthcare condition of Jack, it will be more effective to meet the three objectives of the National framework Policy.
Clinical support must be provided to Jack in his condition of chronic illness. Patient centred care emerges with the growing ageing population in Australia. National strategy framework and the health plan developed by Australian government for aboriginals must be followed undoubtedly for treating patients like Jack in the case study. A physical comfort and emotional support is required for faster recovery of patients with chronic diseases like type 2 diabetes. Access to proper care is highly essential which is unlikely the case of Jack because transport has been a huge issue for him.