Communities and Health

Communities and Health

Vivian L. Hall

Western Governors University

Communities and Health

This assignment will focus on the issue of Risk Assessment with relation to falls in the home in the elderly population. It will discuss the relationship between the community healthcare team and the individual client, the government policies related to the topic, and the influences of health policy upon the provision of community care. The role of the community nurse in public health education and promotion will also be explored.

 The client, in this particular instance, is Mrs Pugh. She is an 84-year-old female who lives alone since her husband's death 3 years ago. Mrs Pugh has a previous medical history of 'unexplained falls'. Her medical records also highlight the fact she is suffering from osteoporosis and arthritis. Mrs Pugh has recently been discharged home from hospital following surgical repair of a fractured tibia and fibula, the result of another 'unexplained fall' at home. Mrs Pugh has a carer who comes in daily to assist with hygiene, helping Mrs Pugh have a shower each day; she also supports Mrs Pugh with general domestic tasks. It is important to emphasise that the pair of them have developed a very good relationship. Mrs Pugh has always been a fiercely independent lady and doesn't take kindly to any, as she puts it, interference in her personal life. However, the relationship she has with her carer is very important to her.

 Health promotion is based on theories about what influences peoples' health and then what constitutes an effective intervention or strategy to improve health (Naidoo and Wills 1999). These theories are based on research. Research may be defined as 'any systematic information-gathering activity which is used to describe, explain or explore an issue in order to generate new knowledge' suggests Naidoo and Wills (1999). Research for health promotion derives from public health and epidemiology, which is concerned with the pattern of disease in a population. Last (1994) describes epidemiology as 'completing the clinical picture'.

 Research has a much higher profile in Health Authorities and Health Organisations today. Policy and service provision is expected to be based on research and practitioners are encouraged to base their practice on evidence. The Department of Health (DoH) has insisted on reliable research, which evaluates practice and procedures as well as the knowledge gained from individual professional experiences (DoH 1993). Funding for health promotion research may come from Health Authorities or a Health Education Authority. A shift towards consumerism and accountability in the National Health Service (NHS) has increased interest in qualitative research, which gives people a voice (Naidoo and Wills 1999). The principles of the World Health Organisation (WHO) Health For All Strategy (WHO 1985) accept that health is a relative concept and illness must be taken into account when trying to promote health. The WHO defines health promotion as enabling people to increase control over their health and factors influencing their health.

 The educational model of health promotion seeks to provide advice and information to enable informed decisions. Tones and Tilford ...