Health and Social Care in the UK: Dementia

Public Health and Social Care

This Report will explore different factors that implement health in the UK, the negative factors it can have on health outcomes and these will be supported using evidence from a variety of research. This report will then go onto discuss different health acts and how they have been used within my placement. The report will define dementia and discuss how this was evident in the workplace and how I was involved in improving the care for the service users and finally, this document will compare health care data to the rest of the UK.

Social determinants of health:

There are a variety of socio-economic determinants in relation to health which result in dissimilarities across the UK. This involves education, age, the use of alcohol and tobacco, the density of fast food outlets and safe housing.

Education can play a detrimental part in health inequalities within the UK. Health education builds on individuals’ knowledge, skills and positive attitudes about health. Being educated about health can endorses positive physical health, positive mental health as well as positive emotional and social health. In addition to this, it can promote a way for individuals to adhere to healthy behaviours. According to the UK: There are almost 290 thousand doctors registered to practice in the UK. All these doctors had to endure robust training to become registered which required intense education to provide for the public. Education can develop public health in a positive way and it can also promote health equity as found by Hahn and Truman, 2015. The authors provide empirical evidence that supports the idea that educational programmes crucial for health. Programs that reduce the gaps in outcomes within educational between those who have a lower income or a different racial and or are seen as an ethnic minority within their population are essential in order for health equality to be promoted. Public health departments, policymakers, practitioners within the health sector and teachers, can come together as a cooperation so that educational programmes can benefit all. It is important that policies within education should not only focus on how smart an individual is or their academic attainment, rather it should focus on the individual as a whole in terms of how well educated they are wholly and in different departments, according to Bonell et al., 2014. The authors suggest that individuals who have been privileged enough to receive a good education are seen to also have better health and well-being, this applies to students also. The authors conclude that education and health can coexist throughout educational programmes such as using personal, social and health education (PSHE) being compulsory in their curriculum learning. 

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According to biology, ageing can be seen as the increase of a wide variety of bodily damage which includes cell and molecular damage that occurs over a long period of time. This can ultimately cause a regular reduction in an individual’s physical as well as mental capacity which can result in unfortunate cases such as an individual having an increase in their risk of developing a disease which can lead to death. These changes however are subjective, and they are not linear or consistent. In terms of the subjectivity of ageism, some 70-year-olds, for example, may enjoy portraying positive health behaviours such as maintaining a healthy diet and may not require significant care and help from others. In comparison to some other 70- year olds who may be fragile and weak and would require significant help from others according to ageing and health, 2018. On the other hand, ageing can be seen as other life transitions such as retirement, relocation, the death of friends and partners according to NHS Choices (2018). As a result, ageing is different for all individuals and can be seen as a subjective matter.

Tobacco and Alcohol use is described as substance abuse and can impact health in a negative way. Tobacco and alcohol both affect the heart and can result in cardiovascular disease, however alcohol use is seen as being more complex in terms of how it causes cardiovascular disease according to Stanley (2017), Mount Elizabeth Hospital. Research such as those conducted by M. et al., (2016) have also found similar findings. These researchers found that amplified alcohol consumptions and cigarette smoking are associated with cardiovascular issues in adulthood. In this study, the authors investigated the relationship between smoking and alcohol abuse on arterial stiffness at the age of 17. Cigarette smoking was measured using a questionnaire which was completed the adolescents; participants were either rated as heavy smokers, which involved them smoking more than 100 cigarettes in their lifetime, recreational smokers which were individuals who had smoked less than 5 cigarettes and finally non-smokers. The findings showed that smoking behaviours even at low levels and intensity of alcohol was associated and increased arterial stiffness. In addition to this, the authors also propose that public health services need to implement strategies to prevent these habits in adolescence to preserve or restore arterial health. 

The density of food outlets in the UK can be described as the amount of fast-food restaurant branches that are located within specific locations. Studies into this have investigated the relationship between the number of food chains across the UK and an individual’s health. An example includes a study conducted by Macintyre et al., 2005. The point of this study was to examine if there was a correlation between childhood obesity and the amount of fast food restaurants and how close in proximity they are to the child’s residential postcode. This study an observation that used an individual-level height/weight data and geographic information in the method. The areas that were involved in the study included Leeds in West Yorkshire in the UK. The study found that the children (27.1%) were described as being obese. The authors also found a significant positive correlation as amount of fast food chains and greater health deficiency was revealed.  (Macintyre et al., 2005)

The house in which an individual lives in can influence health inequalities. Many factors can have an impact safe housing and health, including individuals being able to afford good quality homes (NHS Health Scotland, 2016). In Scotland, there are many individuals who live in houses that do not provide comfort for example the houses may be cold. This can result in a negative impact on mental health, for example, this can cause stress, depression and anxiety as individuals are not comfortable. This provides evidence to show that housing has a direct link to health inequalities in Scotland. In most houses, one of the most leading causes of health is the condition of the houses, some of which include mould and damp (James, Haley., 1995). Mould and damp can cause health issues for example chronic respiratory problems such as asthma, this is according to Healthscotland.scot, 2019.

Corresponding Policies for the Social Determinants of Health

The Health Act 1999 was designed to mend the quality of care provided to patients. It intended to improve the coordination of care between local authorities and the NHS (Health.org.uk 1999). The health act 1999 has been implemented within my placement as for my work placement, I work with individuals who suffer from illnesses and disabilities and therefore work closely with the NHS also. The NHS, as well as my workplace, provide high-quality care around the clock, the NHS abolished fundholding and therefore provide the company with extra funds to provide high-quality care for the service users. An example of the care that is provided bed washing and special dietary requirements such as a feeding tube gastrostomy. Furthermore, as discussed above, the health act in 1999 establishes that primary care is consistent with health care that is delivered to patients when they first develop a health care problem. This can be related to my placement as careers there are primary caregivers and we have been trained to provide primary health care as GP’s would, for example, we have been trained on first aid and how to provide emergency care for example for those who are diabetic and epileptic.

The Care standards act 2002 is an act which establishes a National Care Standards Order. This act aimed to make provision for the registration and regulation of children’s homes, independent hospitals and clinics, care homes and nurses’ agencies (En.wikipedia.org, 2020). My workplace also follows the care standard act of 2002. We aim to keep all the care we provide to a high standard for the service users. To do this, the care home provides accommodation with around the clock care providing personal care and nursing for the service users who are ill, have a mental disorder, those who are disabled and those who are substance dependent, this care that we provide is linear to the act. 

The Health and Social Care Act 2002 purpose is to develop the routine of care and to provide better protection for patients through a faster, more effective and fair system for regulating practitioners and to modernise pharmacy and prescribing services (Scie.org.uk, 2020). This can also be applied to my placement as all members of staff have had a disclosure and barring service check done on them to ensure that they are safe to work with the service users. This will provide better protection for service users and patients. Furthermore, all careers have been trained to give medication to service users quickly and effectively as required. This, therefore, follows the health and social care act 2002. 

The food and safety policies according to government policies require that businesses need to ensure that the food arranged is safe to be eaten by ensuring that nothing is added, removed or treated in a manner that makes it harmful to eat. Also, the policy encourages companies to make certain the food that they serve does not misinform clients in terms of the way the food packaging is labelled and advertised They also require food hygiene, for example, keeping food contact materials such as packaging, food processing equipment, cookware and work surfaces clean to avoid cross-contamination. This is relevant to my placement as the careers are required to cook for the service users, therefore food safety and food hygiene must be obtained to avoid health risks to the service users. The careers are required to make sure that all food orders are in secure packaging. All worker has also been informed that they must wash their hands and cook on clean surfaces. As well as this, it is the responsibility of the workers to ensure that all food items are in date. Also, whilst cooking, careers have been made aware of cross-contamination and have been notified of the client’s allergies. The care home I work to follow the health and food safety guidelines.

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The advertisements of Tobacco promotion act of 2002 according Wikipedia is an the act banned adverts promoting the use of Tobacco products in the United Kingdom. In 2003, the In my workplace, smoking is strictly prohibited in the care home as smoking can have a detrimental negative impact on the service user’s health. None of the service users in the care home are smokers and nor are the careers. There are no smoking signs around the care home so any visitors are aware and if any visitors are smoking, they are advised to smoke outside the care home.

Current public health provision  

Dementia is a progressive illness which involves a range of progressive neurological disorders that affect the brain. One of the most common types of Dementia is Alzheimer’s disease. The cause is dementia is due to the damaged nerve cells in the brain so messages cannot be sent from and to the brain effectively resulting in the prevention of the body functioning normally (Dementia UK, 2015). Dementia is a global concern, however, there are over 850,000 individuals in the UK that live with dementia. As a person, age increases, their risk of dementia also increases (Savva., 2009). 

People with dementia may require more support regarding their health and some families may not be able to provide this care and because of this the families my sent an individual with dementia to a care home so that their needs are accommodated for and specialist care is provided. In my placement, there are service users who have dementia, for example, Mrs Allen. Mrs Allen is 78 years old and suffers from dementia. Her symptoms failing memory, disorientation and lack of understanding of risks which has resulted in her becoming a danger to herself. Mrs Allen often neglected herself and she would often leave her own home and get lost, this happened mostly in the middle of the night. One of the things that made her particularly vulnerable was her tendency to talk to strangers, telling them that she lived alone and where her home was and because of this, her family came to the decision to send her to a care home where she will no longer be a risk to herself. 

The care home immediately adopted ways in which to help Mrs Allen with her dementia. An example of how I was able to help Mrs Allen feel comfortable was by keeping appropriate proximity unless there was a risk. Another way I made her feel comfortable was always smiling at her when I saw her and asking her if everything was well and if I could get her anything. I also allowed her to make her own decisions such as picking what she can wear, this was important so that Mrs Allen does not feel completely powerless.

Within 4 weeks Mrs became more comfortable to change. She started to confide in me and trust me, she stated that she was scared that she could no longer control her memory. She had also become funnier and often offered to help staff and other residents as much as she could and was engaging and affectionate towards those staff she trusted. Mrs Allen has been living in the care home for nearly a year now and she continues to live her life to the full despite her dementia. Mrs Allen is no longer a risk to herself as the care home is secure meaning that it is not possible for her to escape and with the help of care working, she is no longer a risk to herself. 

One piece of public health issue that I have decided to discuss is mental health in young adults. I will compare this to my local borough and the rest of the UK. Mental health is the emotional and psychological well-being of an individual. The Brent centre for young people is an organisation that supports young people who are experience mental health issues. This charity offers talking and therapies (Brent.gov.uk, 2019). In Brent 11% of people reported having low levels of happiness which is greater than the 8% of England’s average levels of happiness. In 2011 and in Brent alone, 16,000 young adults were on their GP register for depression, compared to 1 in 4 individuals for the rest of the UK. The levels of self-reported daily anxiety amongst Brent residents are comparable to the England average according to Jsna, 2015.

Age, tobacco and alcohol use, the density of food outlets and safe housing can all have an impact on health in different ways, which are supported with studies. Furthermore, different acts in the UK have been implemented in the care home system to ensure that high-quality care is provided to clients. These acts all work hand in hand in care homes and they are needed to ensure that proper care is provided. Finally, in my placement, there are a lots of dementia patients which I worked with. I found working with these clients rewarding as they always appear happy and confident due to the service, I provide within the care home. 

This report ends by briefly comparing mental health in young people in my local borough to the UK which found significant differences.

References

• Bonell, C. et al. (2014) ‘Why schools should promote students’ health and wellbeing’, BMJ (Online). doi: 10.1136/bmj.g3078.
• Brent.gov.uk. (2019). Brent Council - Brent Centre for Young People. [online] Available at: https://www.brent.gov.uk/services-for-residents/children-and-family-support/the-brent-local-offer/send-local-offer-directory/brent-centre-for-young-people/ [Accessed 5 Jan. 2020].
• Dementia UK. (2015). What is dementia? - Dementia UK. [online] Available at: https://www.dementiauk.org/understanding-dementia/what-is-dementia/.
• Hahn, R. A. and Truman, B. I. (2015) ‘Education improves public health and promotes health equity’, International Journal of Health Services. doi: 10.1177/0020731415585986.
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• Jsna, B. (2015). Good health? Health and well-being in Brent Brent Joint Strategic Needs Assessment (JSNA), 2014 Highlight Summary Report. [online] Available at: https://www.brent.gov.uk/media/16404324/d210-brent-joint-strategic-needs-assessment.pdf.
• M., C. et al. (2016) ‘Increased smoking and drinking exposure is associated with increased arterial stiffness in teenagers’, European Heart Journal.
• Macintyre, S. et al. (2005) ‘Out-of-home food outlets and area deprivation: Case study in Glasgow, UK’, International Journal of Behavioral Nutrition and Physical Activity. doi: 10.1186/1479-5868-2-16.

• NHS Choices (2018). Smoking and alcohol affect teenagers’ artery health - NHS. [online] Available at: https://www.nhs.uk/news/heart-and-lungs/smoking-and-alcohol-affect-teenagers-artery-health/ [Accessed 5 Jan. 2020].
• NHS Health Scotland (2016). Health inequalities: What are they? How do we reduce them? Inequality briefing Housing and health. [online] Available at: http://www.healthscotland.scot/media/1250/housing-and-health_nov2016_english.pdf [Accessed 12 Apr. 2019].
• Savva, G. M. et al. (2009) ‘Age, neuropathology, and dementia’, New England Journal of Medicine. doi: 10.1056/NEJMoa0806142.

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• Scie.org.uk. (2020). The participation of adult service users, including older people, in developing social care - Meaning and importance of participation: Legislation and guidance. [online] Available at: https://www.scie.org.uk/publications/guides/guide17/participation/legislation.asp [Accessed 5 Jan. 2020].

• Stanley, C. (2017). How Smoking and Drinking Affect the Body. [online] Mount Elizabeth Hospital. Available at: https://www.mountelizabeth.com.sg/healthplus/article/how-smoking-and-drinking-affects-the-body.

• Statista. (2018). UK: Number of registered doctors | Statista. [online] Available at: https://www.statista.com/statistics/698278/registered-doctors-united-kingdom-uk-by-age/.

• Wikipedia Contributors (2018). Tobacco Advertising and Promotion Act 2002. [online] Wikipedia. Available at: https://en.wikipedia.org/wiki/Tobacco_Advertising_and_Promotion_Act_2002 [Accessed 15 Oct. 2019].

• World (2018). Ageing and health. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.