Guest Blog by 4th year Occupational Therapy students at Robert Gordon University
We are writing to you to express an interest in being involved in the National Conversations. We wish to share our views and knowledge on preventative care in the ageing population. We will discuss the importance of community engagement in older people through an occupational perspective of health. Our interest in this topic is supported by current drivers such as the ageing population which has influenced policies such as Reshaping Care for Older People, Scotland’s National Dementia Strategy and 20:20 Vision.
The Royal Geographical Society states that there will be a rise in the ageing population for over 65s in the UK by 61% by the year 2032. There is a current strain on health and social care services which will continue to grow if change is not implemented. Occupational therapists take an occupational approach in order to enable participation in meaningful occupations which are essential to both physical and mental wellbeing in order for humans to flourish and thrive (Duncan 2011).
What support do we need in Scotland to live healthier lives?
As Occupational Therapy students, there are a number of aspects we have identified as areas for potential support for older people in Scotland to live healthier lives.
The support we believe is needed is more Occupational Therapists working in the community to promote older adults in engaging in meaningful occupations such as knitting and sewing, domestic occupations such as cooking and outdoors activities such as gardening. There are currently drivers which highlight the need for more community resources that enable and promote independence such as the 20:20 Vision strategy (The Scottish Government 2011). Resources we feel would be beneficial for elderly members of the community include falls prevention groups, memory groups, nutritional advice groups and social groups (Stav et al 2012). From an Occupational Therapy perspective, such groups would allow these individuals to engage with each other and participate in both meaningful and practical activities, promoting and improving a range of abilities that they have, with the aim to increase the independence and safety of older people thus enabling them to engage in community life to their full potential.
What areas of health and social care matter most to you?
As imminent practitioners, we recognise the value of preventative care as a means of enabling people to live independently in their communities for longer. “The Scottish Government established the change fund to enable health and social care partners to make better use of their combined resources of implementing local plans for older people. It provides bridging finance to facilitate shifts in the balance of care from institutional environments to primary and community settings and enables our refocus on anticipatory care and prevention of unplanned admissions to hospital or long term care” (2012 p.4). This initiative supports our view that current and future healthcare professionals need to focus on delivering their service in community rather than acute settings. This could be achieved by peripatetic working and by using occupation as a tool for creating and maintaining health (Wilcock 1993).
Thinking about the future of health and social care services, where should our focus be?
We as student occupational therapists understand that engagement in occupation is not only necessary at an individual level but also at a community or population level (Townsend 2013).
We believe that taking a preventative approach and encouraging people to participate in their community, as well as increasing signposting to available community resources, will help improve the overall health of the older population and help prevent hospital admissions. The Scottish Parliament have devised a document, named the Community Empowerment Bill which reflects the policy principles of subsidiarity, community empowerment and improving outcomes for those living in their communities. The Bill aims to empower communities for take ownership for what is around them and strengthen their voices to speak up about what matters most to them. The Bill also aims to support those to live in their communities for longer, and to improve the outcomes of these individuals to live safe and healthier lives at home (Scottish Government 2014).
As laid out in Reshaping Care for Older People (2011), there is a strain on current services for the elderly. We believe that by utilising community resources and viewing older people as active and valuable members of the community, this can be overcome. This can be achieved through developing more community groups and utilising community members to facilitate these groups, with the overall aim of improving physical and mental well-being. For example Aberdeen Football Clubs Community Trust (AFFCT) run a variety of groups for older people and some member are also involved in running groups. Aberdeen football club (2015) explained these groups are designed to encourage older members of the community to become physically fitter and avoid social isolation within the community. Evidence shows that community participation contributes greatly to people’s health, physically, mentally and socially. A study by Kearns et al (2015) found that those that had less contact within the community had poor mental health and experienced higher rates of stress, anxiety and depression. NHS choices (2015) describes how participation in physical activity, which could include community groups help reduce decline in function and improve well-being of older individuals. By emphasising the relationship between occupational engagement and health with the incorporation of community resources, older people will be more confident in living healthy independent lives.
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KEARNS, A. et al., 2015. Loneliness, social relations and health and well-being in deprived communities. Psychology and Public Health Medicine, 20(3), pp. 332-344.
STAV, W. et al. 2012. Systematic Review of Occupational Engagement and Health Outcomes Among Community-Dwelling Older Adults. American Journal of Occupational Therapy, 66(1), pp. 301-310.
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THE SCOTTISH GOVERNMENT, 2014. Community Empowerment (Scotland) Bill. [online]. Edinburgh: The Scottish Government. Available from: http://www.scottish.parliament.uk/parliamentarybusiness/Bills/77926.aspx [Accessed 17 November 2015].
TOWNSEND, E. and MARVAL, R., 2013. Can professionals actually enable occupational justice? Cadernos de Terapia Ocupacional, 21(2) pp. 215-228.
WILCOCK, A., 1993. A theory of the human need for occupation. Journal of Occupational Science. 1(1). pp.17-24.