| Page Student ID: 3021749
Coventry University
Faculty of Health and Life Sciences
Adult Nursing January 2010
Inequalities in Health and Social Care 101SWW
Discuss the way in which age impacts on people’s health and well-being in Britain today.
What challenges does this pose for professional practice and how might you respond to this?
Set word count: 2,000
Actual word count: 2,198
Submission date: 26th January 20
In society today people face many challenges in relation to health. This assignment will discuss the way in which age itself impacts on a person’s health and well-being. Ageism has been defined as ‘discrimination against someone on the ground of age’ (Watson, 2001).This assignment will look at different age categories focussing on children, young people and the elderly. The author will look at each age category giving examples of the types of inequalities that exist and will explore how these can be reduced. Further areas that will be explored are the challenges that are faced by nurses and other health care professionals (HCP’s) in Britain in meeting the needs of children, young persons and the elderly.
Child and young person’s health:
A child’s health and well-being can be affected by many different issues. It is important to make sure that every child has a balanced diet to enable growth and development. An inadequate diet can result in restricted growth and development; short-term health can be affected as well as long term. Short term conditions such as dental problems, anaemia and obesity can occur and conditions such as coronary heart disease, strokes, osteoporosis and diabetes in the long term. (Dowler et al, 2001). Meggit, C et al (2008) explains that all children are entitled to basic rights, these include food, healthcare, a safe home and protection: However children need to rely on an adult for their needs to be met and this can vary considerably according to their family’s circumstances.
Poverty can have a dramatic affect on a family’s health and well-being. A report from the Joseph Rowntree Foundation explains that the number of children living in poverty has risen to 3.9 million and a staggering 58% of those children are from working families. In 1999 the government’s commitment was to halve child poverty by 2010 and eliminate it by 2020. However the amount of children in poverty only decreased by 100,000 in 2008/2009. With the economy plummeting further into the recession it is worrying that the children and their families will be hit even harder. Barnardo’s (2010). A child in poverty can suffer with low self esteem. They can lack performance at school and be more inclined to be involved with criminal activities. Poverty in children takes away the tool to build blocks for the future and results in poor health and life choices. Oppenheim, C (1990).
When working with children and young people it is important to allow them their rights. Nurses and other HCP’s involved in their care must not discriminate them in any way treat the child or young person as an individual, Nursing Midwifery Council (2008). When making decisions about their health, young people do need an adult to a degree but HCP’s must ensure that they do not oppress the young person themselves or allow a parent or carer to do the same by making decisions for them. Children and young people must be encouraged to make choices for themselves and contribute to their care plan. All HCP’s must act as the patient’s advocate ensuring that they have the patient’s best interest at all times, this enabling them to access the best possible care. Health professionals must be able to communicate to young people in a way that is understood without being demeaning. By using Egan’s SOLER model: having open body posture and good eye contact, this will communicate to the young person that the healthcare professional is approachable and interested. Paraphrasing can show that the HCP has listened and understood and this is turn can build a good relationship between both. Egan, G (1994). This technique is appropriate for all patients; HCP’s must be able to adapt communication skills to enable patients to receive good quality health care.
Young people in society today have many obstacles to overcome in their lives. Society can be seen to be portraying young people in a negative way, for instance highlighting excessive knife crime, binge drinking and anti-social behaviour.
The elderly and health:
The UK has nearly ten million people over the age of 60, and more than 1.3 million of these people are over the age of 85. (Office for National Statistics, 2009).The rapid growth in the older population is a reflection of the advances in medical care and decreased birth and infant mortality. It has been noted that men who have reached 60 by the end of the twentieth century could live another 15.6 years and woman a further 20 years. With the rapidly growing population becomes increased healthcare needs, and it has been noted that older people now form two-thirds of all patients in acute settings. Taylor, S (2007). Many older people will be living with either one or more chronic condition. As an Adult Nurse it is important to not only understand the condition but to be able to promote and encourage healthy ageing and reduce the effects of the disease. Davies, N (2001). The NSF was published to set out the standards of care that would make better, fairer and more integrated care for the elderly. Standard eight is concerned about “the promotion of health and active life in older age”.
The overall aim is to set out standards of care for health and social service professionals who care for older people. The standards promote independence and health promotion so that older people can be treated with dignity, respect and fairness and ensures that older people are not discriminated against. Alexander, M et al (2006). Living well in later life (The Audit Commission, 2006) however argue that there is still evidence of ageism across all services.
Nutritional health is important to people of all ages. In children the responsibility for this lies with the parent or guardian. When a person becomes older maintaining a well balanced diet can be difficult, this can be due to physiological, psychological and social changes. The older person can be at risk of malnutrition due to many difficulties such as not being able to chew their food properly; this could be due to loss of teeth or through ill fitted dentures. Davies, N (2001). As a person ages they could have a loss of taste or smell which could hinder their enjoyment of food. Gabriballa, S (2004). Other reasons such as the reduced elasticity of the stomach or constipation could affect the absorption of essential nutrients.
As a Nurse it is important to use the Malnutrition and Universal Screening Tool when a patient is either malnourished, at risk of being malnourished, or obese: this enables the team involved in the Patient’s care to use guidelines to be able to develop a care plan. It is also essential to work together with other HCP’s. These include a dietician if the patient is at risk. Patients with swallowing or aspiration problems would need referring to the speech and language team. An occupational therapist and social worker could assist with practical difficulties and put together a care package. A Doctor would be able to control other symptoms that may be effecting eating. Alexander, M et al (2006).
Disabilities such as a visual or hearing difficulty could potentially create problems for the older person. The older person does generally not like to be a nuisance so Nurses and HCP’s must be able to observe their patients to establish whether any assistance is needed and attend to their patient’s needs. As people age, their mobility can decrease for a number of reasons. These can include arthritis of the joints, a fall, infection or a chronic illness. If the patient is unable to mobilise properly this could have a dramatic affect on their health and well-being. Firstly they may not be able to complete daily living tasks such as cooking meals, washing and dressing or shopping. The patient may be confined to the house due to the lack of mobility and may not have any family or friends to assist them, this causing social isolation. It has been noted that isolation and loneliness may lead to symptoms of depression, and this happens in one-in-four older persons.
Financial difficulties for the older person could create problems with their health and well-being. The majority of over 65 year olds have retired from work and a large percentage of these are living alone. With the increased cost of day to day living today, older people have a greater chance of living on a low income or living in poverty, especially woman as there are three times as many women receiving income support. It has also been noted that approximately one million state retirement pensioners do not claim the means-tested benefits to which they are entitled to, losing on average £16 per week. A number of factors could be the cause of this such as lack of knowledge, stigmatisation for claiming a benefit or a physical difficulty. Acheson (1998).
At present the age for woman to qualify for state pension is 60 and for men is 65 years, however the government are set to rise the age for woman to 65 years by 2018 and by 2020 both men and woman will be increased to 66 years. There are currently 3.5 million older people living in fuel poverty and the UK has one of the highest excess winter deaths, this resulting in 29,000 deaths between 2009 and 2010. (Age UK accessed 21/01/2010). Alongside the pension age increase is the increase in age for free prescriptions which will gradually rise from 60 to 65 years between 2010 and 2020, this could potentially put more financial strain on the older person who is already finding it difficult to manage.
In 1998 the government set up sure start children’s centres to help children aged from 0-5years and their families in deprived areas to enhance their life chances. The centres offer advice on maternal and child health. They promote immunisations and encourage and monitor development skills. The centres give the parents access and use of health services and give advice on training and job opportunities. These centres were not only aimed at enhancing health and well-being but there to increase the children’s ability to be prepared for school, and to be socially successful in their communities and in their future. (Direct Gov). Also the healthy start programme was developed to support woman and young children with nutritional support in the form of weekly vouchers to spend on milk, fruit, vegetables and vitamins. There are currently 600,000 woman and children in over 450,000 very low income and disadvantaged families across the UK that benefit.
The NHS breast screening programme was introduced to detect early cancer in women aged between 47 and 63 years old. Research was published which demonstrated that the programme had lowered mortality rates from breast cancer in age group 55-69, and from the early detection it had prevented 75% of cancers. The cervical screening programme was also set up to reduce the number of cervical cancers. The programme is designed to screen women between the ages of 25 and 65 years. Both programmes could be seen as discriminating certain age groups. http://www.cancerscreening.nhs.uk
The Acheson report was an inquiry that was produced to explore health inequalities in the most vulnerable groups. The report looked at the older person’s inequalities, the areas that were considered were: promoting the material well-being of older people; improving the quality of their homes; promoting the maintenance of mobility, independence and social contacts; and improving health and social services. Since then the government have implemented methods such as the winter fuel payment, cold weather payment, the heating rebate scheme and warm front scheme to help reduce inequalities. Such schemes help the older person and others on a low income to be able to heat their home and maintain it, this preventing poor health.
HCP’s should not generalise patients according to their age or their illness as everyone is unique. HCP’s should not be influenced by media portrayal of young persons and should focus on the patient and not the age. The NMC (2008) agree and state that every person regardless of age, race, gender, class/poverty, sexual orientation or disability should be treated as an individual with dignity and respect and not discriminated against in any way. It is also essential that HCP’s take into account their own values, beliefs and attitudes when caring for patients and do not hold the negative attitudes against certain age groups that exist.
It is worrying for any age group in Britain today with all the government cuts and the way in which the economy is plummeting into the recession. There are also many other inequalities that prevent people from living a healthy life. There is however help and support available for all patients and their families to be able to maintain a healthy life. All members of the multidisciplinary team must work in partnership by communicating with each other and providing combined health assessments for the patient, this will be able to provide the patient with the best possible care. Health education, screening and immunisation programmes must be promoted using evidence based practice and all members of the multi-disciplinary team must work to policies, guidelines and government targets to be able to reduce the inequalities that still exist.
References:
Acheson (1998) Independent Inquiry into Inequalities in Health Report [online] available from (accessed on 22/01/2011)
Age UK (2011) State pension [online] available from (accessed on 12/01/2011)
Alexander M., Fawcett, N,. and Runciman, P (2006) Nursing Practice, Hospital and Home. 3rd Edn. London: Elsevier
Barnado’s (2010) Barnado’s priorities [online] available from
(Accessed 12/01/2011)
Davies, N (2001) Promote healthy ageing: the importance of life style. Nursing standard.25, 19, 43-49. November 2 2010
Dowler E., Turner, S., and Dobson B (2001) Poverty bites: Food, Health and poor families. London: CPAG
Egan, G. (1994) The Skilled Helper. 5th Edn. Brookes/Cole Publishing: California.USA
Gariballa, S (2004) Nutrition and older people: special considerations relating to nutrition and ageing. Clinical medicine. 4,5, 411-414.
Meggitt, C (2008) Baby and child health. 5th Edn. Heinmann Educational Publishers: Oxford.
NHS (2011) NHS cancer screening programmes [online] available from ( accessed 26/01/2011)
Nursing Midwifery Council (2008) Standards of conduct, performance and ethics for nurses and midwives: London.
Taylor,S., Field, D (2007) Sociology of Health and Health care. 2nd Edn. Blackwell publishing: Oxford.
Watson, R (2001) ‘Old age: mind, body and spirit—the biological stages of ageing’. Journal of community nursing, 15 (4), pp 24-28.