A9: Health and wellbeing

• Changes in approach to healthcare

  • Policy changes to focus on the promotion of health and wellbeing and prevention of ill health (for example the NHS long term plan or most current policy)
  • Change in approach from treating illness to promoting wellbeing
  • Improved multi-agency working to support individuals' health and social care needs
• How to support a person's health, comfort and wellbeing

  • Collaborative approaches across the healthcare sector, including with social care services, communities and individuals
  • Encouraging active involvement of individuals to self-manage their health and wellbeing, taking into account lifestyle choices
  • Encourage individuals to make decisions about the care, support and treatment they receive
  • Adopting a person-centred approach to support an individual's physical, intellectual, emotional and social wellbeing
• A9.2 How to recognise the signs and symptoms of a person who is experiencing pain and discomfort and/or whose health and wellbeing is deteriorating: 

  • Physical signs and symptoms: 
  • Physical ticks 
  • Altered baseline observations 
  • Skin condition 
  • Repeatedly touching or guarding part of the body 
  • Moving slowly 
  • Wringing or clenching 
  • Verbal signs: 
  • Self-report 
  • Crying out 
  • Groans/grunts 
  • Nonverbal signs: 
  • Facial expressions (for example grimacing, frowning or looking sad) 
  • Behavioural signs and symptoms: 
  • Altered energy levels 
  • Altered character 
  • Changes in usual eating/sleeping pattern
• How to work in a person-centred way, to ensure adequate nutrition, hydration and care are provided to prevent deterioration in the individual's wellbeing

  1. Ensuring effective nutrition and hydration

  2. Providing food and drink that meets individual needs, this includes taking into consideration any medical conditions as well as beliefs and preferences

  3. Ensuring food and drink provided does not have contraindications with any medicine the individual is taking

  4. Supporting individuals who might experience difficulties in eating or drinking due to physical illness or mental health conditions including individuals who may forget to eat or drink

  5. Providing equipment where appropriate to support individuals in eating and drinking independently (for example 2 handled mugs, cups with lids, non-slip mats, plates and bowls with high sides or insulated bowls)

  6. Ensuring individuals are provided with sufficient time to eat and drink and that they choose the equipment that is offered to support them

  7. Close monitoring of nutrition and fluid intake

  8. Communicating with individuals to identify any barriers (actual or perceived) in relation to eating and drinking

  9. Promotion of the value and importance of effective nutrition and hydration to overall wellbeing

  10. Working in partnership with carers or family members to ensure effective nutrition and hydration of the individual

  11. Working in partnership with other healthcare professionals (for example therapists, dietitians, doctors and dentists to ensure effective nutrition and hydration of the individual)
• Prevention agenda

  As set out by health and social care policy and reforms (for example 'prevention is better than cure' vision, Department of Health and Social Care)
• Preventative approaches

  • Help people to stay healthy and independent for as long as possible
  • Are about stopping problems arising in the first place, focusing on keeping people healthy, not just treating them when they become ill
  • Provide people with knowledge and skills to make lifestyle choices that support them to stay healthy
• Health promotion

  Used to support the prevention agenda to support good health and wellbeing
• Social and environmental interventions to empower individuals to improve their health

  • National campaigns from government departments (for example the National Institute for Health Protection campaigns)
  • Opportunistic delivery of health promotion by all healthcare and social care professionals
  • Campaigns by specific groups and charities
  • Sharing examples of health promotion activities (for example smoking cessation, promoting physical activity, promoting breast feeding and reducing alcohol intake)
• Making Every Contact Count (MECC) initiative

  Opportunistic delivery of health promotion
• MECC initiative

  • Uses the day-to-day interactions that individuals have with healthcare and social care professionals
  • Employs brief and very brief interventions whenever the opportunity arises (for example during routine appointments)
  • Highlights risk factors (for example smoking, poor diet, alcohol consumption, physical activity levels, mental health and wellbeing)
  • Signposts to additional support and resources available
• MECC is an approach to preventative behavioural change
• Nutrition and diet choices affecting body mass index

  • Obesity increases risk of developing range of disease including type 2 diabetes, hypertension and heart disease
  • Malnutrition risk of vitamin deficiency
• Smoking

  • One of the biggest causes of death and illness in the UK
  • Increases the risk of lung cancer, as well as other cancers
  • Increased risk of heart disease
• Low physical activity

  • Risk factor for a range of long-term conditions, including heart disease
  • Greater risk of developing hypertension
  • Has been linked to increased anxiety and depression
  • Older adults who are physically active can reduce their risks of falls
• Consumption of alcohol

  • Long-term effects include organ damage including heart, liver and pancreas
  • Increased risk of hypertension and heart disease
  • Weakens immune system, increasing risk of infections
  • Weakens bones, increases risk of fracturing and breaks
  • Effects on the brain including cognitive function, neurotransmitters and brain tissue
• Substance abuse and addiction

  • Effects on health may occur after one use
  • Longer term effects include risk of heart disease, cancer and hepatitis
• Holistic approach to healthcare

  • Treating the person not just the condition (for example spending time treating the social and emotional effects a condition may have a on an individual)
  • Bespoke treatment plans that meet the personal choices and needs (should be made using the personal aims and objectives established by the person)
  • Understanding the individual's lifestyle (for example individual's commitments, such as family)
  • Understanding the individual's mental health needs (for example any potential services they might need access to)
  • Integrated working (for example coordinated approach to services through different areas of health and social care, working together with input from the individual)
  • Health and wellbeing boards (for example improvement made by local authorities to the integration of services between health and social care for the benefit of the individual)
• Signposting individuals

  To determine the most appropriate service for the individual to meet their needs including considerations given to the most cost-effective approach
• How signposting can support an individual's health and wellbeing

  • Provides awareness on a wider range of services available to support physical, emotional, intellectual and social wellbeing
  • Provides alternative options
  • Opportunities to discuss specific complaints or experiences with specialists or peers
  • Provides support with activities of daily living
  • Provides a safe and secure environment for the individual
• Impact of ageing on physical health

  • Cellular level
  • Body systems
  • Senses
  • Age associated diseases
• Impact of ageing on cognitive health

  • Memory
  • Attention
  • Reasoning
  • Problem solving
  • Information processing
• Impact of ageing on emotional wellbeing

  • Transitions and significant life events (for example retirement, bereavement and ill health)
  • Own mortality
  • Loneliness/ social isolation
• Life stage of human development and potential care requirements

  • Birth and infancy 0 to 2 years (for example immunisation)
  • Early childhood 3 to 8 years (for example paediatric care)
  • Adolescence 9 to 18 years (for example sexual health services)
  • Early adulthood 19 to 45 years (for example maternity and paternity services)
  • Middle adulthood 46 to 65 years (for example healthcare screening)
  • Later adulthood 65 years onwards (for example frailty)
• Methods of supporting people to look after themselves at various stages of life

  • Young people (for example promotion of self-care and self-awareness)
  • Healthy adults (for example promoting self-esteem)
  • Adults who have health or wellbeing concerns (for example promotion of activities of daily living, dispelling stereotypes)
  • Old age 65 + (for example attendance of regular check-ups)
  • End of life (for example creating an end-of-life care plan)
  • All stages of the lifespan (for example supporting people holistically with person-centred values)