Health Care Delivery Methods in Dementia and Impact of Poverty

Running head: NURSING
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Introduction:
Dementia is chronic mental health condition associated with cognitive impairment,
decline in memory, communication and language, reasoning and visual perception. It is
progressively disease whose symptoms initiate slowly and gradually worsens. Elderly people are
mostly affected by the disorder and the burden of dementia is understood from the fact that 50
million people worldwide are affected by the disorder and 10 million new cases are detected
every year (World Health Organization, 2019). In case of Australia, dementia is the second
leading cause of death as it contributes to 5.8% of deaths in males and 11.3% of deaths in
females per year. The population group of elderly and females are disproportionately affected by
the disease as females account for 64.5% of deaths and three in every 10 people above the age
group of 85 years suffer from dementia (Dementia Australia, 2019). According Australian
Institute of Health and Welfare (2016), nearly one in every 10 people above 65 years had
dementia in 2016 and the prevalence rate for the same in permanent residential aged care was
52%. Hence, with the increase in ageing population in Australia, the manner in which elderly
people are rapidly being diagnosed with dementia is an urgent health issue.
Apart from age and gender, the incidence of dementia is also high for ethnic population
group of indigenous Australian as the prevalence rate is about 2- times higher among indigenous
people compared to non-indigenous people (Australian Institute of Health and Welfare, 2018).
However, the prevalence of the disease does not differ based on different geographical locations.
The main purpose of this essay is to analyse the health care delivery methods in dementia and
evaluate impact of poverty on the health issue. The essay will also analyse the principles
underpinning cultural safety and person centred care based on review of documents and
standards.

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Types of health care delivery:
There are different types of health care delivery process and the process and assumptions
for each type differ. Health promotion and disease prevention is one of the types of health care
delivery and it is based on the assumption that reducing the impact of preventable illness and
injury is critical to increase quality of life of people in the community. Disease prevention is
targeted either for the entire population or for high risk groups based on age or risk factors.
Health promotion is an important part of disease prevention activities where education, social
marketing and changes in regulation are targeted to build appropriate physical environment and
support target group to adapt healthy behaviours (Australian Institute of Health and Welfare,
2016). Some example of activities implemented under this type of delivery process includes
immunization and vaccination, delivery of health promotion campaign, tailored health education
and screening programs. Hence, the values and principles that guide current health practice
includes positive health concept, participation and involvement, action, a settings perspective and
equity in health (Grabowski et al., 2017). These values play a role in developing and integrating
cost effective and sustainable models for disease management and preventions.
Types of health care delivery in dementia and their underpinning values:
Two types of health care that is available for treatment of dementia in Australia include
primary health care service such as the National Dementia Helpline and the tertiary health care
services. Primary health care services are the first point of contact with the health system and it is
related to activities like health promotion, treatment of acute health conditions and early
intervention. This type of health care service is based on community health and patient-centred
care principles. It involves participation of various health professionals such nurse, GP, dentist,

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midwives and indigenous health workers. It can be delivered in community health centres and
through communication technology. For example, the National Dementia Helpline is a telephone
based support service that support people with dementia and their family members and provide
referral and relevant advice to people (Better Health Channel, 2018). However, the disadvantage
associated with this service is that it cannot address cultural gaps in care and preserve the values
of person-centred care as telephone based services are not delivered by culturally competent
group and it does not have the scope to fulfil person-centred care expectation.
Another type of health care service available for dementia in Australia includes tertiary
health service focussed on treating and supporting people already suffering from dementia. The
values of this type of service are to provide advanced diagnostic support and specialized medical
service to influence health outcome of the group. For example, the Carers Victoria provides
counselling service and other direct support needed by patients, carers and family members
(Better Health Channel, 2018). The significance of this type of service is that as this service is
provided for long term period, there is a scope for meeting cultural needs of client and taking
patient’s preference regarding service or expectation with the service. Goldberg et al. (2018)
gives the insight that cultural safe healthcare service are critical to prevent risk for people,
counter discrimination and provide appropriate care. Skilled aboriginal workforces are working
to address health needs of diverse people with dementia.
Social determinants of heath: poverty
Social determinants of health play a vital role in influencing health outcome and health
status of an individual. One of the social determinants health include income and employment
which influence the way people live their life and how they are exposed to risk factor of disease.