Principles of Primary Health: Using the Ottawa Charter to Address the Role of Nurses in Promoting Health in the Case of Dementia

This article discusses the principles of primary health and how nurses can use the Ottawa Charter to promote health in the case of dementia. It covers the five action areas of the Ottawa Charter and how they can be applied to dementia care. The article emphasizes the role of nurses in promoting effective public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services.

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Introduction
The Ottawa Charter has been influential in strengthening and guiding the
principles and practices of health promotion. It provides a framework in which to focus
on the health of the whole generations on their lifelong while working towards
strengthening the health potential of the people (Fry & Zask, 2016). The charter helps
nurses understand their role in the healthcare system. It gives them a scope of their
practices in promoting health, practice in public health and the development of the
whole community. The areas of principles and action have been practiced for long in
nursing, development of health policy and the overall research in health. There are
many factors which impact health and illness. In health, that is mental and physical, the
factors are employment, income, education, poverty and the access to the resources in
the community. Disease prevention and health promotion strategies at the society level
are now part of a nursing intervention. The importance of the charter focuses on
building healthy public, creating supportive environments, strengthening community
action, developing personal skills and reorienting health services. Collectively they
promote health. These strategies have been used effectively to address the issue of
dementia in healthcare and the role played by the nurses (Anwar-McHenry & Donovan,
2013), (Erickson, 2017).
Using the Ottawa Charter to address the role of nurses in promoting health in the case
of dementia
Dementia is the loss of memory and mental abilities that interfere with daily life. It
causes problems in thinking, poor memory and reasoning. It happens when the brain
used in learning, memory, language and decision- making is damaged(Norman & Ryrie,
2013) . Dementia by itself is not a disease, but a group of symptoms caused by other
conditions like Alzheimer’s disease.
Health promotion action one: Build healthy public policy
This policy requires all the sectors to acknowledge health promotion as they
come up with policies and each governments’ level to endorse laws that advance health
outcomes. To promote public health policy, barriers to their advancement need to be

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singled out and abolished notably in the non- health sectors(Su, et al, 2013). This is to
ensure people are safe. WHO acknowledges dementia as a public health priority. There
was an endorsement of a global action in response to dementia and public health 2017-
2025. WHO plan provides a detailed plan for action to all policymakers which includes
making dementia more known, creating initiatives that are friendly to dementia, reducing
its risks, its treatment and care and support for the dementia caregivers. The disease is
attributed to old age. Health public policy affects the entire generation directly or
indirectly. Nurses have a major role in informing and speaking on behalf of patients,
families and the community at large in promoting effective public policy(Erickson,
2017).The condition is overwhelming to the family of the affected and those taking care
of them which can result in stress. There had been priorities stated by the people with
dementia for Dementia Action Alliance(2010). Nurses have a role in helping these
positive outcomes(Keleher & Parker, 2013). They also observe and report any signs
attributed to dementia.
Health promotion action two: Create supportive environments
There is a link between people and their environment and their approach to
health. The guiding principle in this is that we should take care of our environment by
conserving the natural resources throughout the world. Health promotion ensures
creating a supportive environment by producing a conducive living and working
circumstances that are safe, satisfying and pleasing (Heimerl, Tatzer & Plunger, 2015).
Changing the environment is impacting health rapidly. Factors such as technology,
industrialization, energy production, and work have to be keenly dealt with for the health
of the public. Natural resources must be conserved. For dementia people, the
environment can be in the hospital, residential care setting, private home, community
health service, public space or backyard. For a person living with dementia, a
supportive environment is the one that gives them happiness and independence. The
home environment helps them know where they are and where they want to go.
Change of environment may add more confusion and disorient them. Nurses make
adjustments that are friendly to dementia patients in their approach and environment.
Whether in hospital or home they help to maintain a maximum quality of life and their

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functioning level. They ensure levels of light are good, a signposted toilet near their
space and use of color to differentiate their bed space.
Health promotion action three: strengthening community action
Effective community actions like making decisions, setting preferences and
implementing the strategies planned promote health. An integral process in this is by
empowering the communities(Erickson, 2017). Communities can determine their needs
and how they can be met. It also helps them have power and control by themselves.
Material and human resources in the community promote community development.
Access to information, learning favorable circumstances for health and funding support
strengthens the participation of the public towards health matters. A dementia-friendly
community is the place in which a person with dementia is supported in living a quality
life in its meaning, purpose, and value (Arnott, 2013). This can be determined by how
we support people from different backgrounds, their abilities, and genders. A friendly
community for dementia will be friendly to everyone. This can include businesses and
local government agencies promoting accessible services to people with dementia, and
having staffs who understand it and know how to communicate effectively with people
with it(Roden, et al, 2015). The community can also volunteer and offer employment
opportunities for people with dementia. They can also create social, cultural and
sporting activities that are inclusive and welcoming to people with dementia. Key action
plans should include building community awareness and capacity, participation in
community and advocating for change towards dementia (Heimerl, Tatzer & Plunger,
2015). The role of nurses in strengthening the community for dementia people is by
being involved in the provision of emotional and psychosocial support to the family
carers of people with dementia (Roden, et al, 2015). They facilitate, collaborate and
advocate for dementia patients and carers.
Health promotion action four: Developing personal skills
Provision of information, health education, and life skills enhancement are
personal and social developments of health promotion. This gives people more control
over their own health and environment and chose that which is conducive to their

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health. Health promotion enables people to learn throughout their life. This has to be
facilitated in school set up, home, work, and community(Heimerl, Tatzer & PLunger,
2015). The action is required to prepare themto cope with chronic illnesses such as
dementia. Caregivers of people with dementia should embrace a person-centered care
and have an understanding that social and psychological aspects of care are important
like physical care. Nurses show empathy for dementia people and attitude that is a
person-centered and compassionate to them (Kitson, et al, 2013). This helps induce a
state of cognitive security to the dementia patient. It also advances their sense of
wellbeing. They also undertake the health assessments of them and deliver health
interventions needed. Nurses give timely education and information which helps
improve their health literacy and skills to care for themselves as dementia patients.
Health promotion action five: Reorienting health services
All sectors must work together in ensuring a health care system which enables
the search for health. Health care must move beyond the responsibility of providing the
clinical and services of curing. Reorienting health care is important in ensuring that
promotion of health is the business of everybody. It is shared among individuals, health
professionals, community groups, governments and health services institutions
(Heimerl, Tatzer & Plunger, 2015). It also requires strong attention to research and
changes to be made in professional education and training(Weston, et al, 2018). In
dementia reorientation, certain factors can be considered. Keeping a consistent
schedule daily can help keep the patient more relaxed and soothing. Keeping memory
cues such as family pictures and friends around the home can be helpful to the
patient(Kitson, et al, 2013). Keeping picture labels which help the person identify where
different items are kept. Home and hospitals should be well- lit using soft natural light to
avoid agitation of the patients from other lights like fluorescent lights. Nurses provide
appropriate and timely referrals to dementia patients and other support cases. Being the
first point of contact in the team for patients, they help in delivering person-centered
care to the patient. They also facilitate access to allied health services and social
services in ensuring dementia people get advanced care(Townsend & Morgan, 2017).

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Conclusion
The five action areas of Ottawa Charter integrate various views in health
promotion. When used collectively they serve useful functions in directing the practice of
nurses who work with different people both young and old, their families and the
community. Practice in nursing includes using robust models of health promotion to
address complex issues such as dementia. Nurses role in clinical practices,
consultation, follow- up treatment, illness, and prevention and patient education have
improved the experiences of healthcare services. Nurses work from either a holistic or a
patient-oriented theoretical basis. These foundations are considered to represent the
main concept of health promotion.

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