Public Health Issue: Dementia, Determinants, and Integrated Working

This essay examines dementia as a significant public health concern, particularly within the elderly population in the UK. It delves into the biological, socio-cultural, behavioral, and policy-related health determinants influencing dementia prevalence and progression. The essay identifies and analyzes various health inequalities, including those related to age, culture, ethnicity, education, income, pre-existing conditions, and gender, and their impact on health outcomes. Furthermore, it explores the influence of national and regional health policies and infrastructure on addressing the public health challenges associated with dementia. The essay also discusses the impact of health determinants on the physical, mental, and social well-being of older adults, emphasizing the need for integrated working among healthcare professionals, including nurses, and other stakeholders to provide holistic care and address health inequalities. The role of nurses in managing public health issues, communication techniques, and the significance of health promotion in improving public health outcomes are also evaluated, along with the importance of integrated approaches to address the complex needs of individuals with dementia.

INTRODUCTION
Public health issues affect the wellbeing of large portion of the population thus it is vital that
they must be managed effectively. Dementia is known as the cognitive which influences
reasoning, behavioural and remembering abilities of individuals. This health issue not only affect
thinking and memory but also has brings severe crucial changes in social life. The diseases are
very common in elderly population. According to Dementia UK report, (2021) by 2021 there
will be nearly 2 million dementia cases in UK. By 2014 statistics dementia prevalence over age
of 65 years is 7.1% of total population. Elderly suffering from dementia suffer from extreme
changes in emotional, social and personality aspect which makes their living very difficult and
painful as well as risky.
Thus it becomes very essential that nurses and other health practitioners must work together
to deliver quality care to elderly population suffering from disease. The health promotional
measures taken by the nurses can also help to prevent the elderly who are at higher risk of
developing dementia. This report discusses various health inequalities and determinants which
regulates dementia prevalence and prevention. It will also evaluate the role of integrated working
and health promotional techniques to manage the public health issue.
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Health determinants of dementia
The factors which influences the health of community or an individual are known as health
determinant. For effective management of disease, it is required that these determinants must be
identified so that appropriate care can be delivered. The key health determinants which can affect
dementia in elderly population are as follows:
Biological: The people above 60 years are highly vulnerable to prevalence of dementia. The
genetic and age factor play significant role in it. However, in UK the onset of dementia before
age of 60 years is also rapidly increasing. Thus individuals may have different vulnerability
depending on their genetics.
Socio-cultural factors: The care and support received by elderly as well as their cultural
practices can slow or boost the dementia progression.
Behavioural: Due to declining physical strengths and age impacts behaviour of old people
changes considerably (Thyrian and et.al., 2017). Thus they used to take dementia management as
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unnecessary or may not provide their support. Hence their behavioural aspect can worsen the
disease progression.
Health services and related policies: The quality of care provided to old people is also regulated
by available and accessible dementia services and related policies. Thus implementation of
health care policies can also be one of the key determinant for dementia prevalence and
progression among old people.
Health inequalities and their impact on health issue
Health inequalities are known as the avoidable or unjust differences in health conditions
across the population groups. These inequalities lower the quality and right of quality care which
must be given to an individual. The key health inequalities are as follows:
Age: As compare to young people, old generation has higher risk of dementia. The limited
mobility due to age also make the disease management more complicated.
Culture and ethnicity: Dementia can be managed with certain life style changes. However
certain ethnic and cultural groups have higher prevalence of dementia due to genetic factors.
Further they cultural practices and beliefs can prohibit the prevention and control practices or the
access to health care services.
Education and income: The lack of education or awareness can encourage the dementia
progression considerably (Evripidou and et.al., 2019). The poor economic conditions especially
during old age can lead to ineffective treatment and support services increasing the health gaps
among elderly groups
Pre-existing conditions and disabilities: Old people also have higher vulnerabilities of chronic
diseases and disabilities. Thus prevalence of dementia along with other health conditions can
worsen the wellbeing and health outcomes of individual.
Religious and gender perspective: In some religions individuals may consider dementia as
acceptable element of aging. The bias perspective towards a particular gender can also cause
challenges in care delivery.
Impact of regional and national influences on well being
The national health policies and care infrastructure available at local and regional level is
crucial in addressing the public health challenges. The national policies and health care
promotional initiatives guides individuals about their rights and available services. The old
people who are financially dependent on public funds or who does not have emotional support
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from family members may seek care services and support available at regional level (Jennings
and et.al., 2019). If dementia care services and policies are not accessible at regional level, then
it can have adverse impact on national policies for dementia prevention and care. The national
policies and regulations such as equality act also ensure that old people are given fair treatment
without any discrimination on the basis of their age or dementia condition. The regional policies
also ensure that along with the medication and care old people are also supported with the
emotional needs so that they can cope up their late life with ease and convenience.
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Impact of health determinants on various health dimensions
Various health determinant can impose different impact on social, physical and mental
wellbeing of old people. The genetic factors put the older people in greater risk of dementia.
With age and genetic factors, the physical suffering and dependency of older patients is much
more than that of younger dementia patients. In old age most of the people have financial crisis
or dependency. The isolation from spouse, family members and social gatherings are also seen
largely in elderly phase. The feeling of loneliness and lack of emotional support is much greater
among elder than any other population group. It worsens the mental well health of old people. In
addition to this social exclusion is also quite common with old people (Gilster, Boltz and
Dalessandro, 2018). The behavioural changes and loss of memory also affect the social
communication and interaction of elderly with the others. They even found trust and
communication issues with the service providers due to their cultural, gender, behavioural or
cognitive changes. This result in poor physical health and challenging service delivery for health
care professionals. The health determinants also make it different for individuals to have access
to health care system. This in turn obviously brings significant differences in physical and mental
health care needs.
Significance of integrated working within health care
It is imperative for nurses and other health professionals to work in integration with the old
dementia patients as well as with other healthcare stakeholders such as policy makers,
community and social care agencies. Elderly people with dementia symptoms required physical
as well as emotional support. Thus their needs cannot be addressed only by physicians or the
nurses. For improving their quality of life it is needed that nurses also understand their emotional
and psychological wellbeing factors. If there will be no coordination between nurses and policy
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makers, then it can be impossible for the service providers to overcome the social inequalities.
The dementia patients also need support from surrounding environment so that risks can be
minimised (Stephan and et.al., 2018). For this purpose, the community must also be engaged in
dementia control programs. The lack of integration among various practitioners and community
may lead to poor communication and dementia awareness. Thus for providing holistic care to the
old people as well as to create awareness among dementia patients it is necessary that all must
work together to identify and address the health inequalities.
Role of nurses in managing public health issues
Communication techniques used within healthcare practices
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Need and impact of health promotions on improving public health outcomes
CONCLUSION
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REFERENCES
Books and Journals
Stephan, A. and et.al., 2018. Barriers and facilitators to the access to and use of formal dementia
care: findings of a focus group study with people with dementia, informal carers and
health and social care professionals in eight European countries. BMC geriatrics, 18(1),
pp.1-16.
Gilster, S.D., Boltz, M. and Dalessandro, J.L., 2018. Long-term care workforce issues: Practice
principles for quality dementia care. The Gerontologist, 58(suppl_1), pp.S103-S113.
Jennings, L.A. and et.al., 2019. Health care utilization and cost outcomes of a comprehensive
dementia care program for Medicare beneficiaries. JAMA internal medicine, 179(2),
pp.161-166.
Evripidou, M. and et.al., 2019. Nurses’ knowledge and attitudes about dementia care: Systematic
literature review. Perspectives in psychiatric care, 55(1), pp.48-60.
Thyrian, J.R. and et.al., 2017. Effectiveness and safety of dementia care management in primary
care: a randomized clinical trial. JAMA psychiatry, 74(10), pp.996-1004.
Online
Dementia UK report, 2021. [Online]. Accessed through <https://www.alzheimers.org.uk/about-
us/policy-and-influencing/dementia-uk-report#:~:text=There%20are%20over
%2040%2C000%20people,65%20years)%20in%20the%20UK.&text=This%20equals
%20one%20in%20every,aged%2065%20years%20and%20over.>
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