Nursing Essay: Social Determinants, Policies and Frameworks

This essay delves into the impact of social determinants of health, particularly in the context of aging, using the case of Elizabeth Jackson, an 86-year-old widow with early-stage dementia. It explores how factors such as economic stability, education, social context, healthcare access, and the built environment influence health outcomes. The essay analyzes relevant Australian national and legal frameworks, including the Age Discrimination Act 2004, the Aged Care Act 1997, the Aged Care (Accommodation Payment Security) Act 2006, and the Home and Community Care Act 1985, assessing their alignment with international trends and human rights instruments. The analysis demonstrates the capacity to evaluate policies and frameworks, emphasizing the importance of person-centered care and active aging in supporting the elderly. The essay highlights the role of these frameworks in addressing the needs of the aging population and promoting their well-being, while also considering the challenges posed by chronic conditions like dementia.

Nursing

Table of Contents
INTRODUCTION...........................................................................................................................1
Impact of Social Determinants of Health....................................................................................1
National and legal frameworks on ageing and their relationship to international trends............4
Demonstrating developing capacity to analyse policies and policy frameworks........................7
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Social determinants of health and ageing impact on the human being day to day activities
greatly. As age increases the physical abilities and mental capabilities of human beings gradually
decreases (Buchan and et.al., 2015). In accordance with this context, the essay will describe the
impact of social determinants of health on human beings by analysing the case study of Elizabeth
Jackson. The national legal and policy framework on ageing which are relevant to the case will
be analysed in this essay in order to identify their relationships with the international trends. This
will help in prevention of chronic disease i.e. dementia from which Elizabeth Jackson has been
suffering from. The analysis of Person Centred Care and Active Ageing will be made in this
essay in order to identify their roles and responsibility in order to care for aged persons.
Impact of Social Determinants of Health
The circumstances in which an individual raise, live, work and age is refers to the social
determination of health. These circumstances are shaped by stability in economic conditions,
society and community influences, educational and employment satisfaction and health and
health care (Chenoweth and et.al., 2014). Health inequities in an individual is effected by the
social determinants of health. For example, availability of the resources in order to meet daily
needs such as food and shelter, quality of education and employment, etc. In order to live
peacefully and in harmony human beings keep on engage and adapts in the society by forming
the relationship and bonding with one another (Buchan, Duffield and Jordan, 2015). In the case
of Elizabeth Jackson, she was 86 years old and was a widow. She lives alone as her children and
grandchildren resides in different area. In this context, the social determinants of health which
are relevant to the given scenario is presented below:
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 Economic Stability: Economic stability is one of the essential social determinant that
impacts on the health and psychology of the human being (Scanlon and et.al., 2016).
According to the case of Elizabeth Jackson economic conditions was good and efficient.
She got retired from her teaching profession at the age of 65. Further, she has shelter,
food and financial strong. In order to reduce the psychological strain, an individual must
be economic stable. It is an important social determinant of health and impact greatly on
healthy life of an individual. The economic stability assist in minimising the issues of
psychological strain and an individual can live his or her life more precisely and
appropriately. Lack of economic stability results in increasing the mental problems and a
when an individual becomes old, these issues impacts negatively on the day to day
activity conducted by him or her (Dawson and et.al., 2014). From the case, it was
identified that due to dementia, Elizabeth was not able to play golf efficiently. Education: Education is very important and vital social determinant of the health. In
order to sustain in life, an individual must be educated and literate (Perry, Gallagher and
Duffield, 2015). Education plays essential role in reducing the psychological strain and
mental problems in human being and also help him or her to interact with within the
society efficiently. As per the given case of Elizabeth Jackson, it was identified that she
was a retired teacher. This implies that she has efficient education and knowledge. The
education social determinants of health impact greatly on the life of human being. In
order to interact and socialise in the society, it is important to be educated. This further,
helps in eliminating the social and psychological problems (Roche and et.al., 2015). If an
individual is educated, he or she can get a job or embarked his or her own business
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efficiently and thus can become economic stable. Thus, it impacts on the health of human
being adequately and it is essential for an individual to be educated. Social and community context: Human beings are social creatures and in order to live in
society, they interact with each other and depends on one another so that tough times can
be endured and happy times can be enjoyed (Reed, Fitzgerald and Bish, 2015). From the
analysis of the case of Elizabeth Jackson, it was identified the social context of Elizabeth
was strong as she has many friends and have good reputation in the society. She also
loves to travel a lot with her husbands. After his death and increasing age of Elizabeth,
her social life begins to diminish and early signs of dementia has been observed in her. It
implies that social and community context determinants of health is very important for
human being (Timilsina Bhandari, Xiao and Belan, 2015). The civic participation and
interaction in society is very important for an individual. Health and Health care: An individual must take care of his or her health in order to
eliminate the issues and problems. Health and health care are important social
determinants of health (Baldwin and Chenoweth, 2015). After examining the case of
Elizabeth Jackson, it was identified that she lives alone with nobody to take care of her
health. As per the recent diagnosis, she has been suffering from early stage of dementia.
The ageing process impacts her health and it results in her memory loss and other issues.
Thus, it implies that health and healthcare plays vital role in the social determinant of
health. In order to live a healthy life, an individual must have adequate knowledge about
the health and must be accessible to the health care centres. In this context, health and
health care is one of the social determinant of health that impacts on the human being
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greatly (Cashin and et.al., 2014). An individual must take care of his or health in order to
live a healthy life.
 Neighbourhood and build environment: The surrounding environment and
neighbourhood must be good and appropriate (Duffield and et.al., 2015). The negative
environment impacts negatively on the health of human being and the positive
environment boost up the health of an individual. From the analysis of the case of
Elizabeth Jackson, it was identified that she lives in healthy surrounding and environment
with negligible crime and violence. This impacts on her health greatly. She was
physically fit at the age of 86 and shows some psychological disorder like dementia. Her
economic conditions was stable and she has friends in nearby society for interaction.
Thus, it implies that in order to live a healthy life, the neighbourhood and the society
must be appropriate and efficient (Henderson and et.al., 2014).
National and legal frameworks on ageing and their relationship to international trends
There are several polices and legislation formulated by the government of Australia in
order to provide care for aged and older Australians (Faggian, Corcoran and Rowe, 2016). These
policies and reforms are formulated in order to treat the aged people of the country efficiently
and provide them moral support so that they can live a healthy life. In accordance with the case
of Elizabeth Jackson, the polices and legal framework developed by Department of Health are
listed below: Age Discrimination Act 2004: The aim of the legislation is to act as a catalyst for
attitudinal change and to provide individuals with an avenue to make complaints of
discrimination (Cashin, 2014). The primary purposes of the Act are to raise awareness
that people of all ages have the same fundamental rights to equality before the law
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regardless of age and to eliminate unlawful age discrimination within our community.
The Act also contains the specific objective of responding to ‘demographic change by
removing barriers to older people participating in society and changing negative
stereotypes about older people. After analysing the case of Elizabeth Jackson, it was
identified that the healthcare organisation was not violating the act and considering the
issue of Elizabeth appropriately (Chenoweth and et.al., 2014). It is the duty and
responsibility of the healthcare professionals to ensure that they work with the legal
framework in order to eliminate any legal consequences. Thus, in this way, the health
check up of aged person can be done in effective and efficient manner. The Aged Care Act 1997: The Aged Care Act was proposed by the government of
Australia in 1997 and the act mandates that everyone who requires aged care has access
to it (Buchan and et.al., 2015). It is the duty and responsibility of the health care
organisation to provide quality and efficient care to the aged and older population of the
country. As per the act, the care can be given residential care as in aged care home or can
be provided at his or her resident as home care. The act also makes sure that aged care is
affordable and can be accessible to the older population of the country appropriately. As
per the case of Elizabeth Jackson, it can be said that she was physically fit suffers from
mental issues and have early stages of dementia. As per the legal framework, she has
right to take treatment in any healthcare institutes and organisations. Further, the law
protects her right to have efficient and affordable treatment. In this context, the aged care
act of Australia Aged Care (Accommodation Payment Security) Act 2006: According to this act, if
community or healthcare organisation becomes bankrupt or become insolvent, the
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amount which is given by the patient will be refundable with interest. This act aid in
assisting the older people to safeguard their money in case of any future uncertainty with
the healthcare institutes (Buchan, Duffield and Jordan, 2015). If Elizabeth Jackson visits
any healthcare organisation and that healthcare organisation becomes bankrupt or
insolvent, she has right to take back all the money which she has given to the healthcare
institution. The Home and Community Care Act 1985: The act was proposed by the parliament of
Australia in order to provide effective and efficient facility to treat the aged person at his
own home or any community care centre (Scanlon and et.al., 2016). The provision assists
the aged people by reducing their burden of visiting the healthcare organisations for
frequent check-ups. It is the role and duty of healthcare professionals working at
community care centre to address the issues and problems of aged people residing in
Australia. Elizabeth Jackson can receive the health check up at her home as per this act.
She does not have to leave her home in order to get treatment.
Relation with international trends
The government of Australia proposed wide range of international human rights
instruments which have vital legislation and provisions which are related with health services for
older people (Dawson and et.al., 2014). These include, the Constitution of the World Health
Organisation, the International Convention on the Elimination of All Forms of Racial
Discrimination, the International Covenant on Economic, Social and Cultural Rights, the
International Covenant on Civil and Political Rights, the Convention on the Elimination of All
Forms of Discrimination against Women, and the Convention on the Rights of Persons with
Disabilities. These provisions provide a framework for legislation and policy at the national level
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regarding prevention of aged people human rights value. There are various human rights laws
proposed by United Nations which are interrelated with the human rights laws and legislation of
Australia.
Demonstrating developing capacity to analyse policies and policy frameworks
According to the case study, Elizabeth Jackson is 86 year old women living in Australia.
She lives alone and in the recent diagnosis and medical reports, it was found that she has shown
the early stages of dementia (Perry, Gallagher and Duffield, 2015). Dementia is the chronic
disease in which person memory power becomes weak and he or she tends to forget things
easily. As per the laws and policies made for aged people of Australia, there are various reforms
that helps the elderly people to have effective and efficient treatment without making much
efforts. With the help of these policies and reforms prevention and management of chronic and
complex diseases like dementia can be possible. The range of policies and reforms are described
below: Consumer directed care or Person Centred Care: The Australian government in July
2010 created the reform that aid in providing the effective quality of the treatment to the
aged person. Consumer (or self) directed respite care allows carers to take a break from
their caring role and will give carers a greater say and more control over the design and
delivery of respite services provided to them and the person/s they care for (Roche and
et.al., 2015). This will allow carers to make choices about the types of respite services
they access and the delivery of those services, including who will deliver the services and
when. The person centred or consumer directed care is mainly for patients who are
suffering from psychological or mental disorder like dementia, Alzheimer's, brain
injuries, etc. Expected outcomes of consumer directed care for both carers and the
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person/s they care for include a better quality of life due to increased independence and
empowerment over the services they are receiving (Reed, Fitzgerald and Bish, 2015).
There are several benefits of person centred or consumer directed care which includes
respecting the desires of an individual, allowing an individual to make informed choice,
improved quality of care, etc. In this way the treatment of Elizabeth Jackson can be made
effectively and efficiently. Health Literacy: The level of literacy pursued by the individual not only assist in making
patient centric decisions but also plays important role in extending end of life care. As per
the significant reports, it has been analysed that the literacy regarding health varies from
age (Timilsina Bhandari, Xiao and Belan, 2015). Men and women shows similar pattern
of learning and knowledge in case of health literacy. Lack of information and knowledge
regarding some chronic disease can increase the health risks among people. Moreover,
they are also not able to self-diagnose that they are facing some problem and required to
see to the doctor immediately. Moreover, literacy among old age people is quite low.
Further, it is also not easy to spread awareness among that age group due to decline in
mental processing and enhanced length of time of leaving education. It shows there is a
requirement to organize formal programme so that health literacy can be promoted
among non-medico people in the society (Baldwin and Chenoweth, 2015). Another
important aspect that can be used in promoting health literacy is internet. On one side, it
can promote knowledge regarding diseases among youngsters. However, on the other
hand, it may not be beneficial for older generation as they are less likely to have internet
connectivity as they do not enjoy going online.
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 Active Ageing: Active ageing is the concept of treating the older and aged people of
Australia by the healthcare organisation. It is the reform that was proposed by the World
Health Organisation in order to provide health care facilities to the elderly people of the
country (Cashin and et.al., 2014). The policy was formulated by the government of the
country where it is the duty of the registered nurse to give healthcare treatment to the
aged people who are suffering from various health issues and mental disorders. They
provide treatment at their home or residential care in order to minimise the efforts of the
aged people of Australia. As per the case of Elizabeth Jackson, Active Ageing reform can
support her in order to treat her dementia. This will assist her as she lives alone with
nobody to take care of her. In this scenario, the active ageing policy proposed by the
government gives the right to Elizabeth Jackson to have the appropriate and precise
treatment so that she can recover effectively and efficiently (Duffield and et.al., 2015). It
is the duty and responsibility of the community or healthcare organisation to treat the
patient accordingly and appropriately in order to reduce his or her issues and he or she
can recover efficiently. Further, the patient or aged person also cooperate with the nurse
so that the quality treatment can be given by the registered nurse. Thus, this reform helps
the aged or old patient by providing him or her the quality treatment effectively and
precisely.
 Advance care planning: Advance planning care is a critical issue in aged care. The main
aim of advance care planning is to have high involved of individual while taking health
care decisions (Henderson and et.al., 2014). It makes sure that a plan must be prepared in
advance for family members, carers and professionals so that they are aware that what all
steps are required to be taken when the individual is critically ill and requires support
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from their side. Community awareness campaign was initiate in order to create better
understanding regarding advance care planning. Further, it is necessary to have adequate
personal relationship between individual and health care centre so that preferences of the
patient can be taken care of and end of life wishes can be fulfilled with due respect (The
Aged Care reforms and human rights, 2017). Therefore, government has taken initiative
to provide advance care training programs to the carers so that the best can be provided to
the patient.
CONCLUSION
From the above report, it can be understood that age factor impacts the health of human
being greatly. It impacts on the psychological and physical abilities of an individual greatly. In
this context, this essay examines the case of Elizabeth Jackson who was suffering from dementia
and lives alone in her house. The social determinants of health related with the case study has
been investigated and examined in the essay. This helps in analysing the impact of social
determinants of health on an individual. Further, the national and legal policy that made by the
government of Australia has been analysed and their relationships with the international trends
has been made in this essay. Eventually, the reforms and policy that helps in prevention of
chronic diseases has been assessed in this essay.
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Online
The Aged Care reforms and human rights. 2017. [Online]. Available
through:<https://www.humanrights.gov.au/human-rights-approach-ageing-and-health-
aged-care-reforms-and-human-rights>
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