Essay

Subject: Health and well-being
Topic: Work-based learning

Introduction

For the last three months, I have worked closely with older adults in the home to home with an aim of offering the best services as a professional. There are challenges in practice that I have identified and will need an approach for a desirable situation. There are three areas in which I look forward to improve:

• Develop skills to train raise awareness and promote community participation in assessment, support, reporting and enhance access to services.
• Promote effective participation of older adults in leisure and physical activities by meeting their transport needs.
• Set clear targets of increasing the number of older adults using our organizational services.

Overall aims

Community participation will ensure that the local community reflect and represent the professional when absent.
To allow older adults access efficient and timely transport and make use of additional support services.
Promote demand for older adults’ services by removing the barriers that faces access.

Current situation
There are constraints I have identified during home to home care. I would like to know how my clients are doing at all time and understand deeper issue that my clients may fail to open up (Zijlstra, et al. 2007). It becomes complicated when the client has some problems especially when in pain or in mental distress. However, by having close people who spend much time with the client, I can offer the best services and settle for client-centred services.
Older adults have many challenges that prevent them from accessing the best services (Gillespie, et al. 2009). I have noted that, community members like the relatives, age-mates, carers, and other social support close to a client are very important at this point (Zijlstra, et al. 2007). However, most may lack confidence in working with older adults and particularly when they experience physical health problems, or are having social, communication and economic difficulties.
I have noted that older people do not feel free to use the bus and have challenges lighting rail. There is also a need for door-to-door transport as the older people take long reaching home from the terminals where they are dropped. The challenges have reduced their participation in physical and leisure activities (Su & Bell, 2009). Most places and activities where client are interested are far and it is hard to provide each with one. These facilities include gyms, swimming pools, walking fields and many others.
Older adults need to participate in these activities once or twice a week or as many times as they can depend other challenges like physical, weather, economic and health challenges. Physical activities respond to therapeutic improvements and outcomes and allow older adults to meet other people that they can freely interact with which respond to their psychological and social needs.
Generally, there are challenges I have identified among the older adults in relation to transport. Majority have gone without some food in some days as they lack transportation. In non-emergency needs, most rely on family and friends for transportation (Schmöcker, Quddus, Noland & Bell, 2008).
The current situation is a complex. Older adults in the community have not fully accessed the services offered at home level. Social isolation has led to this but other factors identified include low incomes, little contact with friends, experience of fear, difficult in accessing important services, unmet transport needs, attitudes, views and behaviours of older adults, primary care professionals and many others (Pittman, et al. 2011).
Quite a number of older adults have continued to avoid our services thinking their situations are shameful and information should not be given to health professionals. Others Most men self-mediate themselves with alcohol to mask their moods. They do not want to bother the professionals by believing that their situation is normal and part of ageing. Others have language problems or chronic pain that distracts them (Gomes & Higginson, 2008).

Action plans

What Community participation- Employability
It is the duty of a professional to identify the change in health services, identify the stakeholders, their attitude toward change and employ strategic steps to ensure that the desired change is achieved (Minkler & Wallerstein 2010). I will recruit, develop and retain people to assist. The services will also have to be in response to individual needs (Barnett, et al. 2003).

How
For each client I am assigned, I will have to identify those people that are accessible and ready to work with the client. They might be family members, a neighbour, an age-mate, or a person with whom the client share similar faith like it is the case with most of my clients. I will set a plan depending on the client condition and plan for major areas for training and learning where the people within the support will develop skills (Adams, 2008).
In the process I will allow them to recognize elder abuse, needs of carer, self-harm, neglect and risk involved with older adults in later life. This will happen in the course of services provision and the changes identified will be communicated so that the people may learn how to approach such when needs arises (Bunn, et al. 2008).

When
Every day I will set 15-minutes for training them on how to deal with different situation. As they participate I will identify the areas in which each would best suit; be it communicating with client, reporting and medication. This will take a minimum of ten days. I will focus on communication and reporting as important skills to allow reporting when necessary.
In the next three months, I will train them about the good practice for care pathways, assessments, normal and abnormal ageing and its measures, adjusting skills and therapies and working with clients with impairments.

Reflection

I have seen that it is possible to offer a solution to services when family members, carers and other members in the community are involved in decision making. I have been consulting them for the most preferred services and allowed them to be part of therapy processes.

What

Meet transport needs- enterprise
As Farmer & Kilpatrick (2009) observes, health professional can identify and combine resources as they link professionally, managerially and development due to their enterprise orientation. Social entrepreneur promote new ways to respond to social problems.

How

I have proposed for a shared ride services that will take care of my clients. The organization can offer a vehicle for older adults where these old people will be carried to physical activities destinations. I need to set the plan, access workmates support, present it in my department and together we discuss on its implementation and other support services that we will seek from health departments to make it functional (Gillespie, et al. 2012).
In the mean time, I have noted that organization action will take longer due to bureaucracies involved. However, it is possible to bring together neighbours into a single transport program before the organization program rolls. I intend to raise the need among the client, families and other carers and that way we can come together to plan how the older adults can access transport services. A vehicle shared by 4 or 5 older adults when going to similar activities will allow them to share expenses and offer assistance between themselves (Gillespie, et al. 2012).

When

At first due to constrains of vehicles, I have proposed for the services to be offered twice a week, like Tuesdays and Fridays and that means that other professional can make use of the same vehicle in other days of the week for similar services.

Reflection

There are services that my clients, their family members and carers do not easily perceive. However, it is my role to suggest to them so we can plan and implement the services with available resources. I can also help them connect with other members with similar needs.

What

Increase the number of clients in need of services- Entrepreneurship
As Christensen, Grossman & Hwang (2009) service-oriented health problem require a vision for future address. However, this follows specific objectives and rationale for approach. The benefits, improved performance and likely risks have to be accounted for effectiveness.

How

Referral
The first action will include referrals where those people that work closely with the client and professional will be required to contact those older adults and convince them of the need for the services. I will consult with community members to help identify close members to those clients that are not interested with our services. I will then talk to them and organize for visits, phone calls and arranging on how they can be included in the services. This is the most effective plan seen to impact on rise of home-to-home services demands for the old.
Screening campaign activities
This will be campaigns facilitated by the organization targeting the older adults in the community. The campaign will target to reach all the older adults by emails, posters, referrals where screening will help then know the health problems they might be having and thus see the needs for the services. Free screening will highly promote participation. There is a need to attend them on one-on-one basis to note the needs of each (Demiris, et al. 2008)).
Teamwork with primary care professionals and GPs
Most of these older adults visit the local hospitals and private nurses. Through these professionals it is possible to refer these older adults to home services. This can be addressed at departmental level so as we can do it together. Those visiting hospitals or contacted at other social events can be given contact details for the professional in charge (Darkins, et al. 2008; Shepperd, Parkes, McClaren & Phillips, 2013).

When

These activities will require a six month period for effective implementation.

SWOT   

Reflection

Our organization is growing and that is reflected by increased home to home services. As a professional, I connect the organization with the community and recommend ways to exploit some segments that have not been reached. Personal and professional development will extend to impacts on how I will meet clients’ future needs. I need to recommend for the organization to increases resources for services that meet clients’ needs.
People- workmates, family members and carers
Books/journals – policy frameworks and home to home care journals.
Online resources- use links to recommend carers services.
Training courses/ workshops- attend at organizational level.

Conclusion

The problems that are so far identified in the home to home care can be approached from different point for a solution. Currently, community participation, transport and increasing the number of older adults in the services are core. Strategies seen to change the situation includes improved understating, training others, use dedicated staffs to raise awareness, utilize the available community resources to offer very urgent services and use social networks to market the services.

References

Adams, R. (2008). Empowerment, participation and social work. New York: Palgrave Macmillan.
Barnett, A., et al. (2003). Community‐based group exercise improves balance and reduces falls in at‐risk older people: a randomised controlled trial. Age and ageing, 32(4), 407-414.
Bunn, F., et al. (2008). A systematic review of older people's perceptions of facilitators and barriers to participation in falls-prevention interventions. Ageing and Society, 28(4), 449-472.
Christensen, C. M., Grossman, J. H., & Hwang, J. (2009). The innovator's prescription: a disruptive solution for health care. New York: McGraw-Hill.
Darkins, A., et al. (2008). Care coordination/home telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemedicine and e-Health, 14(10), 1118-1126.
Demiris, G., et al. (2008). Findings from a participatory evaluation of a smart home application for older adults. Technology and Health Care, 16(2), 111-118.
Farmer, J., & Kilpatrick, S. (2009). Are rural health professionals also social entrepreneurs?. Social science & medicine, 69(11), 1651-1658.
Gillespie, L. D., et al. (2009). Interventions for preventing fall in older people living in the community. Cochrane Database Syst Rev, 2(CD007146).
Gillespie, L. D., et al. (2012). Interventions for preventing fall in older people living in the community. Cochrane Database Syst Rev, 9.
Gomes, B., & Higginson, I. J. (2008). Where people die (1974—2030): past trends, future projections and implications for care. Palliative Medicine, 22(1), 33-41.
Minkler, M., & Wallerstein, N. (Eds.). (2010). Community-based participatory research for health: From process to outcomes. Wiley. com.
Pittman, K. J., et al. (2011). Preventing problems, promoting development, encouraging engagement. Washington, DC: Forum for Youth Investment.
Schmöcker, J. D., Quddus, M. A., Noland, R. B., & Bell, M. G. (2008). Mode choice of older and disabled people: a case study of shopping trips in London. Journal of Transport Geography, 16(4), 257-267.
Shepperd, S., Parkes, J., McClaren, J., & Phillips, C. (2013). Discharge planning from hospital to home. Cochrane Library, (2).
Su, F., & Bell, M. G. (2009). Transport for older people: Characteristics and solutions. Research in Transportation Economics, 25(1), 46-55.
Zijlstra, G. A. R., et al. (2007). Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and ageing, 36(3), 304-309.