The terms “health and wellbeing” are often bandied about these days, but as early as 1948 the World Health Organisation defined health as being not only disease-free but also functioning well in physical mental, and social terms. It serves as an acknowledgment of the well-being aspect of feeling well that we should all be able to aspire to.
The NHS and most organizational workplaces recognize that if people (employees) are happy in themselves and feel supported, they are more productive and perform better.
We all strive to feel in control of our lives (difficult in a stressful world), to feel comfortable, and to have a sense of purpose. To achieve this our health needs to be as good as it can be but other needs spiritual, religious, social, and cultural also need to be met.
These fundamental needs apply to all our service users no matter what their condition.
Lifestyle refers to the way you live your life (or how you behave).
The choices you make about what you do with your time, where you go, how sociable you are, how often you go out of the house, and what you eat and drink (consume) are all elements of lifestyle. It is not only about what you do but also the quality of what you do. Exercise and eating a well-balanced diet are medically recommended ways of living well as are avoiding things that are bad for health such as excess fat, salt, and sugar, not getting enough sleep, and neglecting what your body is telling you.
These are all conscious or unconscious lifestyle choices. They play a big part in determining our wellness. For people who need care support, lifestyle choices have been compromised.
Our health and well-being are inextricably linked to our lifestyle. What we do or don’t do reflects our lifestyle. Some people are adventurous, always on the go, eat well, sleep well and have a wide circle of friends (and family) and a strong sense of purpose in life. Other people hardly leave the house, see few people, eat haphazardly and sleep fitfully. These are all life “choices” but some individuals’ choices are more limited than others because of ill health (physical and mental), where they live, past experiences, and financial circumstances. Physical and social mobility often dictate our style of living and whether we thrive or struggle (or even know the difference). Many of our clients need help because they feel trapped by their illness/condition.
The state of a person’s body and mind and the way a person treats/looks after their body and mind are key factors influencing a person’s health and wellbeing. More specifically, basic factors such as diet, sleep and rest, drug or alcohol intake, social life, living conditions, income, mobility, and exercise come into the equation. An individual’s education and upbringing also influence their general health and attitude to health and wellbeing. We often stick to what we know, what we have always done, and what our peers do. It is not always good for us to confirm. For example, there is often pressure on the young to smoke and drink which can lead to excess.
A wider view of health and welfare has to take into account such determinants as an individual’s economic and social status. Does the person have a regular job, money coming in, savings and prospects or is he/she unemployed or low skilled with therefore less choice, access to quality food, accommodation, or mobility? Some parts of the country are much more deprived than others. Access to healthcare can be denied due to the postcode lottery.
It is also harder for some people to access health and welfare because of environmental and cultural reasons. To be born on a council estate in the post-industrial North of England can be a world away from leafy Surrey. Being chronically ill or disabled can be doubly difficult in such areas. Similarly, some cultures demand people (often women) to know their place and are seen and not heard. Carers need to be sensitive to cultural differences. Education or lack of it is an important factor in whether someone even knows how to look after themselves or how to thrive.
Since our role as health and social care workers demands that we be person-centered, we must always be thinking of the client’s wants and needs, as well as keeping them safe from harm. This said, the people we provide a service to are already ill or have a disability, so health promotion messages have to be delivered subtly so that the individual doesn’t feel lectured to or badgered.
We want service users to be as well as they can be, so we have to be positive and enthusiastic about health promotion during our visits. Lifestyle changes can be made to benefit individuals’ health and wellbeing by making small, manageable changes. Our job is to make clients aware of healthy options. Encouraging clients to be mobile, eat regular meals, and maintain fluids intake, prompting/witnessing medication, and encouraging good hygiene and sociability are also important. At the same time, we must also respect a client’s right to choose.
Depending on how much support an individual needs, carers, care providers, and senior staff can provide advice, tips, and signpost ways to improve health and wellbeing. The holistic, integrated partnership working that the Department for Health and Social Care promotes means Public Health England, The NHS, local government and specific care settings such as GP surgeries and pharmacies all have professional staff and websites which strongly push for a better diet, drink/drug awareness programs and exercise advice.
Most local authorities have health and wellbeing boards and health promotion specialists. There are free e-learning resources on matters such as oral health and obesity. Gov.UK health improvement, the CQC, and the Royal College of Nursing also have lots of information and advice to support health and wellbeing.
Public libraries have a wealth of information on keeping fit, yoga, and diet support classes designed to stimulate/relax the mind and body. There are often classes today for older people to remain active as well as for those living with illnesses such as dementia.
Even with the best will in the world, getting a message across can be made difficult by communication barriers. For health and social care workers recognizing the barriers and working to overcome/ anticipate them is important. Individuals we support can often have sensory issues including impairments of sight, hearing, and speech. Encouraging the use of communication aids such as hearing aids, Braille, and simply speaking is essential.
For people living with dementia, family and friends can be called upon to find the best ways to communicate and combat the isolating nature of the condition. Removing distractions such as loud TVs or traffic can help.
Another barrier to communication can be language. For clients who do not speak English, miming and hand gestures may be required to get across health and wellbeing messages. At times translators may be needed such as family and friends. Again, unsuitable environments must be avoided for example where it is too bright/dark or too noisy.
Much of health and well-being is about being able to express oneself emotionally and spiritually, have a sense of self, and feel in control. Carers need to encourage and promote this.
Taking the lead on approaches to promoting health and wellbeing are organizations such as Public Health England and The King’s Fund. The former works as an agency of the Department of Health and Social Care and focuses on the protection of public health and addressing inequalities. The latter is a charitable organization and think tank to help people navigate and understand what is an ever-changing health care system. Both bodies inform the central government and local government, the NHS, industry, and public health professionals to improve health and promote healthier lifestyles.
At a more accessible level, the NHS and health charities do a lot of work to promote health and wellbeing. The NHS Just Eat More Fruit and Veg 5 a day campaign and the FAST stroke awareness TV advert are both hard-hitting successful health initiatives. Stoptober by the British Lung Foundation has encouraged nearly a million people to attempt quitting smoking and Dry January has made many more drink aware.
So there are many positive approaches to promoting health and well-being which focus on prevention (of illness) as well as cure. However, as healthcare professionals, we are in an ideal position to influence clients’ health and lifestyle behaviors positively by encouraging being active, getting enough to eat and drink, and living well with illness.