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).
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.
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 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.
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 functioning level. They ensure levels of light are good, a signposted toilet near their space and use of color to differentiate their bed space.
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.
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 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.
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).
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.
Anwar-McHenry, J., & Donovan, R. J. (2013). The development of the Perth Charter for the Promotion of Mental Health and Wellbeing. International Journal of Mental Health Promotion, 15(1), 58-64.
Arnott, N. (2013). Working with people who have a disability. An Introduction to Community and Primary Health Care in Australia, 354.
Erickson, M. E. (2017). Modeling and role-modeling. Nursing Theorists and Their Work-E-Book, 398.
Erickson,M. E.(2017).. Empowering people to be healthier: public health nutrition through the Ottawa Charter. Proceedings of the Nutrition Society, 74(3), 303-312.
Fry, D., & Zask, A. (2016). Applying the Ottawa Charter to inform health promotion programme design. Health promotion international, 32(5), 901-912.
HEIMERL, K., Tatzer, V., & PLUNGER, P. (2015). Dementia-friendly pharmacy: a doorway in the community in Vienna and Lower Austria. In Compassionate Communities (pp. 155-170). Routledge.
Keleher, H., & Parker, R. (2013). Health promotion by primary care nurses in Australian general practice. Collegian, 20(4), 215-221.
Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patient‐centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing, 69(1), 4-15.
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Roden, J., Jarvis, L., Campbell-Crofts, S., & Whitehead, D. (2015). Australian rural, remote and urban community nurses' health promotion role and function. Health promotion international, 31(3), 704-714.
Su, Y. E., Sendall, M., Fleming, M., & Lidstone, J. (2013). School based youth health nurses and a true health promotion approach: The Ottawa what?. Contemporary nurse, 44(1), 32-44.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Weston, K., Mullan, J., Rich, W., & McLennan, P. (2018). Medical Student Research during a Longitudinal Community-Based Placement Can Provide Opportunities for Learning about Public Health. Education Sciences, 8(2), 60.
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