Health and Society assessment 3

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Macquarie University *

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MISC

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Medicine

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Oct 30, 2023

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docx

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Health and Society assessment 3- Case analysis Background of patient Eileen Poole immigrated to Australia when she was young with her parents. She is now an elderly widow living alone after suffering the loss of losing her husband ‘Jim’ 6 months ago. She does not maintain much social connectedness in her local community as she does not often leave her home due to her inability to drive, however she remains close ties with her daughter who lives close to her and communicates with her through the phone on a daily basis. Her son on the other hand lives in Western Australian further away. Her husband’s death has contributed to her loss of appetite, loneliness and mild depression; social determinants of food, social support and stress which takes a toll on her stress levels and overall mental and physical health. The social determinants of health Social determinants of health are regarded as the conditions in which people are born, work and grow up in that play a significant determinant of how healthy an individual is (Healthy People. 2020). Artiga and Hinton (2018) state access to education, income level, social support and poverty are a few examples of factors responsible for health inequalities that can have adverse impacts on the patient outcome. They also propose negative impacts from these social factors account for a third of total deaths in the United States. Poverty and poor economic circumstances- for example, in the case of someone diagnosed with Influenza in Winter- may find it harder to recover due to poor access to nutritious food, lack of heat and poor housing (Valenti 2019). A correlation between a lack of income and poor health is evident upon an example of a comparison of two separate individuals who visit the doctor due to sickness. They are both prescribed a medication, however one individual experiences a low socioeconomic status from a loss of employment and so are unable to afford the medication in order to get physically better causing their health to deteriorate. The other individual on the other hand lives in an affluent neighbourhood and has a high socioeconomic status meaning easy affordance of medicine to recover. According to NEJM Catalyst (2017), social determinants of health are an underlying cause of today’s major societal health dilemmas including obesity, heart disease, diabetes and depression. Eileen Poole and food, social support and stress

Health Outreach Partners (2014) cites access to adequate food supply and maintaining a healthy diet is a key social determinant that is central to good health. Eileen Poole struggles with a loss of appetite in her diet which results in the amount of food she intakes to be minimal. Moreover, a right wrist fracture can make using utensils difficult which impacts on her ability to feed herself and reject meals out of frustration. Health Outreach Partners comments that the risk of developing chronic illnesses such as heart disease, hypertension, diabetes, and other diet-related diseases are linked to poor nutrition which demonstrates the cause of Eileen’s development of type 2 diabetes and hypertension. Furthermore, disparities in the cost and quality of healthy food between urban and rural areas in Australia are evident with the claim ‘fresh fruit and vegetables are less available, more expensive and of poorer quality in rural Australia’ (The Conversation 2013). These factors also highlight Eileen’s remoteness being a significant factor to compounding food insecurity. Wilkinson and Marmot (2003) declare good friendship and strong supportive networks are linked to better health as they can protect the individual from negative effects of stress and encourage healthier behaviour patterns. Eileen’s death of her husband 6 months ago along with her children not living with her means a lack of support to guide her in her home with emotional or practical reassurance. Thus the lack of care may have aggravated on her overall condition and inability to cope with adversity which led to her fall. Moreover, it is stated she does not often leave her home which may mean she does not engage in her local community often or have strong social ties outside her home. Loneliness among the elderly with a lack of social support from others has found to be associated with depression, increased stress, eating disorders, sleep problems and a high risk of chronic disease. These consequences interrelate with the medical conditions Eileen struggles with: type II diabetes, mild depression, intermittently sleeping overnight and loss of appetite. Being diagnosed with depression and other medical conditions, a lack of social support groups, grief from loss of her husband are all adverse factors contributing to Eileen’s stress. There is a clear established link between stress and health, stress activates a cascade of stress hormones that affects the cardiovascular and immune systems. Wilkinson and Marmot (2003) claim health outcomes that are tied to long term stress include depression, diabetes, harmful pattern of cholesterol in the blood, and high blood pressure. Eileen Poole

has health issues in the form of depression, hypertension and hypercholesterolemia which are therefore a result of stress. Eileen’s reduced range of movement, right wrist pain and inability to drive also restricts the opportunity to engage in various activities or travel freely by herself, which may impact further on her stress levels due to restricted freedom. Recommendations A caregiver would be of great benefit to Eileen in order to assist with diabetic meal preparation, feeding and weekly food shopping trips. These are of great benefit to Eileen due to her limited transportation options, inability to feed herself properly, and reduced range of movement to prepare meals for herself. A caregiver would ensure Eileen receive meals that include high protein and nutrition which will build Eileen to be stronger and healthier, as well as recover from her medical conditions quicker. For example, in the case of Eileen’s diabetes type 2 condition, nourishment of food is a treatment that helps cure diabetes and can also prevent the condition from exacerbating into other long term health problems. McMillin (2016) proposes depression and loneliness contribute to a loss of appetite in seniors, therefore a home caregiver to be by the side of Eileen whilst she is eating will also be beneficial for increasing her motivation to eat. Eileen might enjoy mealtime more with the company of another companion and see it as a social activity rather than a tedious chore. Findings by The Nutrition Care in Canadian Hospitals Study (2015) declare approximately 33% of patients do not consume food they receive in the hospital, one of the reasons being the difficulty in opening and unwrapping food. This is a problem aggravated for Eileen due to her right wrist pain so a caregiver by her side would assist her in opening packages and unwrapping food. This would prevent undernourishment and once again ensure Eileen receives the adequate nutrition she needs. Pool, Agyemang & Smallbrugge (2017) reveal in a study they conducted that social isolation and lack of social participation can result in poor mental and physical health outcomes for seniors. They suggest a positive correlation between an active social life and areas of physical and mental health. A recommendation to combat Eileen’s loneliness and reduce social isolation is through engaging in a community based service such as a senior citizen centre or assisted living facility. These type of services allows engagement in variety of group activities and encourage meeting and social interaction in the community. As loneliness is a

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