There are many reasons why tangata access community health services.
Health factors
There are many health factors that clients may be seeking help with.
- Alcohol use – information and support to stop drinking alcohol.
- Cancer – support with daily care, comfort care.
- Diabetes – support with managing diabetes.
- Recovering from surgery or illness – support with daily care, household management, and rehabilitation.
- Mental illness – support to manage daily and find information on support services available.
- Obesity – support for having a healthy diet, losing weight and getting physically fit.
- Tobacco use – providing information and support to stop smoking.
- Physical disability – support with daily care, food preparation, and becoming independent.
- Hearing disability – support with work or to get information, e.g., interpreter service, hearing loss equipment.
- Stress – support to manage stress.
- Family violence – information on legal rights, support for counselling.
- Grief and loss – information about support services.
People may also seek information regarding improving or maintaining their health, including nutrition, immunisation, physical exercise, breastfeeding, and other support agencies.
Wellness
People seeking support services will be seeking to support or improve their wellness. Wellness can be defined in many ways. The following diagram shows the eight dimensions of wellness as described by Dr Margaret Swarbrick. (Click on the link to read more about Margaret Swarbrick.)
As discussed previously, Māori see wellness as having four dimensions:
- taha wairua – spiritual wellbeing
- taha hinengaro – mental and emotional wellbeing
- taha tinana – physical wellbeing
- taha whānau – social wellbeing and being connected to whenua
Having these dimensions in balance means people thrive; when one or more dimension is out of balance, wellbeing can be impacted.
To be well, tangata need:
- protection from environmental factors that could lead to health risks
- adequate housing
- a liveable income
- employment or activities to keep them busy
- educational opportunities
- a sense of belonging and being valued
- a sense of control over life circumstances
Reflection
Considering the list of things that tangata need to be well, reflect on the following:
- are there any other items you would add to the list?
- do you feel you have access to everything you need to be well?
- what questions could you ask a client to determine whether they have the things they need to be well?
Characteristics
Tangata accessing community health services will have a broad range of characteristics you may need to consider when providing care. These may include their:
- age and stage of development
- gender
- sexual orientation
- culture
- language
- disabilities
- experience and knowledge
- health status
- personal history
- coping strategies
- housing situation
- socio-economic situation
- level of support from whānau
Each person’s reason for accessing community support and their situation will be different, and their situation will determine the support required. For example, some tangata will be dependent on you, whereas others will have the support of whānau. Some will need temporary support after an accident or illness, whereas others will need lifelong support due to a disability. Some people will work towards total independence, while others can only aim to improve it.
Your role is to provide support so people can:
- remain as independent as they possibly can
- reach their potential
- be involved in their communities
- feel supported
- live their own lives
Support durations
Some tangata need support for a short period of recovery. Others need it for their whole life or the remainder of their life. Click on the headings to display information on support durations.
Rehabilitation is about restoring skills following a health event or accident. The word means ‘to make fit again’. Rehabilitative support may be focused on:
- achieving a goal – returning to work after an injury.
- restoring function – learning to walk after a stroke.
- maximising independence – learning/relearning daily tasks and activities
Short-term supports are those required by a person for a short timeframe. People may need support at different times in their life.
Short-term supports may focus on:
- recovery from a health event or accident – e.g. an operation
- a change in personal circumstances – e.g. the death of a spouse
- rehabilitation (after a health event or accident) to return to a previous level of functioning
- achieving independence
Lifelong support is the ongoing support given to people throughout their lives. The level of support may change over time.
Lifelong support may be focused on:
- health needs – e.g. a chronic condition such as a heart defect
- developmental needs – e.g. autism spectrum disorder
- mental health needs – e.g. bipolar disorder
- disability needs – e.g. physical or cognitive impairment
End-of-life support is the range of support people need to function as they approach death.
End-of-life support may focus on:
- progressive frailty and declining function
- quality of remaining life
- palliative care, which controls symptoms rather than cures the condition
Activity
Complete the following activity about support durations.
A holistic approach to needs
Taking a holistic approach when addressing a client’s needs is important. This means considering all aspects of the person and supporting the whole person, not just their health needs.
Activity
Complete the following activity, listing the potential needs of your client.
Resources for whānau
In many cases, whānau play a significant role in supporting the family member needing care. However, most whānau members will not have medical or support training. They will want information about their family member’s health issues and support options.
Accessing resource materials for family members related to health issues can be challenging. However, you can guide whānau in their quest for information.
If the tangata has a specific disability or illness, background information on this condition can be useful for whānau. They may also want information about how best to care for their loved one and any specific services available to assist or improve the tangata’s wellbeing.
Remember always to evaluate the sources you're using. Stick to reliable and well-established sources to ensure the accuracy and credibility of the information you're accessing. If you are looking for personalised information or advice, always talk to a healthcare professional in that field of experience.
Some potential sources of information include:
- GPs and other health professionals
- brochures – these are often found in GP offices
- reputable websites such as government health sites
- non-profit /charity organisations
- health apps
- books and ebooks – search the library
- support groups
- medical journals
Reading
Visit HealthEd to read a range of free, downloadable health brochures, created by reputable New Zealand health organisations.
What is independence?
Independence means not relying on others for your survival. It's the ability to stand on your own. We depend on parents or caregivers during childhood, but as we grow, we become independent. Some people remain in a dependent state due to disability. Others may lose their independence due to accidents, illness, or age. Losing independence can impact mental wellbeing, leading to emotions like fear, anger, guilt, and depression.
People may need differing degrees of support throughout their lives, depending on their circumstances.
There are three degrees of support that everyone will experience at some time in their life.
- Dependence – a person relies on others for support for day-to-day tasks.
- Interdependence – a person looks to another person for mutual support, usually from whānau or friends.
- Independence – a person doesn’t need any support for day-to-day tasks.
Supporting independence
Organisations provide flexible services to help tangata maintain their independence as long as possible, adapting to changing needs and preferences. Your role may involve collaborating with whānau, support workers, and healthcare professionals to support individuals in maintaining their independence.
Supports required to maximise a person’s independence may include:
- communication
- teaching strategies
- task breakdown
- functional exercise
- physical support
- emotional support
- practical support to carry out activities of daily living
Supports provided are in accordance with the client’s personal plan and within the boundaries of the support worker’s role.
Factors hindering independence
Some of the situations that may influence a person’s independence include post-accident, post-surgery, end-of-life, declining function, long-term disability, and cognitive impairment.
Some factors can hinder a person’s progress towards independence.
Activity
Before you turn each card in the following activity, think about a tangata you have provided care for. Did they experience any of the factors which might have hindered their progress towards independence? How do you think this made them feel?
Case Study
Consider the scenario below and answer the questions that follow.
Penny is 60. She was knocked off her bike by a car as she was riding to work. She broke her leg and injured her back. Penny has been in a hospital spinal unit for two months; she is now able to walk with crutches for a short time but mostly uses a wheelchair to get around. She cannot stand for any length of time. Penny is now at home being cared for by her husband. She can use the toilet and perform basic hygiene tasks herself but needs help with showering and dressing. Her husband is making all the meals and is attempting to keep the house clean and tidy.
You have been assigned as Penny's support worker and have supported Penny for three weeks. When you arrive at her house on Monday of the fourth week, the house is messy and Penny tells you she is feeling depressed at the state of the house. She also feels trapped as her car is not wheelchair friendly and she doesn't know how to use public transport with a wheelchair. She needs to purchase some personal items but does not feel confident about going to the local shops.
Reflection
Reflect on the following questions:
- What can Penny do independently?
- What does Penny need support with?
- What could be done to make Penny happier and support her to be as independent as possible?
