John Grootjans

Ecological Aging: The Settings Approach in Aged Living and Care Accommodation

As the proportion of older people increases within populations, financial demands related to the cost of health service delivery threaten global stability. This population trend challenges the traditional approach to health service delivery to older populations. This article presents the Australian context as a case study to argue that the application of a health promoting settings approach to aged care may lead to improved well-being for older people to the extent that the periods of chronic morbidity often associated with aging can be compressed into an ever shorter period of time. Promoting an ecological perspective to aged care suggests that there is no need to manage older people in isolation, as is common practice, but as integral to the way society lives, works, and plays. The article maps parallels between characteristics of health promoting settings such as Health Promoting Schools and the aged living and care industry, arguing that the setting encompassing services for the elderly is a prime location for the establishment of a new health promotion setting. Supporting life opportunities for our aged is central to such an approach. More broadly, an ecological approach orients us toward the connection between environment and health, and encourages increased attention and action within the aged living and care sector on reducing environmental impacts of this growing population. As such, the application of this approach to the aged living and care sector has the potential to reduce the threat that a dependant older population has on global sustainability.

The application of ecological thinking to better understand the needs of communities of older people

Aim:  This research applied ecological thinking to develop a more integrated or ecological understanding of the needs and aspirations of communities of older people.

The ideas of Frantz Fanon and culturally safe practices for Aboriginal and Torres Strait Islander people in Australia

Mainstream mental health services in Australia have failed to provide culturally appropriate care for Aboriginal and Torres Strait Islander people despite several national reports and policies that have attempted to promote positive service development in response to the calls for change from the Aboriginal and Torres Strait Islander communities. In light of this situation, this article considers the ideas of Frantz Fanon and their potential for promoting cultural safety (Ramsden, 2002) in mainstream mental health services. This article argues that Fanons ideas provide a conceptual strategy for nurses that prompts reflection and establishes a critical theoretical perspective linking power imbalance and inequitable social relationships in health care, thus complementing the aims of cultural safety. The purpose of this critical reflection is to guide nurses’ understanding of the relationship between colonization and health status in order to change their attitudes from those that continue to support current hegemonic practices and systems of health care to those that support the health of Aboriginal and Torres Strait Islander people.

The potential role of ecological health promotion in progressing healthy ageing

The economic and social implications of population trends make it an imperative for the aged care industry to develop frameworks to facilitate healthy ageing, the compression of disease and a more productive, active older population. Ecological health promotion delivered through a settings-based approach has been found to be a useful means to promote population health across a number of settings. Such an approach could offer both a framework to organize the many worthwhile strategies and practices being implemented for healthy ageing and a suite of concrete processes to engage stakeholders in such endeavors. In this regard, residential aged care facilities exhibit many of the characteristics of other settings such as schools and workplaces and, as such, should be developed as a health promoting setting. This paper asks whether residential aged care could become a health promoting setting for the ageing population?

The development of nurse practitioners via flexible learning: Toward an innovative Master’s degree curriculum in Thailand

Abstract The changing health system in Thailand has provided Thai people with more equitable opportunities in accessing health care services. As a result of medical practitioner shortages and a strong desire for nurses to expand their scope of practice, the Thailand Nursing and Midwifery Council (TNC) plans to increase the number of nurse practitioners at master degree level to staff primary care units (PCUs) and Health Centres around the country. Nursing master degree curricula in Thailand are currently offered using the traditional on-campus face-to-face mode of delivery and have low numbers of student enrolments. Furthermore, research indicates that many graduate nurses in Thailand are seeking entry to Master’s degree curricula, but accessibility, convenience and availability of curricula locally are limiting enrolments. Nursing education globally is a dynamic and iterative process. Educational curricula are based on the principles of adult learning, continuing professional education and life-long learning, which advocate flexible and learner-oriented education. Flexible learning, which has the ability to closely match the professional and academic needs of the learner, has the potential to lead nursing education toward meeting the TNC policy and health system reform in Thailand. It is essential that nursing education in Thailand be revolutionised, embracing flexible delivery modes by traditional higher education providers. This paper presents a new model of health care service delivery and the mechanism used to integrate the principles of flexible learning into a new master degree curriculum for nurse practitioners (NPs) in Thailand.