Chapter 4
Health, Wellness, Illness,
and Disability
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
PSW Program Focus
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Caring for the client
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For effective care, you must consider the whole
person.
Holism is a concept that considers the whole
person.
• The whole person has physical, social, psychological,
and spiritual parts.
• These parts are woven together and cannot be
separated.
• Disability and illness affect the whole person.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Caring for the Client
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Two major concepts:
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Client-centred care
Wellness
This gives us a model of caregiving.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Foundations
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Each person has dignity and worth in their
own right and should be treated with respect
accordingly.
Each person has a right to self-direction and
self-determination.
The ultimate goal of the caregiving team is to
improve the quality of life.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dignity and Respect
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Follow these rules to address the person with
dignity and respect.
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Call patients and residents by their titles.
Do not call patients and residents by their first
names, unless they ask you to.
Do not call patients and residents by any other
name, unless they ask you to.
Do not call patients and residents Grandma, Papa,
Sweetheart, Honey, or other names.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Foundations
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“Quality” to mean – as the client perceives it.
Personal support workers work with
vulnerable persons and support them in
achieving optimal wellness.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Basic Needs
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According to Abraham Maslow:
¾ Basic needs must be met for a person to
survive and function.
¾ The needs are arranged in order of
importance.
¾ Lower-level needs must be met before the
higher-level needs.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Wellness
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Achievement of the best health possible in all
five dimensions.
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Physical, emotional, social, intellectual, and
spiritual dimensions
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
Slide 8
Dimensions of Wellness
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It is every person’s responsibility to practice
safe/healthy habits.
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Self-responsibility
Nutritional awareness
Physical fitness
Stress management
Environmental sensitivity
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Holistic Approach
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Caring for the mind, body, and soul
Look at the whole person – not just where the
pain is
Each part relates to and depends on the
other
Physical, social, emotional, intellectual, and
spiritual parts
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
Slide 10
World Health Organization
Definition of Health
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Health is “a state of complete physical,
mental, and social well-being and not merely
the absence of disease or infirmity”.
In recent years the definition also includes the
ability to lead a “socially and economically
productive life”.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Think About This Statement
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Nursing trends change, but
Holistic nursing care remains the same
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True or False?
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health
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Physical health
Emotional health
Social health
Spiritual health
Intellectual health
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health (Cont’d)
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Physical health:
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Influenced by genetics and lifestyle
Achieved when the body is strong, fit, and free of
disease
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health (Cont’d)
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Emotional health
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When people feel good about themselves
Have strong self-esteem, self-control, and selfawareness
Accept help and give help to others
Emotions will vary throughout one’s life.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health (Cont’d)
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Social health:
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Achieved through stable and satisfying
relationships
Approach others with respect, warmth, openness,
and trust.
Most people need and have a social support
system.
Support workers may be key members of the
support system.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health (Cont’d)
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Spiritual health
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May or may not involve participation in a formal
religion, or even believing in a higher being
Elements are compassion, honesty, humility,
forgiveness, and charity.
Support workers must respect their clients’ beliefs.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Health (Cont’d)
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Intellectual health:
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Involves keeping the mind active and creative
throughout life
Activities such as reading, doing crossword
puzzles, doing crafts, gardening, and knitting all
are examples of keeping the mind active.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Wellness
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Achievement of the best health possible in all
five dimensions.
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Physical, emotional, social, intellectual, and
spiritual dimensions
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Dimensions of Wellness
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It is every person’s responsibility to practice
safe/healthy habits
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Self-responsibility
Nutritional awareness
Physical fitness
Stress management
Environmental sensitivity
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
Slide 20
Culture and Religion
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Culture is made up of the characteristics of a
group of people passed from one generation
to the next.
The person’s culture influences:
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Health beliefs and practices
Thinking and behaviour during illness and when in
a hospital or long-term care centre
Some cultures have beliefs about what
causes and cures illness.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Culture
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Culture can influence whether or not a person
will seek out medical treatment, take
prescription medication, take herbal
supplements, or even accept care from
someone who is not a family member.
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e.g., First Nations people
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Religion
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Religion relates to spiritual beliefs, needs,
and practices.
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A person’s religion influences health and illness
practices.
A person may not follow all beliefs and practices
of his or her religion.
• Do not judge the person by your standards.
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The nursing process reflects the person’s
culture and religion.
The care plan includes the person’s cultural
and religious practices.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Determinants of Health
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Look at the bigger picture of where we live
In Canada, the Lalonde Report (1974) first
identified 12 key factors that determine health
status.
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Income and social status
Social support networks
Education and literacy
Employment and working conditions
Social supports
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Determinants of Health (Cont’d)
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Physical environments
Personal health practices and coping skills
Healthy child development
Biology and genetic endowment
Health services
Gender
Culture
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Secondary Prevention
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Strategies for secondary prevention are
designed to intervene when risk factors or
early indicators of health-related problems
are present.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Illness and Disability
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Distinction between illness and disability:
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Illness is the loss of physical or mental health.
Disability is the loss of physical or mental function.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Supporting Clients with
Illness and Disability
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No two clients will experience illness and
disability in the same way.
Many factors affect the way clients
experience illness and disability.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Change and Loss Associated with
Illness and Disability
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Change in routine
Change in work life
Change in family life
Change in sexual function
Loss of independence
Loss of dignity
Change in self-image
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Insight Into the Elderly
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Begins with “your” attitude towards illness
and disability and your client’s attitude
towards their situation and towards you.
IF YOU ARE GOING TO HELP ME …
Please be patient while I decide if I can trust
you.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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If You Are Going to Help Me…
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Let me tell my story – the whole story in my
own words.
Please accept that whatever I have done,
whatever I may do, is the best I have to offer
and seemed right at the time.
I am not just a person – I am this unique and
special person.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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If You Are Going to
Help Me… (Cont’d)
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Don’t judge me as right or wrong, bad or
good. I am what I am, and that’s all I’ve got.
Don’t assume that your knowledge about me
is more accurate than mine. You only know
what I have told you – that’s only part of me.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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If You Are Going to
Help Me… (Cont’d)
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Hear my feelings, not just my words – accept
all of them.
Don’t save me – Help me help myself!
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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