Chapter 15 Institutional Settings

Chapter Overview

Key Issues and Learning Outcomes

Key issues within this chapter:
  • Institutional settings provide valuable opportunities for health promotion with specific sections of the community, such as older people, persons with learning disabilities, abused children, and offenders.
  • People may make transitions between the community and an institution along a continuum of care.
  • A common feature of many institutions is that the residents are not there by choice and often experience loss of control and freedom and feel that they are not able to make their own decisions.
  • Health promotion can involve: health education targeted at residents; service improvements to change the nature of the institutions to improve the quality of provision and their responsiveness to the needs of residents; and advocacy for improvements and safeguards to protect persons in institutions.
By the end of this chapter you should be able to:
  • understand the way the organization of institutions can affect the health of residents.
  • provide a justification for health promotion delivered through organizations.
  • be able to describe the characteristics of a health promoting institution including the active involvement of residents in the operation of the institution, support during transitions from one form of provision to another and active communication between the staff and residents.
  • discuss the particular needs of persons within prison settings.
  • explore the role of health promotion - health education, service improvement and advocacy - within each setting.

Test your Knowledge

Having read the chapter can you now answer the following questions?

  1. What are the characteristics of a health promoting institution?
  2. Suggest three advocacy activities that could potentially improve the quality of life for an older person.
  3. Transition between settings can be a distressing experience for people. How could you reduce the uncertainty and distress? 
  4. Effective communication is important in all health promotion. What particular factors would you consider when communicating with a frail older person?
  5. About 6 million people in the UK act as informal carers. How might you meet the health promotion needs of this diverse group?
  6. What are the responsibilities of social services in relation to supporting children?  
  7. Why is it important to undertake health promotion activities in prisons?

Internet links

NHS website on services for older people
http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Olderpeople/index.htm

Promoting Healthy Prisons
http://www.healthpromotionagency.org.uk/work/training/courses/pdfs/healthyprisons.pdf

Health promotion in prisons models for service delivery
http://www.hsmc.bham.ac.uk/prisonhealth/Islington_Promotion.pdf

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