The Future? OT at a Community and Population Level

What does working at a community and population level mean? I asked people I know and many didn't have a clue; I had to do some research to find out.

The research I did outlined to me the fact that all around us there are influences at community and population levels, mainly put out by the government, but we treat them as part of the wallpaper.

Who hasn't seen the hard hitting, clever adverts that show gruesome drink driving accidents, or friends intervening with binge drinkers and family abusers. Not to mention the oldest of them all, the quit smoking advertisements. Working at population and community levels is nothing new. It involves reaching, educating and influencing a wide audience as opposed to just one or two individuals at a time (Dyson, 2002). It would seem the New Zealand government is mastering this art.

Occupational therapy is moving towards working at these levels. In the future, it is going to become unfeasible for occupational therapists to work in the community seeing clients 1:1. In this role, they are acting as the ambulance at the bottom of the cliff, picking up the pieces. A better alternative is a fence at the top stopping people going over the edge.* This is referred to as an 'upstream approach' (Scriven & Atwal, 2004). Something has to give as the government will not keep supporting this type of intervention without measures in place to help prevent it.

A move to population based healthcare or 'health promotion' (Scriven & Atwal, 2004) is aimed at countering the strain the aging population will put on the healthcare system. To put this in perspective; Healthcare expenditure is set to rise 3.6% each year for the next fifty years (Dyson, 2002).

The government has already started. Objective 5 of the Health of Older People Strategy (2002) is aimed at promoting; ‘population-based health initiatives and programmes’, these initiatives will; ‘promote health and wellbeing in older age’ (Dyson, 2002, pg 38-45). The aims of this objective are; increasing physical activity, improving nutrition, reducing social isolation, decreasing depression and curtailing the number and frequency of falls in older people (Dyson, 2002).

Occupational therapists have a proven record of being of value in these areas. They just have to define their role within the changing face of New Zealand healthcare.

Jamie

*This analogy is used in class by one of our lecturers, it can be found in Scriven & Atwal (2004). Thanks Fiona!

Occupational Therapy Paradigm Change?

As the population ages and the government focuses on cost-effective ways to treat older people, new systems will be put in place by the Ministry of Health.

The onus will then be on the occupational therapy professions to adopt and adapt to these changes.

Therefore, it is my belief that a paradigm change may be inevitable as a result of this.

Occupational therapy (OT) is a very malleable profession. According to Kielhofner, (2004), OT has gone through five paradigms to arrive at the contemporary paradigm we follow today. Who is to say that this paradigm will not evolve again to encompass the changing face of older person’s healthcare as a result of the aging population?

I believe this is very real possibility as the aging population phenomenon is not only being experienced in New Zealand, but in most 'western' countries around the world (Gavrilov & Heuveline, 2003). These countries will also need to adapt the way they deliver healthcare, contributing to a paradigm change.

The occupational therapy profession is in a prime position to evolve and adapt its paradigm alongside the complicated factors that contribute to an aging population. To do this in line with the likely political developments that will take place in New Zealand, OT will need to change from working with clients at a 1:1 level to working at population and community levels.

This reality is being acknowledged at a higher level: In 2006, at the annual New Zealand Association of Occupational Therapy conference, the Minister of Health, Pete Hodgson, stated the need for occupational therapists to move towards defining and implementing their future role in population based health, especially with older citizens (Wilcock, 2007).

Working at community and population levels will be explored in my next post.

Jamie

Where We Stand

http://www.immortalhumans.com/wp-content/uploads/aging-population.jpg

It is a firm reality that New Zealand's population is aging. The challenge is not in changing this, but adapting to it, as it is already happening as a natural result of changing population demographics. Factors such as declining fertility rates (McDonald & Kippen, 2000), rising life expectancy and the follow on effect of the post war ‘baby boom’ from 1945 – 1963 (Daniels, 1988) all contribute to this change.

The challenge is managing and accommodating the aging population. The New Zealand government has already begun this process, through initiatives such as; the Health of older people strategy, kiwisaver and the recruitment and retention of qualified health workers - including occupational therapists. The aim of these changes enacted by the government is to have a positive and stimulatory effect on New Zealand as a nation, even as the proportion of younger people declines.

To put the aging population in perspective, the New Zealand government has predicted that by the late 2030’s, over 25% of all New Zealanders will be 65 years of age and over, compared with 12% in 2005 (Statistics New Zealand, 2006).

What are the challenges and implications of this for occupational therapy?
Is the profession safe with this change in population demographics?
What will have to change in the profession to adapt to the aging population?

These questions will be explored in further posts.

Jamie

Introduction

Greetings,

My name is Jamie Collier; I am a third year occupational therapy student at Otago Polytechnic in the South Island of New Zealand. I have created this blog to specifically explore the aging population phenomenon and what impact it will have on occupational therapy practice in New Zealand.

Some key areas I plan to discuss in my blog posts (always in regard to occupational therapy) include:

• Cultural safety with the Aging Population
• A possible paradigm change due to the aging population
• Occupational therapy at a community level
• Occupational therapy’s future within New Zealand as the population ages
• The Concept of ‘active aging’

And much more...

So stay tuned and feel free to comment on any posts that strike a chord with you, I welcome and value any opinions or thoughts.

Jamie