Stories of Health. Part I
The World Health Organisation states that “of 56.9 million global deaths in 2016, 40.5 million, or 71%, were due to noncommunicable diseases (NCDs). The four main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases”.
The standard model for conventional medicines is reactive, treating diseases after they arise. There is a call for a new standard of care – personalized, preventive, pre-emptive and participatory medicines, yet this is demanding a huge unprecedented economic spend. Public health is considered a sociological problem. Many noncommunicable diseases (NCDs) are preventable, therefore the social spend addressing this human ailing, while commendable, is basically a waste if the disease could have been prevented in the first place.
The Story of Health: 23rd January 2019.
THE STORY OF HEALTH.
Health is individually determined and complex. What does it mean to be healthy in the context of the ever-changing cycle of life and modern society? When we better understand our ideas about health, what does this mean for the quality of care. Today we focus on the care of the employee in your organization. We focus on the responsibility a supervisor has regarding the quality of care for the employees. We will ask you 4 questions:
At what age did you become aware of health? And why? At the age you are now, what do you know about your health? At the age that you would like to aspire to, what would you like your health to be? What should you do to achieve this state of health?
With the answers to the above questions, we will look at how these can be translated into health goals that lead to a better quality of care for employees. After all, healthy working ensures a better quality of life and less healthcare costs or loss of income! How do you, as a supervisor, keep your organization healthy?
The participants were Dutch Association of Regulators in Care and Welfare (NVTZ) members. The local language was Dutch. The total number of participants was 18. 8 males and 10 females. One person excused themselves from the exercise, stating that they did not feel comfortable to share ‘personal information with a group of strangers’.
Connect to the health of your past & future. Understand what is needed today.
Adopting the principles of ‘Theory U’ we enable individuals to walk their health life.
Taking the time to reflect, to allow the unconscious to come to front of mind. Seeing their understanding of health through fresh eyes. Sense their experiences vs. rationalising the experience. Opening their minds, opening their hearts and accepting commitment for a new health behaviour in their future.
Individuals leave the event with personal health hopefulness and tangible actions that ensure they are successful in meeting their aspirations, and able to articulate the actions they will take to be healthy.
Instructions for the exercise.
All participants are invited to start at 0 and walk to the age they are today. At this point they answer Q1 & Q2.
The participants are invited to walk to an age they aspire to. Once reached they answer Q3
Q4 is an active question answered while walking from their aspirational age back to the age they are today.
Question 1: At what age did you become aware of health? And why?
18 responses | 2 responses provided an age [aged 30 , 40] | 1 response did not provide an age | 15 responses answered the question in full, providing an age and text which contextualised the ‘and why’ part of the question.
Childhood responses [aged 0 – 18yrs] [10 responses]. The connections to health were either relating to the health of another family member (grandparent, or sibling) or own health – unexplained health complaints and injury following accidents (skiing, broken leg)
‘a year long stomach age, everyone thought it was me seeking attention – lucky my mother and doctor didn’t and I ended up having an operation [aged 7years]’
‘limited physical possibilities [aged 8years]’
‘big cut in my upper arm, and needed stitches [aged 4years]’
Adult aged responses [19 + years] [5 responses]. In this group there were two quite distinct sets of responses. Those aged in their mid-twenties connected with their health during pregnancy.
‘pregnant and realising that I am not alone any more, and not responsible for just myself any more [aged 27]’
Those aged 58 – 60 responded that they connected with their health following a medical event.
‘brain haemorrhage [aged 60]’
‘immobility due to knee ligaments, cut off – 6 weeks in a cast [aged 58]
There was one response which spanned both child and adult hood.
‘permanent bronchitis [aged 6years], always sick at the best moments of like … breast cancer so had a feeling that end of life was close (lack of infinity) [aged 55years]
Question 2: At the age you are now, what do you know about your health?
The majority of participants were in 50 – 70 years in age. The answers to this question were reflective in nature and acknowledged their aging years.
‘arthritis, and oedema in my arm – I am feeling that I am getting older. I have limitations’
‘chronic health issues, but I do feel healthy – actually I am not sure I really know a lot about my own health’
‘Ok, would like to have a better, fitter condition, but mental health is really good’
‘A little less fit and realising now at this moment how healthy I always was’
‘To my knowledge, my health at this point is good, by not knowing everything about it’.
Q3: At the age that you would like to die, what would you like your health to be?
None of the participants had considered their health in older age, nor an age they aspire to. As a result for a few this question presented difficulties.
I can’t link to that, I only don’t want to be alone in good health
Quality instead of length, in good acceptable situation physically and mentally
Getting old, but not being old
I don’t have a strive for age. I want to say at the moment I am dying that I did what I did and that I did what I had to do. Being satisfied
While the choosing of an aspirational elderly age could be considered arbitrary, the narrative that accompanied the age was rich. Providing a intimate insight into q quality if life which was very personal to the participants.
physically good, mentally more considering, socially enough friends and nice life environment, economic enough financial options, ecological no attack on nature [aspirational age 90]
talking, listening, having a conversation, having contact – enjoying the beautiful things like food, culture, nature, people, children and grandchildren, reading and art [aspirational age 95]
walking. hiking – being connected and open minded [aspirational age 100 +/- 2]
warmth and love. And its good to go away at the peak of life [aspirational age 70/75]
without compromising on quality [aspirational age 85]
being at the end, expectation and resignation [aspirational age 110]
enjoying the people and the things around me. Seeing hearing connections and contacts. Wish is to be mobile and clearly thinking [aspirational age 90 +/-]
I would like to see and hear well, communicating is extremely important. Next to that I want to be mobile, able to scurry around in my neighbourhood [aspirational age 90]
Q4: What should you do to achieve this state of health?
All participants were able to identify a series of activities [which were in line with their personal lives] which would be a sustainable health behaviour. These behaviours suggested an exercising of the physical or mental.
Staying active, being involved with the developments that interest me. Keeping my mind busy and taking care of the garden
Moving and still keeping interested in the world
Stay busy – physically and mentally
Healthy lifestyle. Food and movement
Less stress, enough sleep
Living consciously and enjoying life
Being a little bit healthier and a quieter life
Invest in relations, friends and family. Movement physically cycling and walking, mentally read and following courses regarding art philosophy, wine and cooking
The coming years, doing things that make me happy and satisfied
Physically keep on moving, mentally keep on learning and developing.
Socially – maintain my network and expand.
Discussion - How does these health insights impact your work?
Following the interactive exercise, the facilitator engaged all participants into a conversation which explored both the experiences of the exercise and how the new personal understanding of health could be applied in their work.
There was an overarching positive reaction to the story of health exercise, the groups had not thought about their future health, and found the exercise to be a ‘great way of looking at health’.
Exploring the personal experiences: Two male participants experienced a very personal connection with the exercise and the relatively recent death of their parents.
· Father has died 1-month ago
· Parents had died within 6-months of each other (aged 60 & 68)
The male participant who’s parents had died in their 60’s gained the realisation during the exercise that his age of death might not automatically follow the pattern of his parents, and that his other relatives had/were living beyond this relatively early age. This provided him with a sense of future, and aspirations which had not existed before participating. He also had a role to play in determining his own health behaviours.
Others were able to identify how this exercise could support different discussions within family life, especially at point of transitions. Recognition of value of exercise in personal situations, in the home setting, with a life coach: example given – participant & husband have a farm and son/daughter in law will be taking over. Questions raised included: how long did she want to remain at the farm / how do you look at each other and how do you want to work together
Exploring the work setting: For many of the participants the exercise was very thought provoking, they saw themselves in the role of ‘health leaders’, but realised that they had not given time to themselves to fully explore their own health.
‘This workshop has really made me think about myself’
‘we have all the knowledge in the house to take care of others, but we do not take care of ourselves – practice what you preach’’.
All participants were keen to explore how they could support their staff teams to become more health focused rather than symptom focused. There was interest to explore new ways to encourage discussion, open questions within the workplace and to assess the care needs of those being cared for. Specific reflection was given to the ‘confrontation of an end date’. This created a greater sense of empathy for the lifecycle stage many people receiving care are in. This is not fully appreciated or understood by those proving care.
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