Community health promotion in welfare institutions

Anne Liveng, Heidi Lene Andersen, Charlotte Beck Lau & Jesper Holm.

Center for Health Promotion Research, Roskilde university.

Format of our presentations

• Which challenges, wishes or changes in/for welfare institutions do the project address?

• Our positions as researchers?• What does a health promotion discourse,

practice and idea mean in the specific context? • Focus on community building among staff

and/or “users”.

The concept of health promotion opens:

• A space for articulation of holistic views on working life and everyday life, including staff and “users” – their interactions and relations.

• A space for articulation of experiences from practice.

• A point of connection of “street” and “state”. • An awareness of the potentials and resources

of everyday life – a bottom linked perspective.

Health promotion in home based care for elderly people

Anne Liveng, Center for Health Promotion Research, Roskilde university.

“Citizens with complex problems”• An empirical investigation with focus on vulnerable elderly receiving

municipal home based care, and on how the home based care possibly can support these citizens.

• Citizens with complex problems poses a challenge to home based care – administration and front workers, as they are difficult to help, sometimes resulting in media scandals. Isolation, aggression, alcoholism, psychiatric illnesses and dementia characterize this differentiated group.

• The project applied a grounded, explorative approach, inspired

from reflexive ethnography (Davies 1999), using interviews, observations and field notes.

To be a kind of human being – not a case

• The citizens wished for recognizing relationships: implying to live as one has always done, to be respected as competent in own home, and to be identified through the life one had lived.

• Home based care management invited staff to exchange experiences and a play group acted difficult situations with staff.

• Community was build among staff. Teams discussed and agreed upon a health promoting way of meeting citizens.

Health promotion meant that:

• Mutual agreement led to fewer conflicts with citizens, a feeling of mutual support and a higher satisfaction in work; citizens complained less.

• Users where seen as persons with a life history and resources even if they were scarce.

• Teams worked with “damage reduction” instead of ideals of “curing”.

• NPM ways of organizing time and visits were changed; room for dialog and flexibility created.