Level One Making Every Contact Count for Wellbeing (integrated care)

This simple course will help you to Make Every Contact Count for wellbeing.

This means making the most of everyday opportunities to have conversations with people whom you meet in order to raise awareness of issues that can impact on their health and wellbeing, and to encourage and support the person to make changes that will enhance their wellbeing. 

BE WISE FOR WELLBEING: LEVEL ONE mecc

INTRODUCTION

Welcome to Be WISE for Wellbeing: Level One MECC

We are all working harder to offer integrated care to our patients and clients. 

For health, care and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carer and family. 

It means moving towards a more holistic approach to health, care and support needs, that puts the needs and experience of people at the heart of the care and support that we provide.

There is no doubt that having a sense of wellbeing is helpful for people, whatever their medical or social conditions

This course is for all frontline staff, wherever you work.It's all about the little things that you can do or say that might improve the person's wellbeing

It will help you to recognise everyday opportunities to encourage people to improve their wellbeing.

WHY IT'S IMPORTANT TO MAKE EVERY CONTACT COUNT FOR WELLBEING

WELCOME TO BE WISE FOR WELLBEING

USE THIS BRIEF COURSE ALONGSIDE YOUR WORKBOOK TO DISCOVER HOW TO BE WISE FOR WELLBEING

WELLBEING


WELLBEING MATTERS!

Wellbeing matters. Wellbeing is about feeling good and functioning well; about flourishing in your life whatever your circumstances. Focusing on wellbeing is important as it can strengthen individuals and communities (DH 2014). Here are some of the benefits of wellbeing:

  • Wellbeing adds years to life and life to years
  • Aids recovery from illness: poor wellbeing is associated with slower wound healing
  • Is associated with positive outcomes: people with good wellbeing are more likely to have a healthy diet, be physically active and less likely to smoke
  • Young people with high levels of wellbeing are less likely to engage in unhealthy or risk-taking behaviours
  • Spreads through social pathways and Influences the wellbeing of others close to us
  • May ultimately reduce the health and social care burden
  • Is associated with broader positive outcomes such as employment, education and relationships


WELLBEING MATTERS!

Wellbeing is a resource that supports us throughout our life journey

HEALTH AND WELLBEING

HEALTH IS IMPORTANT FOR WELLBEING

People are living longer nowadays than ever before, but not necessarily living longer with good health.

The top 5 “killer conditions” in the UK today which lead to premature mortality are:

  • Coronary Heart Disease
  • Stroke
  • Respiratory Diseases
  • Cancers
  • Liver Disease

We also know that Dementia is the number one cause of death today

Health behaviours (whether or not we smoke, eat a healthy, balanced diet, keep physically active, drink alcohol and cope well with stress) all impact on the risk of people developing these killer conditions.

Multimorbidity (having two or more chronic health conditions) is common as people are living longer but not necessarily living with good health.

Multimorbidity is found more frequently in people from less affluent areas. A recent study found that 2/3 of people aged 65 and over had multimorbidity, and 47% had 3 or more conditions. About 10% of people over 65 with multimorbidity also have frailty, rising to between 25-50% of people over 85.

Multimorbidity is important because it is associated with

-poorer quality of life

-polypharmacy (use of many medications)which in itself may cause unpleasant side effects

-higher rates of adverse reactions to medications

-higher rates of unplanned and emergency care

Older people living with frailty are at risk of adverse outcomes to their physical and mental wellbeing after relatively minor events which challenge their body systems eg an infection or new medication

Unhealthy lifestyle behaviours are closely linked to mental health too. Drinking too much alcohol can affect a person’s mood and sleeping patterns; when people feel under pressure they may use smoking, sugary snacks or alcohol as coping mechanisms. 

It’s a complicated picture, but we do know that lifestyle behaviours have a big impact on health and wellbeing.

WHAT CAN WE DO?

Well, we can Make Every Contact Count. This means that we can look for opportunities to encourage people to make some simple but significant changes in their lifestyles can have a big impact on health. Quitting smoking, for example, is still the most important thing that a person can do to improve their health. Keeping active every day can help people to have better health and to feel better too. 

Even if the person already has a medical condition, such as type 2 diabetes or coronary heart disease, then adopting a healthier lifestyle can make a big difference to how well the person recovers and how they manage their health into the future.

We can also Make Every Contact Count by encouraging people to make friends and meet up with other people, to join in activities locally, to keep themselves and their homes safe and secure, and to have more of a say in decisions that affect their health and wellbeing. 



WHAT IMPACT DO LIFESTYLE BEHAVIOURS HAVE ON WELLBEING?

  • No impact at all
  • They can increase the risk of coronary heart disease, stroke, respiratory diseases, liver disease and some cancers
  • They only impact on physical health and are not important for wellbeing

5 KEY THEMES THAT ARE IMPORTANT FOR WELLBEING

Wellbeing is NOT just about health

Here are 5 key themes that are important for wellbeing

Encourage your client /patient to have contact with people on a regular basis - it is important for wellbeing

Encourage them to participate in local events and activities - perhaps they can get involved in a local group, join a club or become a helper or a volunteer themselves?

Help the person to consider their safety and security - are they living in a warm home? Do they have a working smoke alarm? Are they vulnerable if they go outside? Can they afford to eat and pay their rent?

Encourage the person to be more independent and to take an interest in their health and wellbeing

First though - think about how these 5 key themes are important for your own wellbeing

WELLBEING

What about your wellbeing?

What does wellbeing mean to you?

Write down in your workbook the things that you feel are important for your wellbeing

YOUR WELLBEING

WELLBEING IS IMPORTANT FOR ALL OF US

What could you do differently that would improve your welllbeing?

Write any ideas that you have in your workbook

WHAT ARE THE 5 KEY THEMES THAT AFFECT WELLBEING?

  • health, education, living environment, language, family
  • health, independence, genetics, number of children, home environment
  • health, relationships, participation, security, independence

WHOSE ROLE IS IT TO MAKE EVERY CONTACT COUNT?


"WHY SHOULD I MAKE EVERY CONTACT COUNT?"

Sometimes people are not sure that it is their role to make every contact count.

Here are some frequently asked questions;

  • I’m not sure it’s my job. Shouldn’t I be a health expert to do this?

If you have contact with people on a regular basis then you can make every contact count. You will simply be raising the issue of wellbeing, being encouraging and supportive of change and signposting to further sources of information and advice. You don’t need any specialist knowledge at all about health issues.

  • I don’t have the time to do this – surely someone else who spends more time chatting with people could do it instead?

You can make every contact count in less than a minute.

  • People don’t come to me for health advice- surely they will get annoyed if I start asking questions about their lifestyle?

You will be shown how to have a conversation that minimises resistance – and if you do meet resistance you can just move out of the conversation gently and onto something else. You will find examples of how to do this in this toolkit.

If you think about the values in your organisation and in your role, you will probably find values such as

CARING

SUPPORTIVE

ENABLING

HELPFUL

All making every contact count does is help you to look for suitable opportunities where you can demonstrate those values in action


WHO CAN MAKE EVERY CONTACT COUNT FOR WELLBEING?

  • Health and social care service staff only
  • Everybody who meets the public
  • Professionals who are experts in health issues

KEY MESSAGES FOR WELLBEING AND INTEGRATED CARE

KEY MESSAGES

"When you are living with a long-term condition it's really important to look after yourself - keep warm, eat well and keep active - all these things can make a difference to how well you feel and how well you cope"

"Small changes can make a big difference - just think about being a little more active every day for instance - that can help you be well and feel well too"

"It's never to late to improve your wellbeing"

"Be active every day. Have a short walk, do some gardening or housework to keep yourself fit and flexible. If you are finding it difficult to take a walk then do some simple flexibility exercises wherever you are"

"Get your health checked. If you have been invited to a health check or a cancer screening check, then do make sure that you go. The earlier any medical condition is identified the better the chance of treatment being effective"

"Carers need to care for themselves too! If you are caring for someone else please don't neglect your own health and wellbeing. Take time to look after yourself - it will help both of you in the long run"



BE WISE FOR WELLBEING

W= THINK WELLBEING

W = THINK WELLBEING AND SET THE SCENE

Here are some ways that you can set the scene to make every contact count. 

Put up posters about the ONE YOU campaign 

Put out leaflets about current campaigns and services to support people to change 

Put up a poster that says “Your wellbeing is important to us. Don’t be surprised if we ask you about your wellbeing……” 

 Put up a poster that says “Whatever your reason for coming here today, if you need information or signposting to other services to improve your wellbeing, then It’s OK to ASK” 

Wear a badge that says “Ask me about Wellbeing”

Just be aware and be on the look out for opportunities to have a quick chat about wellbeing


Always THINK WELLBEING

I = IDENTIFY OPPORTUNITIES TO MAKE EVERY CONTACT COUNT FOR WELLBEING

I= IDENTIFY SUITABLE OPPORTUNITIES TO HAVE A BRIEF CHAT ABOUT WELLBEING

I = IDENTIFY SUITABLE OPPORTUNITIES 

MENTION NATIONAL or LOCAL CAMPAIGNS

 “I don’t know if you are aware of the Physical Activity Awareness campaign that’s on at the moment…..? "

"You may have seen the Be Clear on Cancer campaign on TV. We want to encourage everyone who visits us to take up opportunities to have their cancer screening checks. Can I just check that you have received your invitation for bowel screening....? 

“There is a campaign on at the moment to make everyone aware of how to reduce the risk of accidents and injuries at home. Because of the link with smoking and house fires, we are asking everyone whether someone in their household smokes…...do you or anybody who lives in your home smoke?” 

 SAY SOMETHING ABOUT WELLBEING THAT IS PERTINENT TO THE PERSON

 “I know that you have just come out of hospital, and it’s important that you keep physically active now that you are recovering. May I just ask how active you are at the moment?”  

MENTION SOMETHING PERTINENT THAT YOU HAVE OBSERVED

 “I noticed that you were having a look at our healthy eating booklets – is that something you are interested to know more about?” 

“You seem to still have that chesty cough. May I ask if you are still smoking?”  The important thing about ASK is that you use a “light touch” If the person isn’t interested, then you can move away from the subject at once.

LISTEN OUT FOR THINGS PEOPLE MENTION THAT MAY BE A "DOOR OPENER" TO A BRIEF CHAT

Sometimes the other person says something that can lead into you making every contact count. They may mention that they would like to lose weight or quit smoking. Or maybe they mention that they have been feeling lonely or isolated recently







OPPORTUNITIES

What opportunities have you had to make every contact count?

Write in your workbook any recent opportunities that you can think of

COMMUNICATE WELL

THINK ABOUT THE SIGNALS YOU ARE GIVING OUT

Sometimes frontline staff are worried that if they mention wellbeing they may cause offence or the person may be annoyed with them for raising a sensitive subject.

If you ask from a position of genuine caring and interest, usually the conversation will go fine. it is important that you reflect on your communication skills though.

Are you sending out signals that you are approachable and interested in what the person needs? 

SMILE, and have OPEN BODY LANGUAGE. This means having your arms uncrossed, keeping good eye contact and giving all your attention to the other person.

Think about how you phrase your questions. Are you being sensitive? Are you asking OPEN QUESTIONS (these are questions that don't get a Yes or No answer eg "How are you feeling?" "How active are you at the moment?" )

Using good communication skills, even in a brief chat, can lower resistance 

WHICH ARE APPROPRIATE CONVERSATION STARTERS?

  • "Well you are looking a bit grumpy today I must say!"
  • "Now that you are at home recovering, it is important to keep as active as possible. Can I have a quick chat about the sorts of thing that you can do at home to keep active?"
  • "We are asking everyone who visits our centre if they are interested in improving wellbeing - have you got a moment?"
  • " I can see that you smoke - you simply must quit"
there are 2 correct answers

LOOK AND LISTEN

Look out and listen out for suitable "door openers" to an opportunity for a brief chat about wellbeing

Write some opportunities that you have in your everyday role to make every contact count

S =SAY SOMETHING INTERESTING AND USEFUL

S = SAY SOMETHING INTERESTING AND USEFUL

Making Every Contact Count isn’t about telling people what to do. Rather it is about giving information that may be interesting and useful to the person. We give information in a neutral manner then invite the person to consider what it might mean for them. Here you will find the current recommendations for healthy lifestyles (interesting!) and some top tips for how people can actually use these recommendations in their everyday lives (useful!)

BE ACTIVE EVERY DAY

INTERESTING:  Did you know that we should all try to be active for about 30 minutes on at least 5 days in the week?”

USEFUL: “You can do activity in 10 minutes chunks instead of all at once. Anything that takes a bit of effort and makes you breathe a little faster will count. Things like having a brisk walk, or doing some gardening or even some housework will all do. What do you think about this?” 

QUIT SMOKING

INTERESTING: “ There's no safe level of smoking, so it's always best to quit completely. It’s never too late to quit smoking - whatever your age or medical condition, there will be benefits to your health"

USEFUL: “The best way to successfully quit smoking is through a combination of treatment and support from Stop Smoking Services. I have the number if you are interested”

You can see from these examples how brief the conversation can be. And yet we have still managed to say something interesting and useful to help the person consider what action, if any, they would like to take. You will find many examples of INTERESTING and USEFUL statements in the next few pages 



    




 

PHYSICAL ACTIVITY

- interesting

Adults should aim to be active every day and avoid sitting down for too long

Aim to be moderately active for at least 150 minutes a week (or 30 minutes X 5 each week)

-useful

By moderate activity we mean anything that takes a bit of effort and makes your heart beat a little faster and your breathing to be a little quicker.

Do a mixture of activities that are good for cardiovascular health - eg  brisk walking or swimming

-for strength eg lifting shopping baskets or digging in the garden

-and for flexibility eg yoga or Tai Chi

-You can do your 30 minutes a day in 10 minute chunks




PHYSICAL ACTIVITY

BE ACTIVE EVERY DAY!

Being active is one of the best things you can do t improve your health and wellbeing

It's great for your cardiovascular health, your bone health, your flexibility and pain relief

It doesn't matter how old you are - be more active every day and start to feel great


HEALTHY EATING

 -interesting

Aim to have a balanced diet. A Mediterranean -style diet is good, with plenty of fresh fish and fresh vegetables. 

Aim to eat 5 portions of fruit and vegetables a day.

Limit salt to a maximum of 6gms/day

Eat less sugar

Have more fibre in your diet

Watch out for portion sizes

-useful

Have lots of different coloured foods on your plate. vegetables and fruit can be fresh, frozen or tinned.

A portion size is the amount of food that will fit into your palm

6gms is about a teaspoon of salt. But be aware that a lot of salt is already in food!

Watch out for the sugar content in drinks and in "low-fat" foods

Have a look at the Eat Well Plate to get an idea of portion sizes




HEALTHY EATING

HEALTHY EATING

Having a balanced diet is good for health and wellbeing

QUITTING SMOKING

 -interesting

Quitting smoking is still one of the most important things that you can do to improve your health and wellbeing

Have a smoke free home and car to protect not just yourself but other people too

-useful

You are much more likely to successfully quit smoking with a combination of treatment (using pharmacotherapy to help you to cope with nicotine cravings) and support from Stop Smoking services

Many people are now using E Cigarettes to quit. It is much safer than continuing to smoke, though getting support from Stop Smoking Services will still increase the chances of quitting for good

QUITTING SMOKING

HAVE A SMOKE FREE HOME AND CAR

Smoking can affect the people who live or work with us as well as ourselves. If you can't quit right away, then have a smoke free home and car to reduce the risk to others

ALCOHOL

-interesting

There is no such thing as safe drinking - only LOW RISK drinking

Low risk drinking means drinking no more than 14 units /week if you are a man or a woman

Spread your drinking out over the week and have at least 2 alcohol free days each week too

If you are pregnant do not drink alcohol at all

You should also check with your GP if it is safe to drink alcohol if you are taking medication


-useful

The amount of units in any one drink depends on the SIZE of the glass, can or bottle and the STRENGTH (alcohol by volume) of the drink

A half pint of 3.5% beer, cider or lager is one unit

A small (125ml) glass of wine (8% abv) is one unit

A 25ml measure of spirits (40% abv) is one unit

ALCOHOL

ALCOHOL

Encourage people to keep a simple drink diary

There are some great Alcohol Apps which are freely available

Drink Less App is a good place to start

5 WAYS TO WELLBEING

 - interesting

The New Economics Foundation identified 5 ways to wellbeing that are easy to remember

Connect - meet other people on a regular basis

Learn - keep your mind active- read a book, do a crossword or play chess

Active - keep physically active every day

Notice - take notice of the natural world around you. Smell some flowers. Take a stroll in the park and forget your worries

Give - give something back to others eg a smile, or maybe you could become a volunteer

-useful

Help people to weave the 5 ways to wellbeing into their everyday activities

CLANG! is a useful acronym to help you to remember the 5 ways to wellbeing

5 WAYS TO WELLBEING

SIMPLE CHANGES CAN MAKE A BIG DIFFERENCE

What can YOU do take the 5 ways to wellbeing?

WHAT KEY MESSAGES CAN YOU GIVE ABOUT IMPROVING WELLBEING?

  • Carry on smoking but try to cut down a bit
  • Quit smoking completely and have a smoke free home and car
  • Aim to be active on 2 days each week
  • Aim to be active for at least 150 minutes each week
  • Take the 5 ways to wellbeing
  • It's safe to drink alcohol as long as you don't get drunk
  • Wellbeing is a resource for life
  • It's never too late to improve wellbeing
there are 5 correct answers

REMEMBER THAT WELLBEING IS MORE THAN PHYSICAL AND MENTAL HEALTH

RELATIONSHIPS

The quality of relationships is important. Do they have opportunities to meet with friends and family? Maybe the person can't physically meet friends and family easily - but can they learn to SKYPE?

PARTICIPATION

Can the person become more involved in local community activities?  Are they interested in joining a local group - eg to learn gardening skills, to join a choir, go to a Tea Dance? Do they need transport?  Or just a friendly helping hand?


SECURITY

Does the person have a safe place to live?  The local fire service and police will offer home security checks 

Do they need support to be financially more secure? Do they need to access support to claim benefits?

INDEPENDENCE

Does the person feel that they have a say in their care? Do they need more support to be as independent as possible? maybe writing down a list of questions to ask their GP is a good start.


HOW CAN YOU HELP? 

DO YOU KNOW HOW TO CONTACT LOCAL SERVICES?

HEALTH RELATIONSHIPS PARTICIPATION SECURITY INDEPENDENCE

Whatever your reason for meeting the person - always think WELLBEING

A brief supportive chat and signposting to further help can make a real difference

E = ENCOURAGE THE PERSON TO ACCESS FURTHER INFORMATION AND SUPPORT IF THEY ARE INTERESTED

E = ENCOURAGE THE PERSON TO ACCESS FURTHER INFORMATION AND SUPPORT 

Signpost the person to trusted sources of information and support.

NHS CHOICES

ONE YOU

CHANGE4LIFE

LOCAL SERVICES

Not everyone will need or want to be signposted to a service, but they may appreciate knowing where they can access some on-line information and support.

So tell them about APPS such as 

Five Ways to Wellbeing

Drink Less

Smoke Free

It’s about being encouraging and supportive of them thinking about change

“It’s great that you are thinking about quitting smoking. I know a lot of people who find the SMOKEFREE APP a great place to start.” 

SIGNPOSTING

MAKE A LIST OF LOCAL SERVICES

It's important that you signpost to trusted sources of information and support

Make a list of local services in your workbook

Sometimes people prefer to take some initial steps themselves - can you signpost to a website or App for further information and support? 

WHAT IS WELLBEING?

  • Wellbeing is a resource for life that has many facets including health, relationships and participating in activities
  • Wellbeing is just about how healthy a person feels
  • Wellbeing is just a state of mental health
  • Wellbeing can add years to your life and life to your years
  • Anyone can make a contact count for wellbeing - by raising the issue, being encouraging and supportive, and signposting to further information and support
  • You have to be an expert in health to have a chat about wellbeing
There are 3 correct answers

THANK YOU FOR MAKING EVERY CONTACT COUNT

AND FOR MAKING A REAL DIFFERENCE!