6.3 Knowledge of the special
Health-promoting Pedagogy In Everyday Culture
The goal of the “Health-Promoting Pedagogy in Everyday Culture Project” is to investigate and learn from the three special institutions’ special educational practices and experiences in creating learning, well-being and development for children and young people with various developmental disabilities. It is about developing experience-based, research-based knowledge about good health-promoting pedagogical practice in the everyday culture of the three institutions. Ultimately, the aim is to promote the well-being and health of children and young people in the special services in the region, by creating a public space for mutual learning and also to strengthen the institutions involved’s own practice and knowledge.
The project can hopefully also contribute to creating a broader research knowledge, as well as generate ideas and debate about the challenges and demands that are given in special educational work in a time when the political focus is on special offers realized through the inclusion of special education in regular day care institutions, schools and leisure facilities. Finally, the special institutions are particularly interesting in that they often work for children and young people’s overall life circumstances and are therefore of interest to other children and young people’s institutions that face challenges in integrating health promotion into their practice.
The project is based on an open concept of health promotion from a humanistic-social science tradition. Many of the special educational schools and institutions have, as will be discussed, associated medical and psychiatric expertise and have to a certain extent drawn on treatment therapeutic knowledge in their social and special educational work. We have therefore seen an obvious opportunity to subscribe to the concepts, analysis tradition and theories of the health promotion tradition as a comprehensive language that offers potential to illuminate the existing form of multi-faceted educational practice in the special services. We have also chosen to develop the settings- or arena-oriented tradition in health promotion, which is often based on external requirements for, for example, a school’s health goals, to let professions in executive practice themselves give shape and precision to what is meant by health promotion in the specific context.
Developmentally disabled people are neglected in terms of health
Developmentally disabled adults have several somatic and mental illnesses, but receive fewer health interventions compared to the general population. This is because many developmentally disabled people can’t judge for themselves whether they should go to the doctor, and in most places of residence the healthcare staff have been replaced by pedagogues. Only every fourth residence has i day nurses employed, shows a new study from the National Association of Municipalities. Subject groups and experts dealing with the developmentally disabled discuss what needs to be done is given the highest weight – the consideration of the citizens’ self-determination or the consideration of their health.
A resident has a habit of always resting her head in her hand while supporting her elbow on the table. She does not express pain,before a pressure ulcer has developed, but the signs of the incipient ulcer have been there for a long time. Another resident complains of pain in the oral cavity, but the diagnosis of throat cancer is made first at a time when treatment is no longer possible.
There is hardly anyone who wants the development turned back to the time when psychological developmentally disabled people lived in large institutions staffed by white-coated doctors and nurses, and where the residents were considered sick.
But today, when in many places only non-health professional staff are employed, health professionals and experts warn that there is a risk that the health of the developmentally disabled will be neglected. Too many people are not able to judge for themselves when they need a doctor or a nurse.
Early Detection Of Citizens With Developmental Disabilities And Dementia
Introduction
This memorandum is a guide for the work with early detection of citizens with functional impairment and dementia.
The guidance has an additional focus on cross-functional collaboration in Social and Handicapdrift (SHD) for this target group. The number of citizens with developmental disabilities and dementia is increasing, it can be a challenge to spot early signs of dementia and ensure the right healthcare and educational support.
People with the functional impairment developmental disability have three to four times the risk of developing dementia, and dementia often begins as early as the age of 40, for citizens with Down syndrome all the way down to the age of 30. At the same time, citizens are living longer than before, which contributes to more people developing dementia and other diseases. The memo was written against the background of the work with Projekt ferfærd – a project that specifically focuses on the early detection of citizens with functional impairment and dementia.
Overall, the ambition is that we in Gentofte Municipality achieve a common understanding and holistic effort in Social and Handicap (SH), internally in SH and across the offers in SHD
We want to support that all professional groups are curious about each other’s skills and bring them into play, as well as contribute to breaking down barriers between professional groups and making the best possible use of everyone’s skills, to the benefit of the individual citizen.
The memo is built around five core areas.
- Tracking and investigation
- Well-being and well-being
- Cooperation with relatives and networks
- Internal cooperation in the municipality
- Cross-sectoral cooperation
Tracking, investigation and the work with well-being are considered the main elements in the work with citizens with developmental disabilities and dementia.
Cooperation with relatives and networks must support the two main elements.
The last core elements of collaboration within the municipality as well as cross-sector collaboration are important for the citizen to be investigated and to be offered relevant and necessary examinations and treatments both in the primary and secondary healthcare system.
The primary thing is that the educational staff adapt their expertise as best as possible to the citizen’s situation and dementia course. For each core area there are a number of principles, these principles are general recommendations for the work.In Gentofte, we have attached a checklist for the principles so that they are translated into daily educational practice. The first step in the work is precisely detection and investigation. Work with this core area is therefore fundamental to the work to ensure the best care for the citizen. The checklist for this core area is therefore the foundation for further work with the other core areas.
Inclusion and participation of vulnerable citizen groups in co-creative arenas.
Preface
In the rate pool agreement for 2015-2018, funds were set aside to support partnerships between civil society organizations and municipalities, which focused on creating increased inclusion and participation of vulnerable groups of citizens in voluntary activities.
Three partnerships received grants from the pool. The three partnerships are INSP! and Roskilde Municipality in Roskilde, Sager der Samler and Aarhus Municipality in Aarhus and Vimby in Hjortshøj near Aarhus and Aarhus Municipality.
The purpose of the partnerships was to strengthen vulnerable citizen groups in taking on new roles and developing from marginalized to equal participants in general voluntary communities.
The three partnerships had ambitions to create activities in collaboration and together with the vulnerable citizen groups rather than for the vulnerable citizen groups and worked in different ways to establish new roles for both the vulnerable citizen groups, other participant groups and professional employees.
In addition, the three partnerships worked with self-evaluation. VIVE and RUC have carried out an evaluation of the three partnerships and at the same time supported the three partnerships’ self-evaluation. The evaluation was carried out in close cooperation with the National Board of Social Affairs and Health and the three partnerships, without which the evaluation could not be carried out.
We thank you for good cooperation throughout the project period. In addition to this evaluation report, a Kort & Klart pamphlet is published with the most important conclusions in the report.
The evaluation has been associated with a follow-up group that has discussed the evaluation process at meetings during the project period. Among other things, the follow-up group has discussed the partnerships’ preliminary results and their work with self-evaluation.
We thank you for many fruitful inputs and qualifications along the way. The members of the follow-up group appear in appendix 1. Two external referees with knowledge of the area have read through the report. We thank you for relevant comments. Vibeke Norman Andersen Head of Research and Analysis for VIVE Management and Management 2018.
