{"id":7622,"date":"2021-09-24T09:48:08","date_gmt":"2021-09-24T09:48:08","guid":{"rendered":"https:\/\/active-ageing.training\/self-determination-and-duty-of-care\/"},"modified":"2021-09-24T09:48:08","modified_gmt":"2021-09-24T09:48:08","slug":"self-determination-and-duty-of-care","status":"publish","type":"post","link":"https:\/\/active-ageing.training\/es\/self-determination-and-duty-of-care\/","title":{"rendered":"Dilemma between self-determination and duty of care"},"content":{"rendered":"<p style=\"text-align: justify;\">A Swedish report by R&amp;D-S\u00f6dert\u00f6rn suggests that dilemmas may arise between staff and adults with developmental inhibitions, especially when the adult with developmental inhibition eats or drinks too much and at the same time must be supported in his right to self-determination and conduct his own choices (Assadi, 2012).<\/p>\n<p style=\"text-align: justify;\">The R&amp;D-S\u00f6dert\u00f6rn report highlights in particular the conflict between the individual&#8217;s right to self-determination on the one hand and the need for care on the other, which can end in doubt and conflict in practice. The trade-off between trying to influence the actions of the individual while respecting the individual&#8217;s own choices when it comes to diet, alcohol and exercise is often difficult (Assadi, 2012).<\/p>\n<p style=\"text-align: justify;\">In order to meet this dilemma, the R&amp;D-S\u00f6dert\u00f6rn report emphasizes that the employee must support and motivate the individual adult with developmental inhibition, rather than controlling and addressing the individual. A health-promoting care must focus on the individual, so that he or she experiences everyday life and the demands that are made, as manageable, comprehensible and meaningful. If the individual has an experience of coherence, it can lift control, motivation, create a change in behaviour and meet the dilemma between self-determination and duty of care (Assadi, 2012).<\/p>\n<p style=\"text-align: justify;\">Interventions combining diet and physical activity are seen to lead to some improvement in health. At the same time, studies show that support from carers and close relatives, as well as from the health service, is important for people with developmental inhibition to maintain physical activity (Bergstr\u00f6m et al., 2013; Blomqvist&amp;B\u00f6rje, 2015; CFK, 2015).<\/p>\n<ul>\n<li>\n<h4><strong>Body and food<\/strong><\/h4>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Danish and international research shows that people with developmental inhibition have a greater risk of both overweight and underweight than the rest of the population. This is largely due to inappropriate diets that have a negative impact on physical and mental well-being.<img fetchpriority=\"high\" decoding=\"async\" class=\"alignright wp-image-1396\" src=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE3-300x300.jpg\" alt=\"self-determination\" width=\"250\" height=\"250\" srcset=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE3-300x300.jpg 300w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE3-150x150.jpg 150w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE3.jpg 500w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/p>\n<p><a href=\"mailto:vidensportalen@socialstyrelsen.dk\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\"><em>Dorte From <\/em><\/a><em>| National Board of Health<\/em><\/p>\n<p style=\"text-align: justify;\">Overweight and obesity, but also underweight, occur to a greater extent in people with developmental inhibition than in the rest of the population. While in the normal population there are generally 50 per cent who are normal weighted, 27 per cent are normal weighted in the group of citizens with developmental inhibition. Thus, there is a large group of citizens with developmental inhibition who are either overweight or underweight (Region Midtjylland, u.\u00e5.).<\/p>\n<ul>\n<li>\n<h4><strong>Overweight and obesity have consequences for physical and mental well-being<\/strong><\/h4>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">In recent years, several Danish and international studies have identified obesity and overweight as major risk factors in relation to physical health for people with developmental inhibition. Obesity and overweight have an impact on the person&#8217;s physical and mental well-being in everyday life. A consequence of being overweight can be difficulties in performing tasks in everyday life, and this can increase the risk of further loss of function and thus an increased need for care and support. Another consequence may be social isolation. Overweight and obesity also lead in the long term to an increased risk of cardiovascular disease and diabetes (Bergstr\u00f6m et al., 2013; Wall\u00e9n, 2014; Dry rice et al., 2015).<\/p>\n<p style=\"text-align: justify;\"><img decoding=\"async\" class=\"alignleft wp-image-1392\" src=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE2-300x300.jpg\" alt=\"self-determination\" width=\"250\" height=\"250\" srcset=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE2-300x300.jpg 300w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE2-150x150.jpg 150w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE2.jpg 500w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/>Making good dietary choices is about having the right skills to plan, shop for, produce and eat good meals. It&#8217;s also about an understanding of what&#8217;s good diet and why it&#8217;s important to eat healthily. Ultimately, it&#8217;s about being motivated to eat good diets (Dehn et al., 2018).<\/p>\n<p style=\"text-align: justify;\">Due to cognitive impairment, people with developmental impairment often find it difficult to understand and understand the need for healthy eating. Therefore, it is an essential premise of dietary planning that one not only has an eye on the person&#8217;s own resources and competences, but also includes the total resources around the person, including the professional staff responsible for supporting the person (Adolfsson, 2010; Wall\u00e9n, 2014; Dehn et al., 2018; Bergstr\u00f6m et al., 2013).<\/p>\n<ul>\n<li>\n<h4><strong>Self-determination and participation have an impact on dietary choices<\/strong><\/h4>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Danish and international studies have shown that it is important for people with developmental inhibition to eat healthily that they experience self-determination in relation to dietary choices. The motivation to eat healthily increases significantly when the person is supported in making good dietary choices themselves and experiences it is meaningful. That is, the experience of the good meal is individual and therefore must always be customized individually (K\u00f8hler, 2010; Adolfsson et al., 2012; Fures\u00f8 Municipality, 2014; Johansen et al., 2017; S\u00f8rensen&amp; Rasmussen, 2020).<\/p>\n<p style=\"text-align: justify;\">Within a number of years, several Danish and Nordic projects have been carried out with a focus on healthy eating, where a thorough focus has been self-determination and participation. The involvement of citizens&#8217; own resources and mastery has been a common part of the projects, which has had a major impact on the fact that participants with developmental disabilities have experienced meaningfulness and motivation to make healthy dietary choices (Dehn et al., 2018; D\u00f8nnestad&amp;Dale-Western, 2018; CFK, 2015; Bergstr\u00f6m et al., 2013).<\/p>\n<p style=\"text-align: justify;\"><img decoding=\"async\" class=\"alignright wp-image-1388\" src=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE-300x300.jpg\" alt=\"self-determination\" width=\"250\" height=\"250\" srcset=\"https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE-300x300.jpg 300w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE-150x150.jpg 150w, https:\/\/active-ageing.training\/wp-content\/uploads\/2021\/09\/ART3IMAGE.jpg 500w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/>Among other things, the projects have developed models for cooperation between residents and employees in residential areas on purchasing, choosing a diet and making meals. Several of the projects have also developed concrete tools for residents, such as easily accessible cookbooks. Finally, some projects have included joint health education for residents and employees (Dehn et al., 2018; D\u00f8nnestad&amp;Dale-Western, 2018; CFK, 2015; Bergstr\u00f6m et al., 2013).<\/p>\n<p style=\"text-align: justify;\">It is obvious that interventions that combine diet and physical activity provide some improvement in health. The studies also show that support from carers and close relatives as well as health care is important for outcomes (Blomqvist&amp;B\u00f6rje, 2015).<\/p>\n<p><em>In Denmark the National Board of Health and Welfare in Denmark has developed, published and operated a Knowledge <\/em><a href=\"https:\/\/vidensportal.dk\/\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\"><em>portal<\/em><\/a><em> in Social area.<\/em><\/p>\n<p style=\"text-align: center;\"><strong><em>Stay tuned to learn more about the activities of our project!<\/em><\/strong><\/p>\n<p>&nbsp;<\/p>\n<h4><span style=\"color: #0000ff;\">Sources<\/span><\/h4>\n<p><span style=\"color: #0000ff;\">Bergstr\u00f6m H. et al. (2013).\u00a0<em>H\u00e4lsofr\u00e4mjande gruppbostad: Planering, genomf\u00f6rande och utv\u00e4rdering av ett h\u00e4lsofr\u00e4mjande program.<\/em>\u00a0Rapport 2013: 5. Stockholm: Centrum f\u00f6r epidemiologi och samh\u00e4llsmedicin.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Blomqvist, Sven &amp; Rehn, B\u00f6rje (2015).\u00a0<a style=\"color: #0000ff;\" href=\"https:\/\/svemedplus.kib.ki.se\/Default.aspx?Dok_ID=135586\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\">Fysisk aktivitet och h\u00e4lsa f\u00f6r personer med utvecklingsst\u00f6rning.<\/a>\u00a0<em>Fysioterapi<\/em>, (1): 26-31.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">CFK (2015).\u00a0<em>Indflydelse p\u00e5 egen sundhed<\/em>. Aarhus: CFK \u2013 Folkesundhed og Kvalitetsudvikling.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Elnan, I. (2010).\u00a0<a style=\"color: #0000ff;\" href=\"https:\/\/samforsk.no\/Sider\/Publikasjoner\/Idrett-for-alle-Studie-av-funksjonshemmedes-idrettsdeltagelse-og-fysiske-aktivitet.aspx\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\"><em>Idrett for alle? Studie av funksjonshemmedes idrettsdeltagelse og fysiske aktivitet.<\/em><\/a>\u00a0Trondheim: NTNU Samfunnsforskning AS, Senter for Idrettsforskning.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Fures\u00f8 Kommune (2014).<em>\u00a0Slutevaluering af \u2019Sundhedsfremmeprojekt p\u00e5 bosteder for psykisk udviklingsh\u00e6mmede\u2019.<\/em>\u00a0Fures\u00f8 Kommune.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Socialp\u00e6dagogen Online (2014).\u00a0<a style=\"color: #0000ff;\" href=\"https:\/\/socialpaedagogen.sl.dk\/arkiv\/2014\/paedagogisk-motion-det-skal-vaere-sjovt-at-slaa-dovenskaben\/\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\">Det skal v\u00e6re sjovt at sl\u00e5 dovenskab<\/a>.\u00a0<em>Socialp\u00e6dagogen Online,<\/em>\u00a0Vol. 71(20): 14-17.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Sveriges Kommuner och Landsting (2018).\u00a0<a style=\"color: #0000ff;\" href=\"https:\/\/skr.se\/integrationsocialomsorg\/socialomsorg\/funktionshinder\/battrehalsa.24420.html\" target=\"_blank\" rel=\"noopener\" data-schema-attribute=\"\"><em>Hur skapar vi b\u00e4ttre h\u00e4lsa f\u00f6r personer med funktionsneds\u00e4ttning? Beskrivning av oj\u00e4mlikheter idag samt f\u00f6rslag p\u00e5 f\u00f6r\u00e4ndrade arbetss\u00e4tt.<\/em><\/a>Stockholm: Sveriges Kommuner och Landsting.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">S\u00f8rensen, J. et al. (2013).\u00a0<em>Barrierer for lige adgang til det prim\u00e6re sundhedsv\u00e6sen: For personer med en intellektuel eller psykisk funktionsneds\u00e6ttelse.<\/em>\u00a0Taastrup: Danske Handicaporganisationer.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Wall\u00e9n, Eva Flygare (2014).\u00a0<em>Betydelsen av h\u00e4lsomma kost- och motionsvanor hos personer med utvecklingsst\u00f6rning: En sammanst\u00e4llning av\u00a0evidens.<\/em>\u00a0Evidensrapport nr. 5. Stockholm: Habilitering &amp; H\u00e4lsa. Stockholms L\u00e4ns Landsting.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A Swedish report by R&amp;D-S\u00f6dert\u00f6rn suggests that dilemmas may arise between staff and adults with developmental inhibitions, especially when the adult with developmental inhibition eats or drinks too much and at the same time must be supported in his right to self-determination and conduct his own choices (Assadi, 2012). The R&amp;D-S\u00f6dert\u00f6rn report highlights in particular [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":1387,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[38],"tags":[],"class_list":["post-7622","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news-es"],"_links":{"self":[{"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/posts\/7622","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/comments?post=7622"}],"version-history":[{"count":0,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/posts\/7622\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/media\/1387"}],"wp:attachment":[{"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/media?parent=7622"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/categories?post=7622"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/active-ageing.training\/es\/wp-json\/wp\/v2\/tags?post=7622"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}