Running head: NURSING 153 REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT

ASSIGNMENT

Scholarly Assignment: The Impact of Social Support and Stress as Social

Determinants of Health on the Well-Being of Older Adult Clients at an Elderly
Persons Centre.
Student: Toyin Fakus-Atundaolu
Student No: 8xx xxx xxx
Due Date: May 13, 2014
NURS 153: Practical Nursing Practice 3
Professor:
Humber College (ITAL)

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

Introduction
My Community Service Learning Placement was completed at Villa Colombo Services
for seniors in Toronto as a Friendly Visitor / Activity Assistant Volunteer with the residents.
Villa Colombo is a residence and services facility for seniors of mostly Italian cultural
community. Their weekly day programs include baking, music groups, arts and crafts, exercise
classes, meals on wheels and various outing activities. Volunteers are always needed for
various other activities and services. It is more beneficial if one speaks and understands Italian
language; however, it is not mandatory. As a volunteer, I assisted with walking the clients
around within the premises for fresh air or chatting during their individual programming. I also
assisted in general social events, such as baking, feeding, concerts, arts and crafts, bingo, and
movie time. I helped the Activity department in sorting and posting program activities
schedule for the next day. During various activities and social engagement, I had the benefit of
picking a few Italian words from the elderly clients who speak little or no English other than
Italian. My role as a volunteer is rewarding as my social interactions with the seniors reflect
the practical extensions of my Nursing Theory and Developmental Psychology courses.
The purpose of this assignment is to discuss and analyze how Social support and stress
are the two key social determinants of health factors that can highly impact the well-being of
the seniors in a long term facility. Secondly, using two supporting peer review journals to
support this, I will show how improving social support for and limiting stresses faced by the
seniors at the agency can benefit all stakeholders involved in their care. Thirdly, I will provide
and discuss two available community resources that can support and promote physical,
mental, and spiritual health of the elderly clients in Villa Colombo Services for Seniors.

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

Discussion
Social Support as Determinant of Health Factor in Elderlies of Long-term Care
There is no doubt that social determinants of health have a significant effect on the
susceptibility of individuals or groups to illness and in their recovery from illness (CNA, 2005).
They are the economic and social conditions that influence the health of individuals,
communities and jurisdictions as a whole. Canadian Nurses Association identified social status
and stress as two of the most important social determinants of health and nursing. Thus,
determinants of health are the underlying causes of illness or wellness; which have long been
recognized as being important in Canada.
Social support is a notion that is generally understood by someone as the help or
assistance from other people or group in a difficult life circumstance such as frailty of old age.
It is an individuals belief that one is cared for and loved, respected and valued, and belongs to
a network of communication and shared responsibilities. The support come from caregivers,
family, nonprofit organizations, nurses and inter-professionals involved in maintain wellness
for the seniors. Social support helps seniors cope with their concerns about victimization
(Beaulieu et al., 2008). Thus, if they are victimized, social support helps these frail seniors
avoid some of the problems that characterize post-traumatic stress disorder (Sexton, 2008). In
a study conducted by Chaichanawirote and Higgins (2013), social support was found to play a
crucial role in older adults health, affecting peoples lives through direct and indirect
pathways (Eklund & Hansson, 2007; Low & Molzahn, 2007).
Moreover, there seems to be a strong positive correlation between social support and
quality of life of older adults (Cohen, Gottlieb, & Underwood, 2001). For instance, social

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

support such as emotional support and perceived social support were found to have a positive
influence on older adults quality of life (Hampton, 2004; Kleinpell & Ferrans, 2002). Even from
my personal observations during activities at the Villa Colombo, those that their families and
private hired sitters are present received more social support compared to those who were
there by themselves. A woman was able to advocate on behalf of her father, when she came
to an Espresso and Movie activity to give him support and care; when she had found out that
her father had an unexplained bruise and swelling on his back. She was able to take it up with
the staff and made sure a doctors appointment was booked for him against the next morning,
before she left. Therefore, social support is very important for seniors, especially those living in
long-term care facilities or away from their families. Families and the community should take
care not to make the vulnerable seniors feel abandoned and worthless.

Stress as a Social Determinant of Health Factor in Elderlies of Long-term Care

Stressful experiences are a normal part of daily living. Social and psychological
situations can bring about long-term stress. People age within social and collective
environments, including their living arrangements, facilities and services within their
communities, religious / cultural affiliations, and family and social relationships. According to
psychological surveys, seniors prefer to remain in their homes as long as their physical and
mental conditions allow them to do so (Sabia, 2008). Sabia further wrote that those most likely
to remain in their homes are those with financial resources, large amounts of equity in their
homes, and strong ties to their communities. Those who for one reasons or the other are not
able to stay home or live with families have no choice but to live in alternative residence such
as long-term care facility which means their breaking up with the social ties of familiar

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

surroundings and people. This may further contribute to insecurity, depression, low selfesteem, helplessness, hopelessness, fear of social isolation, and loss of independence as
related to loss of control. Similar to a domino effect, these experiences can have lasting
negative impact on health and well-being, especially on the cardiovascular and immune
systems. Affected seniors experiencing such stressful conditions are likely to be more
vulnerable to illnesses such as infections, diabetes, high-blood pressure, heart attack,
depression and aggression (Wilkinson & Marmot, 2003, CNA 2005 p.3).
In her literature, Melrose (2004) reflected on the reality of relocation stress syndrome
where individuals experience difficulty coping with the process of relocating from a familiar
secure environment to one that is not familiar otherwise known as transfer anxiety in
nursing diagnosis. According to Mallick & Whipple (2000) in Melrose article, dependency,
confusion, anxiety, depression, and withdrawal are the five characteristics of relocation stress
syndrome. Melrose concluded that offering residents and their families choice whenever
possible as well as facilitating communication among the residents, families and staff is critical
and crucial for a smooth or minimal stressful transition.

Two Supporting Community Resources for the Residents/Clients at Villa Colombo

Firstly, Villa Colombo Services for Seniors (1976) through their community services
have an Adult Day Program, where they provide stimulating activities in a culturally sensitive
environment to individuals (over 50) of Italian origin that have been diagnosed with cognitive
impairment due to Alzheimers disease, aging process, and other illnesses or brain injuries.
This will definitely provide social support and reduced stress of being away from love ones and
thereby contribute to their physical, mental and spiritual wellness. Their services include pick-

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

ups, meals, spiritual enrichment (Catholic), hairdressing, and visiting Chiropodist. They are
located at 26-2201 Finch Avenue West, Toronto, ON M9M 2Y9. They can be contacted at (416)
7466247 for fees and registration.
Secondly, Villa Colombo has another community services for their residents known as
Elderly Persons Centre, which is designed to support seniors over 55 years old living in the
community. Similar to the above program, they offer recreational activities, educational
services, exercise classes, outings, and spiritual enrichment such as counseling and daily mass.
There is an annual fee involved and this can be obtained by calling (416) 780-0407 or at 40
Playfair Avenue, Toronto ON M6B 2P9. The other part of this service is Frail Elderly Centre,
which is created for seniors living in the community who are isolated at home due to illness,
stroke, frailty or neuromuscular impairment. These clients can also enjoy a supervised social
environment by participating in the Frail Elderly Centre Day Program.

Conclusion
In summary, this write up reflect my rewarding volunteer opportunity at Villa
Colombo, where during their various social activities and programs, I was able to apply my
empathic behavior from my Nursing Theory Courses in serving the elderly clients.
Through interaction with the senior clients, I was able to see that social support and stress
are the two important determinants of health factors that can impact the overall health of
the clients if not checked through family involvement and communication among the
client, family, and caregivers. Finally, two of the many services provided by the Villa
Colombo community programs to support resident and clients in the community include
Adult Day Service and Elderly Persons Centre.

NURSING 153: REFLECTIVE PRACTICE THROUGH A COMMUNITY ASSESSMENT ASSIGNMENT

References
Canadian Nurses Association (2005, October). Social Determinants of Health and Nursing: A
summary of the Issues. Retrieved 12, 2014, from http://www.cnaaiic.ca/sitecore%20modules/web/~/media/cna/page%20content/pdf%20fr/2013/09/05/19
/20/bg8_social_determinants_e.pdf
Chaichanawirote, Uraiwan,PhD., R.N., & Higgins, Patricia A, PhD,R.N., F.G.S.A. (2013). The
complexity of older adults' social support networks. Research in Gerontological
Nursing, 6(4), 275-282. doi:http://dx.doi.org/10.3928/19404921-20130805-01
Dong, X. Q., Chen, R. J., Chang, E., & Simon, M. (2012). Elder abuse and psychological wellbeing: A systematic review and implications for research and policy - a mini review.
Gerontology, 2013(59), 132-142. doi: 10.1159/000341652
LO3 Social Contexts of Aging. (2012). In Spencer Rathus & Shauna Longmuir., HDEV,
Canadian ed., (pp. 338-342). Belmont, CA: Wadsworth. Retrieved May 11, 2014 ,
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ebe897:4e585d64:12dbe802029:-4ca5&eISBN=9780176616052
Melrose, S. (2004). Reducing relocation stress syndrome in long term care facilities. Journal of
Practical Nursing, 54(4), 15-7. Retrieved from
http://search.proquest.com/docview/228071687?accountid=11530
Natan, M. B., Lowenstein, A., & Eisikovits, Z. (2010). Psycho-social factors affecting elders'
maltreatment in long-term care facilities. International Nursing Review, (57), 113-120.
Villa Charities - Villa Colombo Services for Seniors. (n.d.). Retrieved 12, 2014, from
http://villacharities.com/main.asp?View=ColomboA