The way people in general are brought up and supported has an impact on the choices they make and how they interact. Social motivation can impact patients with dementia in both positive and negative ways.
Macro-sociology looks at the bigger picture of society at all levels and collects data to analyse similarities and differences between societies. In this context Ha et al. (2019) mentioned that, macro sociological factors pose potential impact on t overall behaviour, thoughts, perception, mentality, ideas, performances and assumption dementia patient. Dementia is a psychological illness, in which people is devoid of proper brain function. Macro sociological factors are considered to play important roles in influencing the physical, mental and emotional behaviour of dementia patients. It is evident from recent report that, dement can be linked with the adverse macro sociological condition such as unemployment, racial discrimination, bullying in school life, lack of proper social support, poverty,, marginalisation, war, social violence, tormented, lack of proper governmental and demographic support, lack of proper parental support and poor education. It has been stated in many studies that, people who has experienced the adverse macro sociological situation and factors are more vulnerable to dementia than the people who are exposed in this adverse sociological condition. On the contrary Warner et al. (2018) argued that sometimes it is I seen that, people with dementia do not have any connection with experiences of adverse sociological condition. Although there are many criticisms as well as argument regarding the link if dementia with adverse macro sociological factors, it is acknowledged by many educationists and researcher that, lack of proper macro sociological support such as unemployment, lack of proper schooling, poor education, poo governmental and demographic advantages and poos social support leads to negative impact on the overall mental and emotional wellbeing of people which can be the potential reason behind development of dementia (Giddens, 2013).
The meso level acts as an intermediary between macro and micro levels. In health and social care these are institutions like nursing homes, community centres, and day care centres. It also includes multi-disciplinary teams as well as family members to deliver holistic care to dementia patients. Giddens states that “meso is a place where practical research in health and social care occurs as well as delivering in regard to care” (Giddens, 2013).
Micro-sociology applies multi-disciplinary teams from the meso level to individuals' needs. Different professionals each deliver specific integrated care to dementia patients on a one-to-one basis. These are nurses, social workers, mental health practitioners, pharmacists, community, all looking after the patient’s needs. They look at risks and draw up a care plan that suits the patient, because dementia as an illness is individualised. This proactive care will focus on holistic care that promotes independence to the dementia patient and observes their behaviour. According to Giddens, “it is important for health and social care to take place in the community observing the interrelate macro and micro level of society” (Giddens, 2013).
Bio-medical is a model of care practiced by doctors and health professionals. Where the social model tries to prevent the problem, bio-medical is associated with diagnosis and cure as well as treatment of dementia suffers. Bio-medical focuses on the health system, whereas the social model is a framework that makes a difference to dementia patients by addressing socio-economic factors. It includes a wider range of people. “Placebo therapy has been proven by a wider range of studies to provide relief to huge range of conditions” (Parliamentary, 2020).
Parson was the functionalist sociologist who had introduced the sociological concept of health and illness with discussing the ‘sick role’. Based on this concept sick person represent the social deviance that make them unable to perform any social activities (Dorland et al. 2016). It is roles of the health professionals in the society to provide proper healthcare, physical and mental support to these sick people, in promoting their health and wellbeing. By using Parson’s Theory in case of dementia patient it can be stated that, although biological factor is linked to occurrence of this mental illness, there is also social influences that leads to development of dementia in people. Additionally, by using this theory it can be stated that, as dementia patients can be defined as sick individuals in society, they need proper assistance from health professionals to improve their overall physical and mental wellbeing (Werner, 2020).
Health inequality is caused by macro environments connected with conflict. This contributed to more deaths, due to lack of education, poor environment, over-population, gender and race (Black, 1980).
Dementia patients were seen as being troublesome due to a doctor-patient conflict of interest. The relationship between doctor and patient is hard to comprehend mentally, making doctors look like they do not have enough skills to deal with dementia. Society, family members and other professionals were also facing problems interacting with them (Werner, 2020). According to Marxism “those in power and physicians have authority over sick people, and the poor, but this does not include patients with low income”( Simon, 2016).
Symbolic interaction emphasises illness as social construction instead of a medical condition. Dementia carries stigma and negative labelling such as drama queen or lazy Society and families do not always take dementia seriously. They often dismiss it as incompetence, stupidity or attention seeking. Dementia can be fatal; this is why family and society need to be educated to change the way they think and to act positively towards dementia patients. According to Mental Health Act (1983), “people with mental illness should be assessed, treated and given rights just like everybody else” (NHS, 2019).
By improving the support from micro sociological factors such as community nurse, health staffs, healthcare professions, midwives and doctors, it is important to provide the compassionate and comprehensive care to dementia patients which is important for meeting their complex as well as critical needs. with maintaining strong connection of patient with dementia with micro sociological aspects such as health and social care workers, health professionals, nurse and doctors it is possible to determine the actual needs of dementia patients that health professionals to meet these needs accordingly (Warner et al. 2018). through promoting the Holistic and Medical model of Health into practices, healthcare professionals can provide proper physical, mental and emotional support to patients which not only promote their health and wellbeing but also improves their self-confidences (Mayo clinic staff, 2018).
Lack of a care plan can be fatal. It can also make dementia patients live in fear due to not being able to control their lives like they used to, such as planning, interacting with family members or driving. Confusion will lead to planning problems, isolation and a risk of being bullied. According to Rowe (2013) “Without a care plan people will not receive the right care”.
Lack of support network poses adverse impact on promoting proper health and wellbeing of dementia patients. If the dementia patient has poor connection with support groups such as ward befriender, health staffs and midwives it will create constraints not only for health professionals in terms of determining actual health needs of dementia patients but also for patients to have proper mental, physical and emotional support from health staffs and health professionals. For example, poor communication and lack of proper interaction with doctors and nurse in dementia ward can make patients unable to share their issues with health professionals that reduce the chances of providing high quality service to these patients. in addition to this, if there is lack of friendly relation between patients and health staffs it will effect on the way of service delivery process in which the care service that is delivered to the patients may be irrelevant and inappropriate to patient’s health needs.
From the above-mentioned discussion it can be concluded that, meso, macro and micro sociological factors have strong relation with behaviour, activities, perception, assumption and perception of people. from this study it can also be concluded that, in case of providing better treatment and care to dementia patients health professionals needs to focus on improving social factors surrounding patients rather than only focusing on improving biological aspects. In this context, health professionals need to assure that dementia patients would have proper job security, good health education, proper social support, strong family and social support, proper housing and nutrition. Meso, micro and macro provide a framework for patient interaction and addressing inequalities. Care planning reduces the cost of, and time spent on individual care. Social networks help people with dementia and give them more control, more choices and flexibility. Micro-sociology takes the service to the home or to the social environment in order to minimise unnecessary hospital admissions. According to Corrigan “stigma spoils individual’s identity and robs social opportunities. Everyone has got a right to live safe and free from abuse as well as neglect” (Corrigan, 2014).
Ha, J.H., Hougham, G.W. and Meltzer, D.O., 2019. Risk of Social Isolation among Older Patients: What Factors Affect the Availability of Family, Friends, and Neighbors upon Hospitalization?. Clinical gerontologist, 42(1), pp.60-69.
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