With the axes of the health career model labelled and the care domains - that fall between - identified, what can we read into and from the health career - care domains - model?
What basics of care and caring can we find there, what assumptions can we jump upon?
Here is a list ... (which also illustrates how the model grows with the learner) :)
- Health, well-being and social care are not declared in the face of the model, this suggests the model is high-level - generic.
- Health care (here) has at least seven disciplinary degrees of freedom:
- Sciences (biology, physics, chemistry)
- Health and social care theory and practices are reductive.
- Health care involves the traversal of space - distance.
- Health and social care has the potential to be depersonalising and alienating.
- Health and social care is simple and complex.
- The environment is inherent within the model in its varied forms.
- There is a moment of imbalance within the INDIVIDUAL - GROUP.
- Context is essential as a means to situate care (co-ordinate in an 'x','y' sense).
- The means is provided to situate the care context in a person-centred way.
- This model provides a template for personal and group reflection (shallow or deep).
- The model is open in terms of the final content, the content as expressed in care approach, philosophy, discipline, description (concepts, problems, priorities, strengths, a 'mash-up') is not dictated.
- In acknowledging the existence and primacy of the individual (located at the top so - must be important), the model provides a (potential) focus and vehicle for individualised, personalised, person-centred care.
- Whilst individualised care is at the center of care theory, practice and management, it cannot be defined purely by virtue of the INDIVIDUAL-group axis and the claim of an associated INTRA-INTERPERSONAL care domain.
- The individual must also be considered as a POLITICAL entity, a citizen, a legal entity that falls under the auspices of human rights. As such the individual is someone who can (or has previously) expressed their choices, wishes as to their health, care, well-being, best interests.
- Being an INDIVIDUAL within the family of humankind - 1 of some 6.x or > 7 billion - this person is unique and deserving of highest quality care, dignity and respect that should be accorded to all people.
- Health and social care whilst organisationally distinct (POLITICAL - POLICY) are to the INDIVIDUAL and carers (GROUP) concurrent, transparent and ideally integrated activities.
- Physical care (SCIENCES) can be, and is, defined in mechanistic terms; for example, time (objective), events, place, outcomes, observations / data (discrete, quantitative).
- Physical care is hence primarily objective.
- Emotional INTERPERSONAL care can be, and is defined in humanistic terms; for example, time (subjective), communication, responses to events (behaviour), feelings, beliefs, relationships (SOCIAL), expectations, fears, observations / data (subjective, qualitative).
- Physical care, emotional care is often mediated through the SOCIAL domain and the group - the family unit.
- Since this model indicates an initial structure and content the model is of potential use as a reflective resource for novice through to expert.
- The model is generic and as such not limited to health and social care.
- Such is the generic nature of the model it can support all learners in lifelong learning.
- The Spiritual is not there: it is ineffable. It is everywhere, everything, every'I' and everynow.
- Time is inherent in several forms within health and social care.
- The economics of health care is infused to all the domains, notably in the first instance to the SCIENCES and SOCIAL domains.
- The economic effects upon the individual in a humanistic sense, may be remote, but is inverse in terms of its impact.
- The model reinforces dualism: mind - body (but cognitively innoculates also).
- In highlighting boundaries, dichotomy, limits the model can stress the need for integration.
- The model suggests an antipodean fracture in relationships*: the patient and clinician (across physical care and mental health) inhabit the Northern hemisphere; while the carer (public), manager and policy maker the Southern.
- Health and social care is grounded in human communication (and that which is mediated).
- 'Sense making' must be a key issue in health and social care.
- Given the scope of the model, technology must be making a major impact across all fields of health and social care.
- The model can simultaneously represent the SOCIO- and the -TECHNICAL.
- A great many (potentially - all) values and standards are inherent in the model.
- This model can be represented using many media.
- This model is open to the Management Consultant's delicacy alphabet soup, i.e. using letters to represent approaches / methods, e.g. 4P's, 4C's.
- Health and social care can also be described holistically.
*Clearly, given the relationships and issues that arise this bears further examination and discussion.
This list is subject to revision - addition.