Top tips from our panel on how to care better for the elderly
We need to move with the changing health needs of the population: Concerns about the quality of older people in health and social care are not new. What is new is the concern about quality of acute care and the lack of fit between older patients' needs, and the acute model of care that is offered in hospital.
The whole system needs an overhaul: The National Commissioning Board should be providing the right framework of incentives and rewards to ensure that clinical commissioning groups and trusts focus on the needs of the group that represent the majority users of health and social care.
Incentivising staff: Sums as little as £50 to buy something for the ward, such as a smoothie maker, so that staff can make patients appetising drinks goes a very long way. Saying thank you, recognising the contribution staff make as individuals and in teams are all things that make a massive difference to staff who in general do not receive the thanks and acknowledgement they deserve.
The government can help articulate what in broad terms 'good' looks like: This might usefully be reflected in a revamp of the NHS consitution planned for later this year. I think the social care white paper would be missing a trick if it didn't deal with reducing the need for acute care.
Continuity in care: Real dignity is only delivered by meeting the needs of older people all the way through their care journey, including by supporting them to live as independently as possible outside institutional settings.
David Oliver is the national clinical director for older people at the Department of Health
We need to realise that older people are the main users of health and social care: 60% of social care spend is in over 65s. Yet the values, attitudes, skills and systems were arguably developed for a younger, generally healthy population with less complex needs.
Repositioning attitudes: Too often the medial dialogue talks about all older people from 65 to 100 as 'the elderly', as if there are no differences of need or independence or values between them, and talks about care solely in terms of hospitals or long term care.
Moving patients repeatedly is an example of covert ageism: The patients who suffer most from repeated moves are very old very vulnerable people. It increases their risk of acute confusion, is very distressing when they have become familiar with staff, and it also risks problems of communication when patients with very complex needs are moved. Yet when beds are required who is the first to go? Is the articulate younger adult who can kick up a fuss and is relatively easy to nurse?
Tom Gentry works as health policy adviser at Age UK
We need a positive feedback system: The Dignity Commission included a recommendation on 'appreciative inquiry' - focussing on a range of feedback, including positive, rather than waiting for complaints or failures to discover where things are going wrong.
Prevention is the silent 'P' in QIPP: Delivering more cost effective care is a likely outcome from improving continuity of care and shaping services to the needs of older people.
The NHS reflects wider society in terms of being ageist: I recently joined a new trust, and when I told people I worked on one of the hospital's older adult wards, I experienced one of two reactions: complete disinterest or complete distaste. Several nursing colleagues even wrinkled their noses as if I were emitting a bad smell.
Measuring outcomes: In recent trends towards targets, measurement and counting activities much of what matters to staff and patients alike in terms of patient centred care and practice, is largely invisible to others - "everything that counts cannot necessarily be counted".
Empowering ward staff: Nursing staff and others largely come into the profession to care for others, staff start with good intentions so for me supporting staff well to care is paramount. Nurses need support to deliver excellent care.
• You can read the full live discussion online here.
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Read the complete post at http://www.guardian.co.uk/healthcare-network/2012/apr/03/hospitals-and-acute-care-social-care
Apr 03 2012, 06:51 AM
Healthcare Network | guardian.co.uk