1. CARING FOR OLDER PEOPLE IN THE COMMUNITY Carolyn Gibbon and Alison Cochrane Chapter 25

2. Introduction This presentation will guide you through some of the main issues surrounding care of the older person. You can work through the questions in your learning groups, and refer back to the scenario of in the printed chapter to support your investigations,

3. Older People Q. How do you define old age? Q. What do the words elderly and frail mean to you? Discuss your answers in your learning groups

4. Currently there are 60.2 million people in the United Kingdom, of whom 5.5% were aged over 85 years in 2003 and projected to be 7.9% by 2031: www.statistics.gov Q. What are the trends in population in your area? Q. What are the implications for caring for older people? Care of the Older Person

5. Ageing Q. How and why do our bodies alter with age? Q. How might this affect the individual psychologically? What should you be aware of as a practitioner? In particular you might like to focus on issues such as dementia and depression

6. Social Service provision is vast and may vary from area to area. Q. What kinds of social services are available? Currently there is a great deal of discussion about funding social care and who will be eligible, and the Government’s policy on this continues to evolve. Q. Who currently funds the social care in your area? What are the issues surrounding this? Q. What role do voluntary agencies play? Social Services

7. Interprofessional Working A number of health care and social services practitioners can be involved in care of the older person. It is important that their activities are coordinated so that there is no disparity or duplication in the services provided. This type of working is known under a number of different names, such as multidisciplinary, interprofessional and interagency working. Barrett, Sellman and Thomas (2005) state that ‘the prefix multi tends to indicate the involvement of personnel from different professions, disciplines or agencies, but does not necessarily imply collaboration. The prefix inter tends to imply collaboration’ (p10).

8. Q. Who might be involved in the care of an older person in a community setting? Q. Which health care professional takes the lead role and why? You might like to refer back to the case study of Vera in the printed chapter, and draw a flow chart to illustrate how her care progressed

9. Assessment Q. What is the CAPE assessment? Q. What is the Single Assessment Process for Older People ( (SAP)? Q. Can you identify particular strengths of either approach?

10. Care Planning Q. Who should you consult when planning care for an older person? Q. What is a care pathway? Identify care pathways for your practice area and make notes on what is involved.

11. Drugs and the Older Person Q. What effect does ageing have on the ways in which drugs are metabolised by the body? Q. How might this affect care?

12. Working with the Older Person Professional behaviour is governed by Codes of Practice or Conduct. Examples can be seen for nursing: http://www.nmc- uk.org/aFrameDisplay.aspx?DocumentID=606 Physiotherapy: http://www.csp.org.uk/uploads/documents/csp_rul es_conduct.pdf Review your own Code of Conduct and explore with a colleague how you may be an ‘active voice’ for the service user.

13. Informed Consent When a patient is given full information by a competent person so that he/she can accept or reject a course of treatment. The health care practitioner should be able to act as the patient’s advocate in these circumstances, thereby ensuring that the individual is provided with the information and time needed to explore the options available to them (Kendrick 1996). Further information may be found at http://www.man.ac.uk/rcn/informedconsent/i nformedconsentdec05.pdf

14. Promoting Health Q. What steps can you take to encourage older people to engage in health promotion? Q. Make notes on the ways in which you could help an older person to improve their nutrition, level of exercise and self-care.