Referrals to the Angus Carers Centre from health providers were low. This is a key source of identification of carers where support can be provided to allow them to continue to care and have a life outside of caring.
The service aims to promote the understanding of the need for an integrated approach in care of the elderly in acute care. It demonstrates the impact that psychiatric morbidity can have on physical health and rehabilitation and how joint working with other professional groups can improve the quality of care and outcomes for elderly patients. It has developed and implemented an acute pathway for people with cognitive impairment entering the acute hospital, and assisted in early identification and diagnosis of dementia by providing specialist assessment and treatment interventions, education and support to patients, staff and carers.
Many older people were being admitted to appropriate wards from an acute medical perspective but were missing the opportunity to benefit from a coordinated comprehensive geriatric assessment which would potentially ensure a better patient journey and reduce the hospital stay.
We are addressing the specific needs of older carers and carers of older people. The aim is to identify and support older carers by addressing the emotional and practical impacts of their caring role and providing information sessions and guidance/training more specific to the needs of older carers.
Anticipating patients that are moving towards a health transition because of emerging health issues.
In Moray we monitor daily the number of patients that are over 65yrs, who attend A&E and are subsequently discharged. We used the Change Fund to second a senior nurse practitioner to work alongside a Consultant Geriatrician to follow up the patients who were discharged. Case studies suggest that early intervention of this type has prevented further deterioration or enabled planned interventions removing the unpredictability of an unscheduled admission.