‘Moving, for independence’

Examples of Practice

  1. Client accommodation was unsuited for older person safe independent living (first floor, no lift, many steps, poor layout)
  2. Person was frightened by thought of moving; family has pressed to ‘go into a home’ – clearly not older person’s preference.
  3. GP confirmed suitable ground floor accommodation meant no need for move to care home or similar
  4. Greatest barrier was older persons fears – how could I manage to move, how can I afford to move, how do I deal with everyone (who?), how do I pack / unpack.  Do I have to give up independence because I am too old to cope.

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Social Return on Investment (SROI) on Adaptations and Very Sheltered Housing, Bield, Hanover & Trust Housing Associations and Envoy Partnership

Examples of Practice

To research the Social Return on Investment (SROI) of Stage 3 Housing Adaptations and Very Sheltered Housing.  SROI is a stakeholder-informed cost-benefit analysis that uses a broader understanding of value for money.  It assigns values to social and environmental outcomes as well as to economic outcomes.

Stage 3 adaptations are modifications to a property to reduce a disabling effect on the tenant, and suit the changing needs of the tenant.  Very Sheltered Housing (also termed “Extra Care Housing”) provides enhanced staff cover and additional welfare checks compared to other forms of non-Care Home housing for older and disabled people.

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So Much More Than Just Another Lunch Club

Examples of Practice

To work in co-production with teams of older people from specific communities raising the awareness of the importance of good mental health and wellbeing.  To empower them to identify issues, come up with, and test ideas to deliver on actions to address issues identified in the “Mental Health and Wellbeing in Later Life”* report published by Age Concern and The Mental Health Foundation in 2006.

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Smithfield Court Rehabilitation Service, Aberdeen

Examples of Practice

To provide a service designed to promote recovery and a return to independent living for service users.  Rehabilitation for adults with physical, social, communication and/or sensory difficulties, and for some with reduced confidence following illness, accident or other crisis situation.  The objective is to provide an holistic range of social care, therapies and activities to enable service users to achieve and maintain their best possible function and to support their return to independent living.

The overall goal is to decrease dependence on health and social care support, increase community integration and improve the quality of life of individuals whilst also supporting their carers.  The client group is older people and adults recovering from illness, accident or acquired brain injuries.  During the development of the service a gap for rehabilitation for younger people was identified and the facilities were further developed to enable their discharge from a specialist unit to continue their rehabilitation in a home setting.

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Scottish Partnership for Palliative Care (SPPC)

Examples of Practice

Palliative care is not just “terminal care” over a few weeks or days.   Palliative care approaches are relevant to people living with advance disease, regardless of length or clarity of prognosis.

Around 38 000 people with palliative care needs die in Scotland each year and a much larger number are living with advanced progressive disease.  Most are older people.  Around 30% of acute bed days are used by people in their last year of life, and over 50% of people will die in hospital, although most people express a preference to die at home.  How Scotland cares for those approaching the end of life is therefore an issue of major and universal significance for the Scottish population and has a major impact on how Scotland uses scarce healthcare resources.

Palliative care is an integral part of achieving the transformational change (and shift of resources) envisioned in Reshaping Care for Older People.  Regardless of the success of preventative strategies death and dying is inevitable.  And unless we get this part of the trajectory right we are likely to continue to commit huge health care resources to providing care in the acute sector for people whose preference would be for care elsewhere.

Good quality palliative and end of life care is fundamental to delivering the safe, effective and person-centred care described in the Dementia Strategy and the Healthcare Quality Strategy.

Research indicates that patients who have been identified and placed  on a palliative care register are more likely to have their needs/wishes met, for example they are more likely to die at home (75%) as opposed to those who are not on the register (22% die at home). Currently, most people on a register have a cancer diagnosis but palliative care is relevant to people with any advanced life threatening disease.  References: Murray S.A, Boyd K, Sheikh A, Thomas K, Higginson, IJ. Developing primary palliative care. BMJ. 2004; 329:1056.

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