It is important to look for underlying reasons why people fall and if these are preventable. We know that falls record the highest total length of stay for all admissions and can result in a fracture with the associated loss of confidence and lengthy rehabilitation. Many older people have a ‘community alarm’ and use this to call for help when they have fallen with immediate support provided through the Social Care Response Service (SCRS). Information relating to the call out is gathered by the service and logged, however the information is not shared and other than GP/Emergency service referrals, there is no pathway from the service to falls clinics, etc.
This Example of Practice focuses on a range of initiatives within one specialist older person’s housing complex which included straight forward design enhancements and provision of respite accommodation. There were two overarching issues:
the design and accessibility of specialist older person’s housing common areas and the impact this has on older people’s capacity to be involved in social interaction opportunities; and
the aim to improve the range of respite options available to older people and their carers.
It was identified that participation from tenants and older people from the wider community was significantly hampered by the design and layout of specialist older person’s housing common areas. The accessibility issues to access the common room coupled with the design of the actual common areas had resulted in some instances that tenants were unable to gain access to the common areas unaided and when using the common areas were particularly limited in their capacity to engage in activities safely.
The common areas were accessed via traditional fire doors and the design although a relatively new build purpose built specialist development presented challenges for older people who had a memory problem, physical disability or frailty or visual impairment.
Access to social opportunities and engagement in meaningful activities is crucial in maintaining and improving health and wellbeing and is of particular importance within specialist older persons housing in helping older people feel socially included and connected within their communities.
Improving support for carers was also identified as a priority and the development of new respite provision within the specialist older person’s housing complex was also an objective.
The issue which had been evidenced through analysis of referrals was that in the Wishaw / Shotts area there were significant numbers of older people who were experiencing some degree of isolation and were seeking support to connect to social activity in their communities. It was recognised that the experience of loneliness and isolation, if not addressed, carried risk of precipitating detriment to medium to longer term health and wellbeing. The issue encompassed the need to work with older people to ascertain directly what would for them constitute meaningful social activity.
The pro-active identification and assessment of people at a high risk of experiencing an adverse drug reaction leading to hospital admission / re-admission, otherwise known as a polypharmacy medication review.
Supported by improving communications and information transfer between hospitals and primary care with regards to medication.