Previous mapping of the falls pathway had demonstrated that there was no clear systematic approach to the identification and onward referral of those presenting to the A&E department at the local hospital with a fall.
This Example of Practice is a case study which highlights the use of additional AHP support which was provided to community service users through the use of Change Fund resources.
Service user was referred to speech and language therapy by her GP. She had been experiencing significant word-finding difficulties and was worried about her memory. Previously service user would have waited a lengthy period for assessment which would have required out patient assessment.
The Carers Anticipatory Care Project supports the Reshaping Care for Older People agenda by supporting the carers of older people in their own communities at the earliest point in their caring journey thereby minimising the need for crisis intervention and ensuring that independence is maintained for as long as possible.
The reablement approach in homecare offers support and encouragement to individuals to empower them to help themselves and so increase their independence. It supports individuals ‘to do’ rather than ‘doing to’ or ‘doing for’.
Goal setting and review of outcomes achieved are central to the reablement ethos. This means that we work with individuals and their carers to establish what tasks they want to gain confidence in doing or relearn particular skills. By engaging with individuals around an agenda of what they can do and what they would like to do we can develop short term interventions which support them to achieve these goals. These are often around basic daily living skills such as dressing, meal preparation and mobility. It is not uncommon for an individual to have lost confidence around their ability to carry out certain tasks after spending time in hospital.
Our traditional home care approach has been to assess people around what they no longer can do and provide a service to meet these deficiencies. As a result services are embedded into people’s lives, often for length periods of time. While this is perfectly acceptable for a number of people who suffer from severe and complex conditions it has the potential to create a dependency for people who may have had the potential to relearn or regain skills. Reablement focuses on this potential and research suggests that many people who would have received a traditional service leading to risks of dependency can eventually become more confident and lead fulfilling lives when they regain lost skills.
Older adults are under-represented in Primary Care Mental Health. Potential barriers include the perception that common mental health problems are an inevitable part of growing old, social isolation preventing older people accessing psychological therapy services, older people’s views, behaviours and attitudes may get in the way of them receiving psychological therapy and health professionals may inadvertently prevent older people from accessing psychological therapy.
Whilst many older people enjoy an active and fulfilling life, many may develop physical and psychological problems. In long term physical conditions, psychological factors have an important role in helping or hindering people’s responses to the treatment of such conditions.
Failure to address psychological elements hinders rehabilitation, leads to unnecessarily poorer outcomes and overloads hospitals and health care systems.