This service was developed in response to the fact that older people can often be unnecessarily admitted to hospital, due to there being a lack of readily available transport to take them home, and the risk that the 4hr A&E target may be breached for them. It was recognised that patients may also be more likely to be admitted especially if they have arrived at A&E later in the day, and there is a lack of family/care support to ensure a safe return home.
In addition to this, a service that would support individuals into their own home, ensuring their safety and comfort, was seen to be beneficial both in terms of direct support to the patient, and potentially picking up on issues which might prevent further deterioration or a potential readmission to hospital.
The Golden Games in Aberdeen City won the 2013 UK Award for Health & Wellbeing at the Association of Public Service Excellence.
The Golden Games tackled attitudes about what older people can still actively participate in, linked participants into ways to continue activities sustainably and at little or no cost. In particular the Games included teams of participants from nursing homes, to underline that, in principle, nobody was too old/too frail to participate. Some participants were carers who received indirect support from participation.
Client accommodation was unsuited for older person safe independent living (first floor, no lift, many steps, poor layout)
Person was frightened by thought of moving; family has pressed to ‘go into a home’ – clearly not older person’s preference.
GP confirmed suitable ground floor accommodation meant no need for move to care home or similar
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.
In the view of ‘Care closer to home ’(Darzi) 2008, AHPs play an integral role in deciding whether a patient is safe for discharge. They are well positioned to deal with the wide range of pathologies and complexities presented. Additionally, evidence relating to emergency admissions of older people suggests assessment should take place as early as possible depending on medical stability (RCPL – Management of the older medical patient, RCPL 2000).