This short paper provides an overview of investment released in 2015/16, grouped where possible into investment themes, and sets out some of the key areas of national activity, including that progressed under the Improvement Programme. TEC Programme – Overview of Year One Activity (July 2015)
Traditionally older adults with a long term condition who had or are having frequent uncomplicated exacerbations would be highly likely to be admitted to hospital care. This is due to the fact that other than GPs there is no other professional that has traditionally been able to offer advanced assessment in the community.
Under the new approach, the ANPs would identify individuals who would benefit from an anticipatory intervention and develop a personalised ACP through advanced nursing assessment to support them to be remain at home 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.
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.
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.