Prevention is Key to delivering on Transforming Your Care
You cannot argue with the direction of TYC – the right care at the right time. Older people want to remain at home for as long as possible. For some older people that will not be possible and we will always need some form of institutionalised based care.
Just how radical do we to be need to be? How difficult is this? We know that keeping older people out of hospital is one of the solutions put forward by many commentators and is a cornerstone of TYC.
But, we need to ask why so many older people end up in hospital when clearly it is not the right place for their needs to be met. Is it due to the absence of community alternatives and in some instances family and friends? The key to delivering the right care for older people is to provide the care they need in the right place at the right time and a care environment that combines effective treatment with sensitive and dignified care.
We need to look to solutions that will prevent older people from needing care in the first place. By staying well and feeling good, older people are more likely to play an active role in their communities, contribute to society and live independently.
When we hear the word prevention, we automatically assume obesity, alcohol, smoking and exercise. There is no doubt that this focus will pay dividends, but for older people these initiatives may not be suitable. Prevention services for older people range from wellbeing and independence through minimizing disability and maximizing functioning.
For many older people the provision ‘that little bit of help’ can result in older people being less isolation, less lonely, more independent and connected to their communities and neighbourhoods. Services like befriending, luncheon clubs, housing adaptations and active lifestyle programmes can result in dramatic outcomes for older people.
Re-ablement seems to be the buzz word these days and offered as the panacea for keeping older people out of hospital and reducing their need for social care. Great idea, but re-ablement is only one component of a wider prevention strategy. What is causing me more concern is that individual Trusts are developing their own re-ablement models each with their own mechanism for capturing data.
Developing public policy in a piecemeal fashion such as this is ill-judged and a missed opportunity to coordinate services across Health and Social Care Trusts. It is crying out for strategic direction and leadership from the Health and Social Care Board in the first instance, but ultimately responsibility lies with the DHSSPS.
Why is it so hard – we have a population of over 1.7 million and covering an area of 13, 834 km2. It should not be beyond the realms of possibility to design a preventative strategy of which re-ablement is one component, which can mitigate discrepancies in the provision of social care across Northern Ireland.
The reason this is happening is the absence of an overarching prevention strategy. The implementation of prevention and early intervention in adult social care is gaining traction but this needs to lead to a compelling will to act. In the first instance, the Commissioning Plan must prioritise prevention – it needs to be bold and up front and it is vital that we continue to hold the line on prevention.