Nobody goes to work to do a lousy job. Most NHS employees work very hard. But despite the best efforts of staff, older people often experience adverse outcomes as they move through the healthcare system. Over 1.5 million older people have three or more falls a year and the number who fracture following a fall has increased year on year. In addition, older people are more likely to die from contracting Clostridium difficile than in a road traffic accident and the number leaving hospital malnourished has doubled in a decade.
People are living longer today and the older people we care for now are therefore
more vulnerable than those I cared for
when I first qualified. Nursing older people needs to be better today than it was 30 years ago. The problem is that this care isn’t improving fast enough.
Most people occupying hospital beds are old. There are old people in A&E and in surgical and medical wards. These people need staff who understand about age-related changes and changes caused by illness. They need nurses who know when to enable and empower and when to comfort and care.
Every adult nurse should have the education and expertise to care for older people. It should be a requirement of pre-registration education. Some students don’t benefit from any specific education in care of this client group. Some students have lectures cancelled and qualify without any specific education on caring for older people. How can we possibly expect these nurses to identify and meet the older person’s care needs? Senior staff on general wards seldom have a firm educational grounding in their care.
It doesn’t have to be this way. We can help older people to recover as fully as possible from illness but we need to do things differently. We must ensure all adult nurses receive education and experience in caring for them. This might lay to rest ageist notions that caring for older people is not demanding and does not require the brightest and the best. It might show staff how good nursing can make a huge difference to outcomes and quality of life.
We have a long way to go before we can say that every older person is receiving the very best care. So let’s begin by ensuring that every registered nurse has the opportunity to understand the ageing process and how illness affects people who are old.
Linda Nazarko is nurse consultant at Ealing PCT
NEXT WEEK: Rob Harteveldt on nurturing the human spirit when caring for patients