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Older people's care - everyone's business?

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Imagine you’re at the start of your career as a fledgling, enthusiastic nurse exploring different areas to specialise in

You’re given the option of either working in a field that provides for people’s basic needs or in one that serves to manage the most complex healthcare requirements of any patient group.

Which one would you pick? Nurses at a conference I attended this week agreed the latter description was what best represented their speciality – older people’s nursing – but that the former was still being used to describe their work.

So was it any wonder there were concerns about how to attract the next generation into this part of the profession? Particularly at a time of shortages and competition from other specialities.

”Most people that come into healthcare are of an older age”

At the King’s College London event – where nurses gathered to celebrate research achievements in the field through the Older Person’s Nurse Fellowship – there seemed to be agreement that gerontological nursing needed rebranding.

Not only that, practice should be spread to all nurses working with adults. Not just because it was an interesting and rewarding skillset to have but because it made sense; the majority of people seen in health and care services are older.

As consultant nurse Cliff Kilgore put it: “Unless I go and work in paediatrics, most people that come into healthcare are of an older age. So it wasn’t rocket science for me to think actually where my career is going to go.

”It’s time to get away from ‘I’m an older person specialist, I help people wash, I deal with their basic needs’”

“It’s something that’s become a necessity – I think that’s actually what we should say to our students,” he added.

Older patients don’t just have one disease, he said, they have multiple ones at the same time – combinations of conditions, plus polypharmacy.

“It’s time to get away from ‘I’m an older person specialist, I help people wash, I deal with their basic needs’ because I think their basic needs ARE their long term conditions and their complex healthcare needs,” he stressed.

Jackie Bridges, a professor from Southampton University who also spoke at the event, was in agreement. She said the skills required for the specialism were consistently undervalued and needed to be better articulated.

“She wasn’t naïve to the challenges already existing”

And to sustain this care more widely, “everybody who is working in providing health and social care to the adult population needs to see older people’s care as their business” she said.

But she wasn’t naïve to the challenges already existing in services for older people.

“We know there are people at the coalface who are running on empty because there is a lack of investment in their wellbeing,” she noted.

Creating an environment that was designed for people to learn and be supported rather than just “doing and delivering” was what would lead to better quality care in these services, she said to a round of applause.

”So older people’s care needs a rebrand”

And focussing on just “doing and delivering” may well be causing what Fiona Clark – a former carer and the lay member of the event’s panel session – said her older friends experienced when they access care; the feeling of being a nuisance.

“When they get into hospital they do notice the nurses are very busy and, therefore, don’t ask them things they want to ask because they feel they are being a nuisance. They say nurses were very helpful and kind but they were so busy I didn’t like to bother them.”

In answer to what older people want from the workforce, she was clear: both consideration and kindness must be maintained.

But there’s the problem – that’s exactly what the profession is trying to move away from in its description. Not because it doesn’t or shouldn’t provide these elements, but because they are not the only part and do not represent the breadth of practice.

So older people’s care needs a rebrand. But one that benefits both the workforce and patients. Perhaps it’s a case of tailoring the message to the audience? And, maybe then we might begin to see it become everyone’s business.

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