Nurses at Burton Hospitals NHS Foundation Trust are launching a ground-breaking new model of care for older people focused on promoting independence and a more personal approach.
Elderly People Assistance and Care (EPAC), is the brainchild of senior nurse for older people Julie Thompson who developed the model after consulting older people in the local community, existing elderly patients and staff including nurses.
Queen’s Hospital, Burton
“There is this perception that older people can’t really do a great deal so the whole point of this model is to promote independence rather than dependence and look at the person rather than the age,” she told Nursing Times.
“The key word here is assistance, so it is about assisting people rather than disabling them,” she said. “It’s about looking at the individual, their biography, their values, their relationships and looking beyond their immediate needs.”
Ms Thompson said the new model was mainly about “attitude and culture”, and nurses and other clinical staff would get training on the approach in coming weeks.
“One of the things older people said to me was ‘nobody asks me about me’,” she said. “People also asked me, ‘Why don’t they treat is as normal, why do they think we’re gaga?’ – that came up a lot.
“So this is also about ensuring people are communicated with appropriately,” she said. “This is more than how they are addressed but also the tone of voice – whether we’re using a patronising tone, whether we’re talking to them like we’d talk to another adult or talking to them like a child. All of that will be built into the education programme that will run alongside the roll-out.”
Dementia patients currently have a “This Is Me” dossier setting out information about their life, background and needs.
”The whole point of this model is to promote independence rather than dependence”
Ms Thompson said she was working with matrons at the trust to develop a new type of personalised document for every older patient that they would generally fill in themselves to give staff a better idea of their history, interests and loved ones.
Meanwhile, practical measures included ensuring enough hand mirrors on the wards so older male patients could shave themselves, rather than being shaved by nurses.
The model would also involve striving to keeping patients active, mobile and out of bed and promote best practice in medication and pain management for the elderly.
Healthcare assistants in particular have been given a key role in ensuring the model is embraced across the trust’s three hospitals in inpatient and outpatient services.
“Nursing assistants will be ambassadors for the model,” said Ms Thompson. “They are the people that are going to be integral in ensuring the model happens and is embedded in practice.”
The ambassadors will meet monthly to discuss elements of care and Ms Thompson will also work alongside them on the wards to assess progress.
“Nursing assistants will be ambassadors for the model”
She said feedback from nurses so far had been “really positive” and the aim is to roll out EPAC in the weeks and months before Christmas so it has been adopted across the trust by the new year.
Ms Thompson explained that instead of drawing up a dry strategy document, chief nurse Brendan Brown had asked her to “think outside the box” when looking at ways to improve older people’s care.
The new model of care follows the launch of the trust’s three-year dementia strategy and the recruitment of a number of specialists teams including an enhanced care team to care exclusively for those with dementia.
More recently a frailty team was set up to mainly work with frail older patients over the age of 70 to reduce unnecessary hospital admissions.