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'Revolution' needed to improve care of older patients


Frail older people are being passed around in hospital like “parcels” because of a lack of continuity of care, a report has warned.

Pressure to maintain high bed occupancy, reduce lengths of stay and meet access targets often lead to patients being assigned the first free bed, often in the wrong ward, before being transferred again, said the report by the King’s Fund think tank.

The most “distressing failure” of continuity of care was a communication breakdown with frontline staff, which could leave patients and carers “feeling isolated and frustrated”, it added.

In addition, terms such as “bed blocker” were often used to describe older patients, highlighting the problem of specialising in the care of older people being perceived as unattractive.

The report – titled Continuity of Care for older hospital patients: a call for action – said there needed to be a “revolution” in the way older people experienced care in hospital, with a named key worker available 24/7 and all staff trained in the care of older patients.

Alongside this report, the King’s Fund also published the conclusions of a two day summit attended by senior figures from the NHS and social care, academics and organisations representing patients and older people. Those attending the event made five key recommendations:

  1. Ward leaders should be identified to take responsibility for standards of care and must be given the authority to ensure that patient care is always put first.
  2. Hospital boards must ensure that frail older people are recognised as their organisation’s core service users and hold managers to account for meeting their needs.
  3. The Government should set the framework for delivering care, then reduce the number of central directives and make hospital leaders responsible for ensuring standards of care are met.
  4. Professional bodies should mount a concerted campaign to change professional attitudes through education and training and raise the status of caring for older people among the healthcare workforce.
  5. Policy-makers, commentators and society must challenge negative stereo typing of older people and change social attitudes towards ageing.

Leeds Metropolitan Univerity senior lecturer in community nursing Paul Mackreth described the report’s findings as “shocking and disappointing” but “not a surprise”.

He said: “Although there have been many policy incentives over the past decades to address the negative stereotypes of older people requiring health care, there are also many policies that detract from good, dignified and joined up care.

“Working with older people requires time, patience and a high level of skills. Yet we continue to think that their care can be delivered by the least skilled staff. Staff are increasingly pressured to be more efficient therefore making older people who require time burdensome.”


Readers' comments (7)

  • tinkerbell

    we just need a revolution, full stop.

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  • yeh, just like the French one with the guillotine an' all!

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  • Caring for elderly patients has always been portrayed as unattractive, usually with the lowest staffing levels. As for being 'parcels' passed around within the organisation, this all came about with the advent of emergency admission units. This prevented (all) patients being admitted to the appropriate wards. With cardiac patients and now stroke patients being admitted directly to their respective units, hopefully the elderly will be directly admitted to an appropriate ward, where they will stay for the duration of their admission. It will also reduce the repetitiveness of assessments from one team to another, and the time taken for staff to get to know the patient and their needs.

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  • can also be very disorientating moving elderly patients around and with frequent changes of staff.

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  • Anon 11.06 - good points you have raised, I see EAU as really only an extension of A&E but with beds. I do think we need more CofE wards, there just aren't enough beds for an increasing elderly population, especially now as so many care-homes and 'geriatric' hospitals have closed down.

    Overseas nurses I work with are always shocked when they first start work to see how many elderly people are on the ward waiting for social sort-outs when, back home, they would be with their families.

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  • I have never witnessed poor care towards the elderly, I really enjoyed my student placement in elderly rehab where the staff were really motivated, kind, hard-working and committed to their jobs.

    I think that the never talked about mental health and disability nursing are perceived as the less attractive kinds of nursing, saying that I don't think any nursing can seriously be seen as being 'attractive' these days.

    Who exactly do they think is going to volunteer to be a 'named key worker 24/7'.

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  • Dr Why ?

    Point 4 applies to lots of issues - but with an over-stretched NHS, and little spare in the way of time or money, pointing out that education and training are necessary is one thing - making it happen, quite another !

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