“New Vision of Later Life” – 2 – Health Improvement Centres

My second image of later life looks at the other end of the health care system.  The acute sector of the NHS looks after us very well throughout our childhood and our working adult life.  At its heart, the doctors and nurses do a good job of getting us better when we really need them, which is why they have been held in such high regard since the NHS was formed on the 5 July 1948 (63 years ago today!).

So what has gone wrong for the elderly? :-

  • The numbers of elderly people are increasing faster than NHS resources.
  • More things can be done to keep people alive for longer – e.g. hip replacement, recovery from heart conditions, etc.
  • The elderly are living longer so acquire more chronic conditions – e.g. arthritis, diabetes, etc.
  • Their condition is often complex and needs input from more than one specialist.
  • They take longer to recover so don’t fit easily with the new fast track NHS; rather they end up being seen as bedblockers.
  • Finally dementia/confusion is a feature of many older people’s condition which adds significantly to the caring work load.

Elderly people are a problem for NHS hospitals from start to finish and we should recognise that and adjust the approach to acute care of the elderly.  Acute hospitals still need to be there for acute conditions and surgical interventions, but many elderly admissions are for preliminary assessment which would be better done in less extensive and technological diagnostic environment, with less specialist consultants.  A bit like a cottage hospital but to give it a new name, lets call it a “Health Improvement Centre”.  Many elderly people may then never need to move on acute hospital care.  Equally after acute treatment, elderly people could be moved to this less expensive provision to be allowed to recover more slowly than young patients.  So what does this new facility look like?

Well the first thing is it’s not a hospital at all.  It is a virtual care environment where you stay where you are and the doctors and nurses come to you.  Equipped with more sophisticated diagnostic tools and backed up by properly trained specialist nurses for the elderly.  Available in your own home for a time limited period and paid for by your private health insurance.  Yes it is more expensive than at  present but its better quality.  The health outcomes will need to be proven to be better and recovery times will also need to improve.  The good news is that there is far less risk of cross infection (MRSA, Norovirus and C.Difficile).  There is also better opportunity for family support.

People who cannot stay in their own home may need a short stay at the Health Improvement Centre for initial observation and assessment.   Equally after recovery from acute treatment in hospital, they may need to convalesce or receive high quality rehabilitation in the Health Improvement Centre.  This would obviously cost rather more that care in your own home and should be funded out of a re-allocated NHS budget.

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9 Responses to “New Vision of Later Life” – 2 – Health Improvement Centres

  1. begethers says:

    Thanks for this vision John. I know that i would choose it when the time comes. It is very helpful to see such a clear summary in terms of why the NHS is failing the elderly – so often in the news and so easy to blame the nurses (there are some uncaring ones though). my own feeling is that we must focus on ‘breaking old habits’ and to practice new ones which result in a ‘consistently compassionate approach’. The habits are Undivided attention, transformational questions and appreciation – we call it ‘Everyone Matters’ and it seems to be working where leadership is clear and ‘in values alignment’. if interested see blogs at http://www.knowingyoumatter.com
    thanks for all you do and for being unsettled!
    Andy Bradley

  2. John many bloggs on old age dementia and care in old age on this your blogg site. For interest I followed the Andy Bradley Blogg link ;knowing you matter. I was dissappointed this lead to another site with bloggs, under the umberella of ‘Worldpress’, and then you are into other tweets and things. Is this what was intended if we wished as individuals to start bloggs on your site. John I like your threads and views and opinions where you may rant, rave and advise in a dutch uncle scenario, I feel at home.

    • john graham says:

      Glad to hear you feel “at home” David and thanks once again for all your contributions. Do keep them coming you add great experience to my blogs.
      Andy Bradley also has a connection to an ExtraCare village through his mother. He works in this field himself. I thought his short video said some very profound things about dementia which need more exposure.

  3. To answer your blogg John, I feel we have been here before, and Andy does have a viewpoint: Only while he proposes a solution, what he has missed is that people need people of their own age around them to share their own individual experiences. Living in a atmosphere of an ‘Extracare Village’ for the over 55’s with mixed age group population of 60’s 70′ 80’s and 90 year olds with care in the home helps one understand the problems of old age, and to some extent face them. The proportions of dementia and alhziems in a typical village of the Extracare Village is a handfull ( mabe 5-8 persons) in a community of some 380? This is acceptable and manageable. Where the sufferer from Dementia or Alhziemers becomes a danger or a liability to themselves, then experience shows alaternative arrangements have to be made.
    In general what I am spouting on about is that not every old age person at the same time becomes a sufferer of demetia or alhzeirmers, and to diaognose and move on these sufferes once diagnose to a special residential or nursing home is not the initial reaction or solution I would want!
    There are in the latter stages of the ailments need for more full time 24 hour care, but here again this maybe not necessarily in a nursing home designated for alhziermers or dementia, but general residential homes with 24 hour care or a nursing home. The label of dementia or alhziemers is good for the non sufferer to describe the condition and get some peace of mind from a common approach, but the individual sufferer may be your relative and then it becomes personal and very personal, and the solution is understanding by all of us for the benifit of the sufferer.
    Obserbing my mothers deteriating condition, I note she may not instantly recognise me, but she does get comfort solice and peace of mind from those of her age group around her, and 24 hour care from the staff of the younger working age group workers in her care home. It Is people and human contact my mother desires and is most settle with when this is provided.
    As a family you may ask why do not I and and my siblings provide this? Strange we have asked this question, but the suffered if related demands time and personal attention!. In a surrounding of same age grouped persons and staff of understanding but not related my mother will accept the answer No, more readily and move on to the next conversation/person. Should It be a family member one has to answer the call and say NO this in our case was not accepted follwed by tantrums and child like behavior: You may say we as a family are cruel, but by observation I would answer compassionate, and understanding. It is a difficult choice, I would not pretend it is easy? My mother is progressing towards her 92 birthday and we hope many more, and if she does not recognises us or call us by name she is still loved and our Mum. I say no more: One day you may have to make the choice for a family member or even your spouse or partner, and I ask you what would you do for the quality of life for the sufferer?

    • john graham says:

      Thanks for sharing that very personal insight, David.
      You speak for the many families who have a mother / father with this most difficult illnes.
      The compassion, understanding and love that is required comes through in you words .

  4. Foge says:

    Keep it coming, writers, this is good stuff.

  5. Marlie says:

    Thanks for sharing. What a pleasure to read!

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