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Community Care For Our Elderly

wheelchairI attended a public meeting a few weeks ago concerning the proposed model of care for the elderly and integration of health and social work. By just writing that one sentence I have probably sent the majority of readers racing to the next article.

No one wants to think about their final years and how they will be cared for. We are incredibly lucky in the provision we have for elderly care on Tiree, but change is happening which will affect us and as individuals, families and community we need to look at why that change is happening and how it will affect us because unless you have a mirror in the attic it will happen to you.

‘We are an ageing population’ How many times have you heard that term in the media but do you truly understand the implications of an ageing population? Very simplistically it means the average age of a population is increasing along with life expectancy but the birth rate is declining. For Tiree it means that we will live longer barring accidents and plagues. However if you factor in current lifestyle factors such as obesity, alcohol consumption and lack of exercise it may mean we live longer but have more complex diseases such as type 2 diabetes, heart disease, liver disease , strokes, dementia and cancers. If the birth rate declines it means there are fewer people to look after the older people. Throw in the cost of caring for a person with multiple diseases to the NHS and you begin to see why care of the elderly has become a national concern.

So on Tiree we have a few separate issues going on around elderly care. One is the Model of Care which involves the Integration of Health and Social care which is a nationally driven policy supported by government and happening across Scotland. On Tiree it means that all elderly care will be managed and delivered by health as one team. It means we can work more flexibly and apply resources where they are needed. It makes sense. The Model of Care has the aim of keeping people at home or within their own communities longer. That means as a community we need to change the way we think about caring for our older folk. Instead of intervention at a crisis we need to look at ways of preventing crises occurring in the first place. When a person is ill we need to be able to put resources into the person’s home to ensure they are supported and cared for. All of us need to work together which means everyone working closely with families and the voluntary sector. Integration of the teams is aimed for by 2015 and I will update through An Tirisdeach as more becomes known so everyone knows what is happening.

A separate issue is the provision of a new care facility on Tiree. This is a separate issue because the integration of services will go ahead independently of the care home situation. The care provided in Tigh an Rudha is exceptional but the building and residential model no longer meet the required standards of care required by the Care Inspectorate. The model currently being discussed is the Progressive Care Model where people can live independently and dependently around the care facility. So imagine a building where all your community care staff are located. It could have a day centre and a chapel of rest or even a small hydrotherapy pool. It would have a communal area for eating and socialising. It is very much at the negotiation stage and Curam are working in partnership with health, social work and housing to ensure the facility reflects what the community needs.There will be housing units attached and care will be delivered to the person in their housing unit, even overnight.

Primarily people will stay in their own homes but the units will be available if this is no longer an option. The housing units will also have the latest Telecare. Telecare is an advanced monitoring system so a person’s whereabouts in their home can be monitored. It includes fire, flood and door alarms and the technology is advancing rapidly so people with advanced dementia can live independently of residential care.

At the meeting people were concerned about older people having to leave Tiree if the housing units were occupied. My team’s focus will be on people not leaving their own homes. However every case is different and even today we have people unable to return to the island and people who have had to be cared for elsewhere so even our current care model cannot guarantee that everyone can stay or return to be cared for on Tiree. The success of the new facility will be in terms of community engagement in the process so everyone is knowledgeable about the model and what is happening with care provision.

I hope this has helped inform everyone about what is happening regarding care for older people from my perspective as a district nurse. Next time Wills and Advance Directives – bet you cannot wait x

Kate MacCallum – Team Lead Community Nursing/Midwifery