The recent focus on the pressures on A&E departments has led to renewed debate about where older people should be treated, with repeated assertions that care should be provided in the community. Today the British Geriatrics Society and the Royal College of Physicians (RCP) are addressing the need to improve the acute care of older people through a joint conference being attended by over 200 healthcare professionals.
The Francis Inquiry was the latest in a series of similar reports highlighting the need to improve hospital care for older people and those with dementia.
Professor David Oliver, vice president of the British Geriatrics Society said:
Of course we should invest more in prevention and better community responses to avoid older patients defaulting to hospital avoidably. However, although some episodes of ill health can be managed in the community, frail older people often have complex conditions with multiple co-existing illnesses which require all the skills of the multi-professional team. A well-resourced hospital environment is frequently the safest and most efficient way of ensuring that patients improve and can be maintained in their own home after discharge.
The majority of hospital patients are over 65 but increasingly older patients no longer come under the care of geriatricians. The evidence shows that when frail older people are admitted to hospital they are 25% more likely to be alive and living independently at home when they are looked after in a specialist unit for older people. It is therefore of paramount importance that general and other specialty physicians have the necessary skills to deal with frail older people, including the ability to recognise and respond to geriatric syndromes such as delirium, falls, immobility and functional loss.
Dr Linda Patterson, clinical vice president of the RCP said:
The presentation of older people to hospital should not be treated as an unwelcome surprise. Instead, we should deliver high quality care by staff with the relevant skills, and make sure older people don't stay in hospital any longer than they need to. That needs development of better community and primary care services, as well as physicians working more in the community. The Future Hospital Commission, due to report in September, is addressing the organisation of services so they better meet the needs of older people.
There is no doubt that general hospitals should, and will, continue to play a major role in healthcare delivery for older people, particularly those with multiple morbidities, who will continue to need immediate access to acute and restorative hospital care. Hospitals must be age attuned in terms of the physical environment and the skills and cultural attitudes of all staff working within them to ensure that hospital care is as effective as possible.
For further information, please contact Linda Cuthbertson, head of PR, on +44 (0)203 075 1254 / 0774 877 7919, or email Linda.Cuthbertson@rcplondon.ac.uk
- On 26 June the British Geriatrics Society and the Royal College of Physicians is holding Acute Care of Older People. A 1 day conference which will provide a comprehensive overview on how to address the medical care of older people.
- The Silver Book, a set of standards for the emergency care of older people, recommends ways in which emergency admissions can be reduced and the experience of those admitted improved.