Health and care: What matters most to older people?

Older people chattingThis week, we have a guest blog from Laura Stuart, Frailty Programme Manager at UCLPartners, a world-leading centre for research, healthcare and education.

Today (1st October) is International Older Persons Day and a great opportunity to reflect on the services that we provide for older people.

‘I’m still me: a narrative for co-ordinated support for older people’ will be published later this month. This document will outline recent research from National Voices, Age UK, NHS England, UCLPartners and others.

We wanted to examine the National Voices Narrative for Co-ordinated Care to see whether it reflected the needs of older people, including those living with frailty. To do this we wanted to find out what was most important to older people by asking older people themselves.


The main component of the research was in-depth interviews with older people. We spoke to people in Age UK day centres, hospital wards and their own homes and coming with a range of health needs and backgrounds.

From the themes that emerged we drafted a list of what we call “I statements”: describing what people want from care and support as if they were talking about themselves.

These statements are arranged around the themes of independence, community interaction, decision making and care & support.

The aim of the work is to get health and social care services to really reflect on the services that they provide and think about whether they are delivering what is really important to older people.

I did about half of the interviews myself and can only thank the people I spoke to for sharing their stories so freely; generally they were very appreciative that someone was taking the time to ask them about what was important to them in their lives.

I have worked in health care for over 16 years and have interviewed hundreds of older patients, but always with an agenda of what I needed to find out to be able to fulfil my role. To be able to ask about their lives in the fullest sense was a truly rewarding experience.


Two of the themes which really struck me was how much independence meant to them and also the prevalence and impact of loneliness.

I have always considered myself a patient-centred clinician but this project has really made me reflect on my practice. This also made me reflect on how many of the services I have worked in have not truly met the needs of the population we aim to serve in the way that is important to them.

We hope that this publication will generate similar reflections from those who read it.

Often, such research gives us more questions than answers and in the document we also call for a national dialogue around how we identify and define frailty.

Clearly we need to identify people who are living with frailty to ensure that they are given the right support and services. However, the older people we spoke to expressed a clear dislike of this terminology.

They tended to see the terms of ‘old’ and ‘elderly’ as a factual description whereas many felt that frailty implied ‘weakness’ and a sense of having given up.

There is a need for continued reflection and dialogue around many of the issues which will be raised in this publication – and we need to continue to fully engage and listen to older people – they are the experts!

Laura Stuart is the Frailty Programme Manager at UCLPartners and is an occupational therapist by background. / @laurajstuart

Author: Tom Gentry

Policy adviser - health services @tomogentry

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