Guest Blog: The oldest old and preventative services

This guess blog was written by Chrissy Bishop, an Occupational Therapist.

The term ‘prevention’ in health and social care is promoted as a gold star, a cost saver, a key policy driver; but is it being practiced? Is this term applicable and realistic to apply to the oldest old population (85+)? Are those involved in care of the elderly prepared and sufficiently educated to focus on prevention for a very old individual?

These queries have materialised from my current work in a reablement project. Reablement services are a pivotal, well known incentive of the government’s continued efforts to save costs of long term care packages through enabling independence. But on a controversial note, is the heavy focus on cost saving as opposed to the patients needs?

From a professional experience reablement still seems like an ‘action on crisis’ approach, and highlights a gaping hole in services. Why is this when National Service Frameworks have drummed preventative strategies into health workers for years now? Additionally, studies continue to highlight the overwhelming consequences of the oldest old developing a health problem, which is usually followed by a ‘cascade effect’ with one condition triggering another problem, and another and so on. This downward spiral is a challenge for all health professionals involved, and the medical and nursing protocols are more black and white than the social and emotional support required. Continue reading “Guest Blog: The oldest old and preventative services”

Ageism in treating the oldest old

This guest blog was contributed by Occupational Therapist, Chrissy Bishop.

As an occupational therapist working in intermediate care, a common predicament occurring in health care environments is the constant battle with prejudices and age discrimination, consequently in meeting the needs of people over age 85: the ‘oldest old’ (or as some refer to this age group, the ‘frail elderly’).

When planning discharge and care for an over-85 client, a fundamental dilemma of the multi-disciplinary team is establishing rehabilitation needs. This means making an informed decision and estimating how they will manage at home, and assessing their ability to regain independence in activities of daily living.

Unfortunately, it is not uncommon for unintentional age discrimination to occur, fundamentally related to the capability of the oldest old of engaging in a rehabilitative treatment plan to maximise their level of independence in their preferred home environment.

In retrospect, why does this age discrimination still occur? We need to challenge our assumptions about people.

Rehabilitation teams need to continually ask questions such as:

  • Exactly what is the reasoning for your 100 year old patient who has recently fallen to go into a care home?
  • Would you consider this change of home environment for a “faller” in their 60s or 70s?
  • Do you consider loneliness when discharging the oldest old back home?
  • Is your patient educated on the effects of the medications they take, and has anyone looked at possible medication interactions?
  • Are they even taking medications correctly? Continue reading “Ageism in treating the oldest old”