Editorial

Citation

Klee, D. (2013), "Editorial", Working with Older People, Vol. 17 No. 3. https://doi.org/10.1108/WWOP-06-2013-0014

Editorial

Article Type: Editorial From: Working with Older People, Volume 17, Issue 3.

There are 175 definitions of “integrated care”, according to the Kings Fund, although it may also be called “co-ordinated care” or “joined up care” (Pulse Today, 2013). Whatever the definition the need is straightforward – we all want services that are easy to access and meet our needs, putting us at the centre, not the service.

Muriel and Bert, friends of my parents, were exasperated when they both needed a blood test. Bert was caring for Muriel at home and so it was difficult for him to get to the local hospital for his blood test. A district nurse was visiting Muriel and so when she arranged to give Muriel a blood test, Bert thought, “Great, she can do mine as well” – but not so great, that wasn’t possible. Bert still had to go to the hospital, making arrangements for someone to stay at home with Muriel, because it was a different department and budget. This is just one example of how we have to fit around care and support services rather than them fitting around us.

Norman Lamb's announcement in May that health and social care would be joined up by 2018 was welcomed by many leaders in health and social care (Inside Government, 2013). Most local authorities and health partners are already working towards integrated services in the commissioning and delivery of services because it makes sense. It can save money by avoiding duplication and make the best use of professionals’ skills, but success depends on the relationships between the professionals involved and their leadership. The pioneer sites will be announced in September, let us hope that they lead the way to a more person-centred approach to care.

It is a good thing that we are living longer, but this does mean that we are more likely to develop multiple medical conditions such as COAD (breathing difficulties), heart conditions and diabetes. People over 75 make up just 8 per cent of the population but use 28 per cent of NHS expenditure. Surely this means that they are one of the most important service users (customers), and yet services are not designed to meet their needs. If integrated care means the “whole person” is treated and this treatment is delivered in or close to the person's home then it will make a huge difference for older people.

If there is a theme that runs through the papers in this issue of Working with Older People (WWOP) it is about services that are, compassionate, that recognize and respond to us as individuals and are accessible.

We are delighted to have a contribution from Japan, “Toward an age-friendly city in Akita city”. Readers may remember a paper setting out how Manchester is developing an age friendly city (McGarry and Morris, March 2011).

Akita City is also part of the World Health Organisation global network of age-friendly cities. Kadoya Yoshihiko highlights two potential causes of isolation and loneliness; people who live alone are less likely to participate in social activity as are those who cannot drive. She goes on to make recommendations on how access to public transport could be improved.

Nick Wilson (2010) has written for WWOP in the past on opportunities for older workers. His paper in this issue is about older volunteers. He uses case studies to describe how employers with good practice in their employment of all workers, embrace older workers and value the flexibility, availability and life experience that they bring.

Most of us have experienced the stress of having to navigate health and care services when supporting a family member or friend. A study by Professor Jill Manthorpe and Jo Moriarty found that on-line information for carers, provided by local authorities, varied considerably. They make the point that carers should not have to navigate, confusing systems and that information should be made more accessible to all, including those who do not have access to the internet. This paper follows on nicely from one by Bright et al. (2013) in the last issue of WWOP which was about accessing social care information on line.

The Care Inspectorate for Scotland has developed a resource for care providers to improve the quality of care provided to older people. The resource, “Make Every Moment Count”, emphasizes the importance of participating in day-to-day life, to health and wellbeing. This resource was issued to all care homes for older people and home care providers in Scotland. Edith Macintosh's paper reports on the experience of those who have used “Making Every Moment Count”.

Andy Bradley is known to many, for his pioneering work in compassionate care, through Frameworks for Change. He has written a moving paper on the experiences of some older people in care homes. He reminds us that the emotional and spiritual life of residents is just as important as their physical needs. He describes a care home where the residents are using their skills and experience to contribute to the day-to-day life of the home. He says that many older people experience grief in moving to a care home, when they realize that they are considered no longer capable of giving. This resonates with Edith Macintosh's claim that people need to participate fully in every day life.

Let us look forward to 2018 when Muriel and Bert can both have a blood test by the same district nurse in their own home, at a time that is convenient for them. When information about all services is available to the public in one place and easy to find. When compassionate staff treat the whole person, responding to spiritual and emotional needs as well as physical. When older people feel valued for the contribution that they can make to their community. I am not sure integrating health and social care will achieve all of this but we can live in hope.

Deborah Klee

References

Bright, L., Clarke, A. and Dalley, G. (2013), “Finding out about social care :what information seekers want”, WWOP, Vol. 17 No. 2, pp. 85-94
Inside Government (2013), 14 May, available at: www.insidegovenment.co.uk (accessed 31 May 2013)
McGarry, M. (2011), “A great place to grow older: a case study of how Manchester is developing an age-friendly city”, WWOP, Vol. 15 No. 1, pp. 38-46
Pulse Today (2013), January, available at: www.pulsetoday.co.uk (accessed 31 May 2013)
Wilson, N. (2010), “Making the most of opportunities for older workers”, WWOP, Vol. 14 No. 3, pp. 29-39