Older People
End of life care is an issue for all adults but for older people it is a particular concern and has broader associated health and social care considerations.
Older people are not a uniform group and they have a wide range of needs. They may be broadly seen as three groups:
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Entering old age: These are people who have completed their career in paid employment and/or child rearing. This is a socially-constructed definition of old age, which, according to different interpretations, includes people as young as 50, or from the official retirement ages of 60 for women and 65 for men. These people are active and independent and many remain so into late old age.The goals of health and social care policy are to promote and extend healthy active life, and to compress morbidity (the period of life before death spent in frailty and dependency).
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Transitional phase: This group of older people are in transition between healthy, active life and frailty. This transition often occurs in the seventh or eighth decades but can occur at any stage of older age.The goals of health and social care policy are to identify emerging problems ahead of crisis, and ensure effective responses which will prevent crisis and reduce long-term dependency.
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Frail Older People: These people are vulnerable as a result of health problems such as stroke or dementia, social care needs or a combination of both. Frailty is often experienced only in late old age, so services for older people should be designed with their needs in mind.The goals of health and social care policy are to anticipate and respond to problems, recognising the complex interaction of physical, mental and social care factors, which can compromise independence and quality of life.
Dignity in Care
High quality health and social care services should be delivered in a person-centred way that respects the dignity of the individual receiving them. Unfortunately, older people are not always treated with the respect they deserve. The Department of Health are currently sponsoring the Dignity in Care campaign.
- National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care (PDF)
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This revised framework sets out the principles and processes of the National Framework for NHS continuing healthcare and NHS-funded nursing care. It describes how the phrase a ‘primary health need’ has developed, and how this concept helps in determining when someone should receive NHS continuing healthcare.
(Department of Health, Older People and Dementia, July 2009 (Revised))
