Health and wellbeing needs: Older people

Normative Needs - what experts define as need based on some standard

From NICE Guidance - Older People with social care needs and multiple long-term conditions (November 2015):

• Identify and assess social care needs. Consider referral for a specialist clinical assessment by a geriatrician or old-age psychiatrist to guide social care planning for older people who social care needs are likely to increase or who may need to go into a nursing or care home.
• Telecare to support older people with social care needs and multiple long-term conditions.
• Care planning - Coordinate and plan care collaboratively. Ensure care plans are tailored to each person giving them choice and control and recognising the inter-related nature of multiple long-term conditions. Develop care plans in collaboration with GPs and representatives from other agencies. Ensure older people with social care needs and multiple long-term conditions are supported to make use of personal budgets, continuing healthcare budgets, individual service funds and direct payments.
• Support carers.
• Integrate health and social care planning.
• Deliver care through provision of support and information, support self-management and ensure continuity of care and links with specialist services.
• Care in care homes. Ensure care plans include ordinary activities outside the home for example shopping or visiting public spaces. Include activities that reduce isolation because this can be particularly acute for older people with social care and multiple long-term conditions and build people's confidence by involving them in their wider community, as well as with family and friends.
• Prevent social isolation.
• Training for health and social care practitioners to ensure they are able to recognise, consider the impact of, and respond to common conditions such as dementia, hearing and sight loss; common care needs such as nutrition, hydration, chronic pain or falls, common support needs such as bereavement and end-of-life and deterioration in someones health or circumstances.
• As a result of pressures in the social care system, managers and practitioners often prioritise meeting older people's essential personal care needs over their wish to live a 'normal' life. The NICE guideline for older people with social care needs and multiple long-term conditions recommends that there must be a change in perceptions and that social care managers and practitioners:
• Review current provisions of information and advice to ensure it covers all aspects needed to enable people to choose and manage their own care and support
• Draw an awareness and understanding of the impact of social isolation
• Work with older people locally who already use personal budgets, continuing healthcare budgets, individual service funds and direct payments to review the support they need.
• To support older people with social care needs and multiple long-term conditions, health and social care practitioners need to have skills and knowledge about a range of conditions, care needs, support options and legislation.
• Traditionally, health and social care services that support older people with social care needs and multiple long-term conditions focus on managing separate health conditions and the system is complex to navigate. Systems and structures need to change to help professionals to work across service boundaries and specialisms.