However, neither the concept nor the implementation f an acute-based, multidisciplinary older persons outreach and support team (OPOST) has been reported in the literature to date.
The 2004 report, Better Health in Old Age, from the national director for older people's health, provides an impressive range f comments, with supporting evidence, on the success f the National Service Framework for Older People (NSF) as seen through the eyes f various stakeholders.
This attractively presented document looks back over the three years since the launch f the NSF and forward to a vision f the future. Readers f Nursing Older People may find it somewhat irritating that the image chosen for the cover is in stark contrast to their own experiences f caring for older people. The photograph f older people canoeing, and clearly enjoying it, on the report's cover may have encouraged some newspapers to adopt the theme f taking responsibility for personal fitness as a spur to better health. Tai chi is an increasingly popular form f exercise, suitable for many older people, and given the imminent publication f the White Paper on public health it was no surprise that it was used as the focus, and to illustrate news reports. While adopting such a theme is undoubtedly a positive approach it may also mask many f the other significant achievements.
My chosen theme is 'climate change'....
My chosen theme is 'climate change'. Let me explain what I mean. The NSF's first standard is aimed at eliminating ageism and that must, in my view, start with the language and attitudes we use to express ourselves. We have all come a long way from the days when a report describing the pressures emerging as a result f longer life expectancy, and the growth in the number f older people experiencing mental health problems could be published with a title as pejorative as The Rising Tide (HMSO 1983). The health secretary, writing the foreword to the new report, states that 'the NSF has galvanised the NHS and social care ... and reduced ageist attitudes and practices. That tide is now irreversible...'. So, by that measure, as far as I'm concerned, ageism, if not defeated, is certainly in retreat. It's up to us to drive it out altogether.
Before reporting progress in relation to the individual standards, the report highlights four principles that have underpinned the development f the NSF:
- person-centred care: providing a personalised response that gives respect and dignity to the older person
- joined-up services: bridging the gap between hospital, home and wider community
- timely response to needs: giving rapid access to services, following assessment, or in a crisis
- promotion f health and active life: aiming to prevent the onset f illness.
Looking back over the ten years to 1993, evidence is presented f growing life expectancy, based on significant reductions in deaths resulting from cancer, strokes, coronary heart disease and even suicide among over-65s. This seems to support a number f views: that medicine itself is becoming more effective; that earlier interventions are preventing the