Other aspects that will be covered include spirituality, the role of religion and issues of loneliness and isolation, depression in old age and feelings of worthlessness. The issues that seem to be of concern in old age include lack of family support and concern, boredom in old age due to inactivity and retirement and depression due to illness or fear of death.
According to the World Health Organisation 'Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (WHO, 1946). A National Service Framework (NSF) for Older People has been established to examine and solve the problems of older people so that they could be delivered better services. The NSF emphasises on plans to eliminate the age discrimination and helps support person-centered care with newly integrated services (DH, 2001). The Department of Health stresses that intermediate care should be developed at home or in care settings and appropriate hospital care should be delivered by the staff. The NHS has also been urged to take action on stroke prevention, an ailment common in the elderly; and aid in the promotion of health and active life and a reduction in the number of falls for older people (DH, 2001; Ahmed et al, 2005). The Health authorities have emphasised that older people should be given integrated mental health services. Nationally supported standards of healthcare for the elderly have been identified to provide local delivery through the NHS.
According to the NHS, the needs of the older people may not be uniform as people have a wide range of needs. The three stages of old age include entering old age, transitional phase, and frail older people. These stages and the specific needs are given here.
Entering old age - old age may signify the end of professional life and these may be people who have completed their career in paid employment and/or child rearing. Old age is a socially constructed definition and may include people from the age of 50 years to 60 or 65 years of age. These people who enter old age may remain active and independent till very old age. The goals of health and social care policy are to promote a healthy active life, and to compress morbidity or the period of life spent in frailty (DH, 2001).
Transitional phase - This group of older people is the next stage when older people are in transition between healthy, active life just after retirement and frailty at a very old age. This transition occurs when people are in 70s or 80s.The goals of health and social care policy are to identify the emerging problems ahead of crisis in very old age, and ensure that effective responses will prevent crises and long-term dependency.
Frail Older People - Frail older people are vulnerable as a result of health problems such as stroke, dementia, paralysis, social care needs or a combination of these factors. Frailty is often experienced only in late old age, so all healthcare services for older people should be implemented 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 that can adversely affect the independence and quality of life (National Service framework for older people, DH