Assessment of Older People's Health and Social Care Needs and ...

Assessment of the Health andSocial Care Needs of OlderPeople: The Northern AreaHealth Board/BeaumontHospital Home First ExperienceAdrian Charles, General Manager, Community Services, Northern AreaHealth BoardCeline Deane, Head Social Worker, Beaumont Hospital, Dublin._f----------------------------------This paper concerns Home First, a collaborative project to provide home care for older people. Withthe support of the Eastern Regional Health Authority, Home First has been piloted on a partnershipbasis by the Northern Area Health Board, Community Services 8, one of three management units inthe ERHA, and Beaumont Hospital since 2000. The Home First project seeks to developcomprehensive packages of care that will provide the increased level and availability of home supportto enable older people to continue living at home. The Authority has provided €630,000 to fund theinitiative and the first patient was discharged from hospital to Home First in March 2001.The Philosophy of Home FirstIIThe philosophy underpinning Home First is people-centredness. The crux of patient-centred care isinformed and shared decision-making. The success of patient-centred care depends on achieving asatisfactory blend of professional, managerial and person-centred perspectives. At present, in theplanning and delivery of services, the main influence determining the assessment of need and theresources necessary to provide for these needs is the professional and managerial perspective.In this climate, older people seek a new vision of care established on the principles of respect,dignity and choice. This vision of ageing highlights the need for a holistic approach and anacceptance of the importance of home and community care. This vision introduces a new perspectivewhich moves the planning and delivery of care from a service-driven approach to a needs-ledprogramme of care. This shift is significant as the service offered then places the person who usesthe service at the centre of the process.The ERHA in its own ten-year 'Action Plan for Services for Older Persons' affirms the principles of carerecommended in The Years Ahead: Shaping a Healthier Future and Quality and Fairness (1994).Assessment of Older People's Health and Social Care Needs and Preferences