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

Ms. Mary McDermott, Regional Director, Services for Older People,Western Health Board, Merlin Park Regional Hospital, GalwayAt the end of our Conference on assessment, there are a number of points that I would like to make:• Firstly, I would like to challenge the concept that a person is old at 65 years. Older people areliving longer, healthier lives and I think we should be planning services for older people aged 75years and over. As a general rule, I think we need to focus more on health promotion for olderpeople. We also need to examine the idea of screening older people who are considered to be welland to carry out pilot studies to assist us in developing this idea.• We have heard many examples of good practice in assessment of older people's needs today.Though the approaches to assessment described have developed in isolation from each other, theyshare many similarities and I find that reassuring in terms of the future direction of this work.However, assessment approaches will fail if we do not get our health systems and health deliveryservices right. We must be able to respond to the needs that are identified through assessmentprocesses. Furthermore, we must enable older people to access the services that they need. TheGP and the Practice Nurse each have key roles to play in facilitating this kind of access. Otherchallenges for us include the need to involve service users in the planning of assessmentapproaches and to look at how we can evaluate our approaches to find out whether they areimproving the quality of life of older people.• All older people who need it should have access to a geriatrician and his/her team of whatevertype, and we need to develop a common approach to this part of the assessment process. Inparticular, we need to develop a common assessment process for admission to long-termresidential care. At the moment, the processes for admission to public and private facilities differgreatly.There is also a need to include service users in our assessment processes.• I want to include a comment about the 'at risk' register of older people which has been mentionedhere today. I have difficulty with the concept of a book of names which, in my view, is what itamounts to. We do need data for planning purposes, but could achieve this if we installedeffective IT systems. We have been talking about computerising our records in the health boardsfor many years now.• What is the way forward from the point we're now at 7 My view is that we don't know what weneed, but we do need a process to help us find out what we need. A National Steering Committeecould be established to work on the agenda of a common assessment process. This Committeewould look at what needs to happen and gUide the future development of a common assessmentprocess. In that context, a number of pilot projects could be undertaken, but we would need ringfencedfunding for those and appropriate follow-up services for clients.I!Conference Proceedings