Alternatives to acute hospital care for older people: a patient / carer perspective

Conference:

SAPC ASM 2016 - Dublin

Talk Code:

P2.02

Presenter:

Melanie Chalder

Co-authors:

Alyson Huntley, Sue Jenkins, Ali Heawood, Chris Metcalfe, Will Hollingworth, Jonathan Benger, Sarah Purdy

Author institutions:

University of Bristol, University of the West of England

Problem

Avoiding unnecessary use of emergency hospital services is one of the biggest challenges currently facing the National Health Service. Whilst many initiatives have already been set up to try to tackle the problem, the number of people being admitted to hospital at short notice remains high and is a particularly issue amongst the over-65s. In order to address the problem, we believe that a number of fundamental questions need to be answered:- what are the alternatives to acute hospital care for older patients?- which patients would be best suited to these interventions?- would older patients choose these alternatives?

Approach

After conducting a systematic review of the literature for alternatives to hospital admission, we asked members of the public, older patients and carers of the elderly to reflect on the findings of the research and to respond by sharing their ideas, experiences, hopes and concerns. This work has been planned as a series of individual and group consultations, using an experienced researcher to facilitate the sessions and analyse the feedback. Data collection is underway and is due to conclude in June 2016 so full results and conclusions will be available in the poster presentation.

Findings

Initial feedback from the consultation work with lay people highlights two key findings. Firstly, it is difficult to precisely define the characteristics of those older patients who may or may not require a hospital admission since people and their circumstances are so diverse at the point of presentation. Secondly, the development of any alternative interventions needs to incorporate flexibility and choice, with appropriate information and professional guidance to suit a range of individuals and their particular situations.

Consequences

Lay opinion on unplanned admissions for older people appears to endorse plans to find new forms of care which could be safely and effectively delivered outside the hospital setting. More research is planned to explore this important issue in a way which places the needs, experience and preferences of the older patients and their carers at the heart of any decision-making and service development.

Submitted by:

Melanie Chalder

Funding acknowledgement:

This work was conducted using with funds from two sources - NIHR Health Services & Delivery Research programme (project number 12/130/53) and Avon Primary Care Research Collaborative (APCRC) . The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Health Services & Delivery Research programme, NIHR, NHS, Department of Health or APCRC.