Staying Happy and Well at Home for Longer
Project Background
This project was based in Northern Ireland and was interested in older people. The initial focus was on ‘prevention’ however the evidence indicated that prevention was not broadly understood, and guided by conversations, the facilitator adopted the language of ‘staying happy and well at home for longer’.
Our Facilitator, Orla Fitzsimons, is based in the Southern Trust community services leadership team in Gilford, S. Armagh.
Her focus is to explore what older people need to stay happy and well at home for longer. To understand this topic she spoke to:
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Initial Evidence
Across the UK, the number of older people are expected to increase significantly over the next few decades. In Northern Ireland, by 2039 the population aged 65+ will have increased by 74%, with ever growing complexity of need. This represents a huge and growing challenge in terms of the demands on health and social care services in Northern Ireland, and to the current and future wellbeing and independence of older people living at home and in their communities.
Preventative approaches and earlier intervention are proposed in current policy direction in Northern Ireland as a way to address this challenge. Prevention and preventative approaches to adult social care transformation in Northern Ireland are defined as:
“Prevention and early intervention will enable people to live more safely, and live in their homes for longer, with higher levels of independence” (DoH NI (2023): Consultation on Reform of Adult Social Care: Summary of responses to the public consultation,p54)
Benefits of preventative approaches
The evidence reviewed for this project, recognises the benefits of some preventative approaches in adult social care for older people, including:
- Integrated Care Systems which collaborate effectively with local community and voluntary providers for older people
- Social Prescribing models developing peer support networks for older people, enhancing older people’s community inclusion and enhancing social connectedness to improve older people’s emotional health and wellbeing,
- Asset based approaches to implementing Community Navigator models/Directories of older people’s services and supports locally
- Improving access to Community Transport
- Clinical preventative home visits by GP’s, Allied Health Professionals, community nursing and other statutory services
- Improving access for older people (and their family carer advocates) to choice and control options for their community health and social care support at home and in local communities, such as Self Directed Support/Direct Payments
Challenges to preventative approaches
- Implementation of preventative approaches for older people is hampered by the focus of service development on reducing hospital admissions/admission to residential care to reduce costs, rather than looking at tackling health inequalities among older people living at home.
- Medical priorities dominate the narrative around preventative approaches, such as preventing the older person’s ‘functional and clinical decline’, rather than focusing on preventing older people’s social isolation, poor emotional wellbeing, and/or tackling health inequalities in older people by addressing the social determinants of health in local communities.
- Recruitment and retention across the social care workforce in Northern Ireland is facing significant challenges and has been for many years.
Engagement and Findings
The initial evidence review identified a lack of qualitative evidence, especially from those with lived experience, and this project adds to the evidence in this way. Through conversations with older people, carers, professionals and volunteers, four themes were identified. These were enhanced through coproduction workshops with relevant stakeholders. The themes are:
Alongside the report, a vision statement was co-produced, outlining what would support people to stay happy and well at home for longer. Find them both in the buttons below.
Our Facilitator: Orla Fitzsimons
Orla Fitzsimons, our project facilitator, is a parent carer for a 16-year-old son with disabilities, a mental health service user, and a survivor of domestic abuse.
She’s also a Community Children’s Nurse with 25 years of experience working with children and young people with disabilities/palliative care needs, their parent carers and families in Northern Ireland’s communities, homes, and schools. She discovered co-production and its benefits when she (and other parent carers) formed Parent Action CIC, a social enterprise providing independent advocacy services for parent carers.
Social Connection