Preventative Approaches for Older People
Project Background
This project is based in Northern Ireland. It focuses on preventative approaches to social care that support older people to stay in their own homes and communities for longer. This includes introducing earlier interventions such as co-produced methods and approaches.
Our Facilitator, Orla, 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 more, she will be speaking to:
- Older people
- Family carers
- HSCT staff
- Community and Voluntary Sector Organisations
Our Facilitator
Orla, 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.
Our Facilitator, Orla, introduces her hopes for IMPACT:
Please introduce your project
The focus of this Facilitator project, is around the question, what do older people NEED to stay happy and well at home for longer? I will be working with older people, their family carers, social care and health managers and frontline staff, in the host HSC Trust in Northern Ireland, Ulster University, and frontline staff and managers,in local community and voluntary sector organisations, who are providing support to older people and their family carers, in the two local council areas in Northern Ireland, covered by the project.
I will also be focusing on listening to the voices of older people themselves living at home in the project area and their unpaid family carers, and frontline staff, to explore and propose early intervention and preventative approaches to supporting older people to remain living in their own homes and communities for longer.”
Why did you want to be involved with IMPACT?
I had been involved with the IMPACT Coproduction Advisory Group as a person who draws on care and support, and as a parent carer of my son who has disabilities, since 2023. I really enjoyed this first experience of IMPACT’s way of working, especially IMPACTs emphasis on the voice of unpaid carers and people who draw on care and support, in implementing best practice evidence into adult social care practice. I felt very supported to have my voice heard, and as I am a leader of a community and voluntary organisation in NI using coproduction approaches, I wanted to work more closely with IMPACT, to help to promote this way of working in Northern Ireland.
What are your hopes and aspirations for the project?
My aspirations and hopes for the project, are that by facilitating the four stakeholder groups, older people, family carers, Trust staff and managers, and community and voluntary sector organisations locally, to share their views and come together to co design a ‘shared vision’ for what older people NEED to stay happy and well in their homes and communities for longer, we can gain skills and processes in better communication and working together to identify with older people and their carers, what they need, what works for them and why, and how we can ensure that older people, family carers and staff and volunteers, get the right support, at the right time, from the right services, so older people can stay happy and well at home for longer.
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.