Archive February 2008
IMPROVING HEALTH OF OLDER PEOPLE

What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

 

Statistics
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Links
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Documents
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What we know

We know that in most developed countries, people are living longer than before. Life expectancy in Northern Ireland has increased from 55.4 years for males and 56.1 years for females in 1925, to present day estimates of 75.4 and 80.4 respectively (NISRA). This means that the number of older people is increasing and forms an increasing percentage of the total population.

Increasing life expectancy is sometimes described as 'adding years to life', however, quality of life is also important and it is vital to 'add life to years' by ensuring that people are free from disease, illness and disability for as long as possible. Although people are more likely to have health problems as they become older, many older people are well and can live independently. However, for those older people who do require support, changing patterns of family life such as smaller families, increased mobility and more women entering the workplace, means that there is often less informal family support for elderly relatives and a greater demand on health and social services.

The wider determinants of health have a particular impact on the lives of older people. Older people may be living alone and feel isolated, socially excluded or have difficulty in accessing services. Some may be living in comparative poverty or in ill-suited housing. Both physical and mental health can suffer. Hearing, vision, and balance often deteriorate with age making people more prone to falls and accidents. People may also require multiple medications for a range of health problems. Some may have difficulty with their memory and become confused and unable to care for themselves. Health care in old age must be multidisciplinary and assess the older person as an individual, taking into account all aspects of their life, including social circumstances and support.

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What information do we have about the Eastern Board area?

In the 2001 census, there were 97,124 Eastern Board residents over 65 years of age, making up almost 15% of the total Eastern Board population. This can be divided into 8% aged between 65-74years, 5 % between 75 and 84 years and 2% aged over 85 years. These figures are set to increase over the next decades, as people live longer.

The Eastern Board area has an older population in comparison to other Health and Social Services Board areas. As the Eastern Board also has the largest population, this means that they have the greatest number of older people compared with other Board areas.

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What is the result of this on our health locally?

As the number of older people in the community increases, the cost of health care also increases. In the Eastern Board the demand for health care for older people is greater because of the higher percentage of people in this age group. However, it is important to recognise that not all people over 65 are frail and require services. The National Service Framework for England and Wales describes three broad phases of ageing:

entering old age - this describes people who have completed their career in paid employment and/or child rearing
transitional phase - between healthy, active life and frailty
frail older people - vulnerable as a result of health problems, social care needs or a combination of both.

Although each person must be seen as an individual, these categories are useful when planning services in the future.

 

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Policies

Local and regional health strategies include the New Targeting Social Need (TSN) initiative. New TSN specifies that: 'Some groups have additional needs which, if not catered for, could place their most vulnerable members at risk due to social exclusion’.


In April 2004 an extensive consultation commenced on a strategy to tackle poverty and social exclusion in Northern Ireland. In the consultation document, entitled "New TSN - The Way Forward Towards an Anti - Poverty Strategy," a range of proposals is described for the future direction of New Targeting Social Need (New TSN). It aims to tackle social need and social exclusion by targeting efforts and available resources towards people, groups and areas in greatest social need, including older people.


Promoting Social Inclusion is a specific initiative within the Government's policy of New TSN that aims to bring different Government departments, agencies and voluntary organisations together to examine the problems facing particular groups and to make recommendations as to how these problems can most effectively be addressed.

The Department of Health’s National Service Framework for Older People was published on 27 March 2001. It sets new national standards and service models of care across health and social services for all older people, whether they live at home, in residential care or are being looked after in hospital. While this framework does not apply in Northern Ireland it is a relevant point of reference and model of good practice.

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What is happening in the Eastern Board area?

Work is currently underway to develop a Health and Social Services Strategy for Older Persons living in the Eastern Board area. This will look at issues such as:

community health and social services
domiciliary, residential home and nursing home care provided by the health and social services and by private organisations
specialist elderly hospital care, including day hospital services
community services for people with dementia and other mental health needs

Key questions to be addressed by the EHSSB strategy include:

How do we help people remain independent and active as they age?
As people are living longer, how can the quality of life in old age be improved?
How can we strengthen health promotion and prevention policies, especially those directed to older people?
How do we best balance the specific role of the HPSS when it comes to caring for older people?

Older people have wide experience of life and have much to offer the rest of society. Any strategy for older people must aim to promote fuller participation in society, recognise the contribution the older people have to make and promote their rights as citizens.

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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk

Eastern Health and Social Services Board Champion House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028) 9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website: www.ehssb.org E-mail: pr@ehssb.n-i.nhs.uk
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