USE OF OCCUPATION TO PROMOTE WELL BEING FOR OLDER PEOPLE WITH MENTAL HEALTH ISSUES

Use of Occupation to Promote Well Being for Older People with Mental Health Issues



Use of Occupation to Promote Well Being for Older People with Mental Health Issues

Introduction

This paper reports on some of the findings of a literature review, which formed part of an empirical study into integrated care for older people. The study was commissioned by a group of service providers from health and social care in the same locality, who were beginning to work together in an integrated way to provide care for older people, a field beset by the historical divisions in the UK between health and social care, and between care and services, such as housing and transport. The empirical study collected data from staff and service-users to explore their experiences of care, and the ways in which integration had been developed. This literature review was designed to support and expand this activity, by providing a foundation for enquiry and analysis, identifying key concepts and definitions, and informing the development of the questions that the empirical study would seek to answer.

Discussions with the commissioning team identified a number of key issues that they wished to address. The project had been stimulated by the recognition that existing services fell short of providing appropriate, timely and coordinated care for older people. There was a consensus that older people have complex and interacting needs, and they often require treatment and care from a range of professionals and carers, services and agencies at the same time. Furthermore, it was recognised that older people accessed the support that they needed from a wide range of statutory, independent and voluntary sector services. When so many staff, services, sectors and agencies are involved it was felt that it was all too easy for gaps in care, fragmentation of care, lack of co-ordination between services, or duplication of services to occur.

In addition to concerns about the impact that these factors have on the quality of care that older people receive, there had been increasing awareness that they have an impact on the efficiency and effectiveness of the available services. For example, an older person may have an extended period of hospitalisation resulting from difficulties in arranging the necessary services to support them in the community rather than their need for specialist in-patient care. In this situation, ineffective use is made of the available hospital service and the overall cost of care is increased because in-patient care is more costly than care in the community.

From this accumulated knowledge about the difficulties that beset the care system the idea had emerged that collaborative working and integration of the various parts of the care system will minimise the problems that older people and service providers encounter. There appeared to be a general agreement in the commissioning team that system-integration is beneficial both to the service user and to service providers. For service users, strategies that reduce the complexity of accessing health and social care ...