Approaches to long-term conditions management and care for older people: similarities or differences?

AIM: In the past few years, there has been an increased emphasis both on the care for older people and the management of long-term conditions within the United Kingdom. Currently, the Department of Health and the Scottish Executive identify and manage these two areas as separate entities. The aim of this article is to examine the current approaches to both of these areas of care and identify commonalities and articulate differences. BACKGROUND: The population across the world and particularly within the United Kingdom is ageing at an unprecedented rate. The numbers suffering long-term illness conditions has also risen sharply in recent years. As such, nurses need to be engaged at a strategic level in the design of robust and appropriate services for this increasing population group. EVALUATION: A comprehensive literature review on long-term conditions and the care of older people was undertaken in an attempt to identify commonalities and differences in strategic and organizational approaches. A policy analysis was conducted to support the paper and establish links that may inform local service development. KEY ISSUES: Proposing service development based on identified needs rather than organizational boundaries after the establishment of clear links between health and social care for those with long-term conditions and the ageing population. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse Managers need to be aware of the similarities and differences in political and theoretical approaches to the care for older people and the management of long-term conditions. By adopting this view, creativity in the service redesign and service provision can be fostered and nurtured as well as achieving a renewed focus on partnership working across organizational boundaries. CONCLUSIONS: With the current renewed political focus on health and social care, there is an opportunity in the UK to redefine the structure of care. This paper proposes similarities between caring for older people and for those with long-term conditions, and it is proposed these encapsulate the wider issues that need to be debated to achieve a truly joint approach to care.

Sharing funding for long term care.

The issue of funding for long term care always generates considerable debate, and the situation is not helped by the existence of different polices across the four countries of the UK. In England, long term care is means tested, whereas in Scotland it is free. However, conclusions drawn in a new report, The Future of Care Funding - Time for a Change suggest that the funding system of long term care is not fit for purpose.

The rise of falls research.

Interest in falls, and morbidity and mortality related to falling, first gathered momentum from the publication of a standard in the National Service Framework for Older People ( DH 2001 ). Since then the topic has seen investment and disinvestment as interest ebbs and flows. The recent European Symposium on Calcified Tissues held in Barcelona (May 24-28) did much to renew enthusiasm and debate.

Patient dignity: why nurses still struggle to achieve it.

Dignity is, was and will be the focus for nursing and for every member of the nursing family. The concept was central at this year's RCN Congress in May which coincided with a new survey released by the Royal College of Nursing ( 2008 ). This survey revealed that eight out of ten nurses leave work upset and distressed because they have not been able to deliver dignified care to patients. The survey of more than 2000 nurses by the RCN also found that nurses want dignity to be given a higher priority in the workplace, but face significant obstacles to delivering the kind of care they would like. Dr Peter Carter, in his address to Congress delegates, outlined several of these obstacles, including staff shortages, scarce resources, mixed sex wards and paperwork.