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Thursday 10 March 2011

Ageism, the NHS and 'no more just 'elderly services'

In this week's Nursing Standard editorial the problem of ageism in the NHS is given an airing, see http://nursingstandard.rcnpublishing.co.uk/resources/editorial/editorialv25n27.asp

What struck me is that we have services that tend to reinforce this approach; the elderly have been categorised into a group it is easy to discrimnate against. It is right in the past that our attention has been directed to the particular needs of older people but the 'post 65 years' marker seems so out of date now. I do not wish to denigrate the important research done in the past, nor the clinical practice that led to the development of older people services. Nor should we abandon the ongoing work about ageing and its effects; dementia however can strike before you are in your 60s so lets get real about this.

It is not safe to assume everyone will have finished work by 65; nor is it safe to presume retirement means some kind of slowing down and an end of usefulness. Indeed I suspect David Cameron hopes many retired people, of whatever age will help prop up the 'Big Society' or bs idea of his. He'll need to hope that this group remain in robust mind and spirit to sustain their contribution. The volunteers I meet regularly have often given many years of service; and have an energy and vitality that can be used for the community good. On occasion though they may need health interventions such as surgery and so long as their individual needs are taken into account it can return the person to the same situation of enjoyed contribution as before.

So, presuming getting older, and indeed approaching retirement is not a sign of an end of usefulness we should surely be looking at developing health and related services (idea - why not combine health and social services into 'Community life services' including libraries, schools etc?) into places where your important health concerns are addressed before anyone gets to see your birth date. In recruitment best practice the birth date has dropped off the list of things automatically seen; let us focus on a name and NHS number for identifying people and step away form the use of birth date - unless critical for safety - once a considered decision has been made on the care approach to go forward with.

Yes we need a change of approach to those in our care, and somehow we have to take the best of the work on ageing and weave it into all our services to help improve the care of those who are getting older.

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