Statement 8 Flashcards

1
Q

Statement 8

A

‘The needs of the older service users and how these can be met.’

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2
Q

Introduction

A

According to the Northern Ireland Statistics and Research Agency, Northern Ireland has an increasingly ageing population, with almost a quarter of people projected to be over 65 years old by 2039 (NISRA, 2015). The very elderly population (people over 85) is projected to more than double by that time.

As people get older, they are likely to become more vulnerable, their needs become more complex and they are more likely to require help and support to meet their needs.

Individuals who are older vary greatly in their needs and in the level of support they require to meet them. Some older people live independent lives and only need to use the services any adult would use, for example, GP or hospital services when they become ill. Many older people, particularly the very elderly require at least some support to meet their needs, whilst others need a great deal of help and support.

The level of support older people require depends on factors like the types of chronic illnesses they suffer from, the extent of physical disability they have, such as sensory disabilities and mobility problems, and whether they have mental health difficulties or dementia.

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3
Q

The Needs of Older Service Users

A

•Physical needs

•Intellectual needs

•Emotional needs

•Social needs

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4
Q

Physical Needs

A

Nutrition
Older people’s ability to cook for themselves or to feed themselves may be affected by restricted mobility or frailty. They may have problems with chewing and swallowing and digesting food so need foods that are easier to eat.

Mobility
The ability to walk and have the range of movements necessary to carry out everyday activities may be limited, for example, to dress or to get in and out of bed or the bath.

Medical Care
Many older people need medical care to manage conditions associated with ageing, for example hypertension, heart disease, arthritis or type 2 diabetes. Many need medication to control the symptoms and manage pain.

Personal Hygiene
The ability to wash, bath or shower may be limited due to poor mobility or frailty.

Exercise
Due to limited mobility, a weakened cardiovascular system or arthritis, taking part in most forms of exercise may be difficult.

Safety
Many older people are prone to slips, trips and falls within their home and local environment.

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5
Q

Intellectual Needs

A

Mental Stimulation
Due to physical problems like limited mobility or lack of co-ordination, or problems with eyesight or hearing some older people may find it difficult to engage in stimulating activities such as reading, gardening, crafts etc.

Knowledge of illness/condition
The experience of short- term memory loss may make it difficult for some older people to retain information about an illness or condition they have and how they should manage it, for example, the medication they need.

Opportunity to learn new things
Older people may have to give up work or hobbies they enjoyed and some may feel they are too old to learn new skills; some older people however will regard retirement as an opportunity to try out new hobbies.

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6
Q

Emotional Needs

A

Sense of autonomy
Physical problems may make it difficult for older people to carry everyday tasks without assistance; it is important to encourage older people to remain as independent as possible so they can remain in control and have a sense of autonomy.

Sense of belonging
Older people may lose their sense of belonging in society especially if unable to continue in their jobs, go out with friends/family or attend social activities.

Feeling cared for
Older people often feel anxious and uncertain about what the future holds so they need someone to listen to their worries and concerns in order to feel cared for.

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7
Q

Social Needs

A

Communication
Some conditions such as stroke can prevent older people communicating as they did previously, leading to them feeling frustrated, isolated and unable to voice their opinions.

Social interaction outside the family
Due to physical disability or mental health problems, an older person may miss out on opportunities to interact with others, for example, at work or maybe seldom get the chance to take part in social activities like going out to a restaurant.

Relationships with family and friends
It may be difficult for some older people to maintain existing or form new friendships as opportunities to meet others may be limited due to poor mobility or the sensory problems prevalent in older people; others may view retirement as a great opportunity to spend extra time with family and friends.

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8
Q

Summary of Needs

A

Physical Needs
• Nutrition
• Medical care/ medication
• Personal care
• Mobility

Intellectual Needs
• Mental Stimulation
• Knowledge and understanding of their condition/ treatment
• Opportunities to share knowledge and experience (reminiscence)

Emotional Needs
• Fell valued and cared for
• Respect and dignity
• Spiritual/ Religious needs
• Autonomy

Social Needs
• Communication
• Contact with family and friends
• Interaction with others

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9
Q

Care settings

A

Older people use various health and social care settings include:

  • Care homes
  • Hospitals
  • Day centres
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10
Q

The needs of older people and how these could be met by staff in a Care Home

A

~Physical Needs~

Nutrition
On admission to the care home the nursing manager should find out the older service user’s dietary requirements considering their health, religion, likes and dislikes etc. This information should be recorded in their care plan and passed onto the kitchen staff so that the meals provided are appetising and appropriate for their nutritional needs and religious beliefs. Care assistants in the setting could also support an older service user who needs help with eating and drinking so that they do not become malnourished. A fundamental need for older service users in a care home is ensuring that they consume enough fluids. The staff could meet this need by ensuring the older service user is offered drinks throughout the day. Some foods can also be used to boost fluid intake such as soup, custard, fruit, ice cream and jelly.

Medication/ Medical care
The nursing staff in the care home must ensure the older service user receives their correct medication for their medical conditions in the correct dose as directed in their care plan. The nurse must report any changes in an older person’s physical or mental health to the care manager who will contact their GP. The staff in the care home should also accompany an older service user to their hospital appointments. Other needs such as podiatry, dental or eye care need to be identified and the relevant professional contacted for a consultation in the home if the older
service user is unable to attend the setting.

Personal Care
Due to ill health and chronic conditions an older service user may need support with toileting as they are unable to do this safely and independently. Many also need help washing, bathing and dressing etc. The care assistants in the care home can help an older service user with this to ensure they are clean, comfortable and their dignity is upheld.

~Intellectual Needs~

Mental Stimulation
The staff in the care home could provide newspapers and books for the older service users to read. These should be in a format that the older service users can use, such as large print, audio tape etc. The setting should also have a television for the service users to watch to keep them in touch with what is happening in the world. The staff in the setting could also provide suitable activities for the older service users to be involved in. Activities could be organised by an Activities Co-Ordinator, e.g., bingo, music therapy, keep fit, art and crafts so that they are kept mentally alert and have a sense of purpose and satisfaction.

Knowledge and understanding of their condition
The staff could provide the older service user with information about their care plan, condition, treatments etc. in a format that they can understand, e.g., in larger print for an older person with a visual impairment and an easy read pictorial guide for an older person suffering from dementia. Any changes in their care plan should be communicated to the older service user so that they can make choices and decisions about their care.

Opportunities to share knowledge and experience (reminiscence)
The staff in the care home should encourage the older service users to share their experiences, memories and stories from the past e.g., ‘Look and listen activities’ where pictures of bygone years are shown and discussed to encourage mental stimulation. Staff could also organise and partake in a ‘trip down memory lane quiz’ on music from the older service user’s era, historical photographs etc. All of this helps to engage an older person in conversation and can provide relief from boredom and symptoms of depression, helping them to feel that they are important and valued.

~Emotional Needs~

Feel valued and cared for
There are many ways the staff in a care home can make an older service user feel valued and cared for. The staff can create a safe, warm, homely and welcoming environment for the older service users.
An older service user in a care home will have a ‘named’ care worker. They will be responsible for the older person’s care and will spend time getting to know them and their individual needs.
Chatting and taking the time to listen to the older service user can help to build a rapport with them. This helps to build trusting relationships.
On their birthday staff and residents in the setting could celebrate the older service user’s birthday helping them to know that they are cared for and valued.

Dignity and Respect
It is important for staff in the care home to be kind and compassionate towards the older service users. Staff in the care home should knock before entering the older service user’s room and show respect for their space and belongings. They must also protect their dignity by closing the door when toileting, bathing, dressing or undressing so that they are not embarrassed and humiliated in front of others. The staff should always ask for consent before engaging in any personal care. They should explain to the older service user what they are doing and engage in conversation to make the situation more comfortable for them.

Spiritual/ religious needs
The staff in the care home should ensure older service users are able to practise their religion and beliefs, e.g., by allowing quiet time to pray, provide access to religious literature and permit religious pictures or ornaments in their rooms. The staff should facilitate visits from religious leaders to the older service user, and have an area designated for private visits or prayer time. The cook in the setting should also ensure special dietary requirements are met e.g., Halal food for a Muslim or Kosher food for a Jew. All religious festivals/celebrations should be facilitated in the home, e.g., Easter, Ramadan, Diwali etc.

Autonomy
The staff in the care home could empower and encourage the older service user to make decisions about their care. The staff should consult them about their care plan and their treatment. The older service user should be given choices and encouraged to make decisions about all aspects of their care in the home and offered choices with regards to their meals, clothing, activities, treatment etc. so that they feel respected, valued and in control.

~Social Needs~

Communication
Some conditions such as stroke or a hearing impairment can prevent older service users from communicating effectively, leading to them feeling frustrated, isolated and unable to voice their opinions. Staff in the care home should ensure that the older service user’s hearing aid has working batteries in it and adjust the pitch level. Staff should ensure the care home environment and lavout are used in a way that encourages social interaction. e.g., by reducing background noise, by arranging the seating to enable face-to-face contact. This makes it easier for the service users to communicate and interact with others.

Contact with family and friends
Staff in the care home should be friendly and welcoming to the older service user’s family and friends. They could encourage them to visit frequently and should make a space available away from others so that the older person can have private time with them. The staff should also involve familv and friends in activities in the care home, e.g., family movie nights and sing-a-longs to which families are invited and encourage family and friends to accompany the older service user on trips or outings e.g., summer trip to the seaside.

Interaction with others in the setting (staff and residents)
Staff in the care home should encourage the older service user to socialise and interact with the other residents. They could do this by encouraging them to sit in the day room with other residents, have their meals in the dining room, take part in group activities or attend events in the care home, e.g., weekly religious service or the sing a long etc. This will help the older person to develop friendships with others preventing isolation and loneliness.

Contact with wider community
To prevent older service users from being isolated and excluded from the outside world the staff in the care home could invite community groups to the setting, e.g., church group or children from the local playgroup/school. Furthermore, the staff in a care home could organise various events to help the older people to integrate with members of the wider community by a barbecue where the setting is open to the public etc.
If the older service user is able to leave the setting the staff could arrange for them to go shopping, visit a park, or have a meal out with their friends or family.

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11
Q

The needs of older people and how these can be met by staff in a Hospital

A

~Physical Needs~

Nutrition
Older people need nutritious food and drinks. This need can be met by staff in the hospital providing older service users with various options for nutritionally balanced meals which will encourage them to eat. Staff should provide the older service user with assistance if required (e.g., a stroke patient) so that food and drinks are consumed. Foods may have to be pureed so that older service users with eating and swallowing difficulties can eat safely. Staff also must consider an older service user’s dietary health e.g., if they have Type 2 diabetes their sugar intake would have to be closely monitored.
Dehydration is a serious problem in relation to older people and can put them at risk of low blood pressure, weakness, dizziness, risk of falls, delirium, UTI’s etc. Staff can give the older service user a jug of fresh water at regular intervals during the day and monitor their fluid intake.

Medication
The staff in the hospital administer the medication prescribed by the older service user’s doctor. This should be recorded in the older service user’s medical records. Nurses should administer medication according to the recommended dosage, provide water and supervise intake to make sure the older service user takes their medication. This avoids the risk of overdose or the older service user forgetting to take their tablets.

Personal care
Nurses/care staff in a hospital would be responsible for assisting with toileting, washing and dressing the older service users as they may be unable to do so themselves due to their condition/frailty. They may need a bed pan or a commode if unable to walk to the toilet. A lot of older people require assistance for incontinence and the staff in hospital can provide the right incontinence products to help manage the issue. An older service user in hospital may need a ‘bed bath’ if they are not well enough and cannot safely leave their bed to go to the washroom. For older people daily bed baths can help keep their skin healthy, control odour and increase comfort. Good personal hygiene has an important role in maintaining dignity, self-esteem and quality of life.

Mobility
Older people can become immobile in hospital. The staff can encourage an older service user to get out of bed and sit in a chair. They can also be referred to physiotherapy for remobilsation and exercise to strengthen their muscles. An occupational therapist can also provide walking aids such as walking sticks, walking frames or rollators to aid mobility. Porters are also available to help transport older service users in wheelchairs if they need to be taken to a different department for assessments.

~Intellectual Needs~

Mental Stimulation
Staff in the hospital should provide opportunities for older patients to watch daytime TV by providing a television in their room or ward. Staff could encourage older service users to read a daily newspaper, or book to read and keep up to date with current affairs. They could also encourage them to complete word searches, crosswords, or suduko.

Knowledge and understanding of their condition and treatment
Hospital staff need to inform older service users about their condition and explain the treatment plan. Staff could also give older service users a leaflet/booklet about their condition in a format suitable for the older person, e.g. large print for those with a visual impairment. This would help the older person understand their condition and necessary treatment and enable them to be included in decision making regarding their care.
Staff in the hospital should also provide information for older service users in a variety of languages or use interpreters or an advocate if necessary to communicate effectively with them so that they have knowledge and understanding of their condition and proposed treatment.

Opportunities to share knowledge and experience (reminiscence)
Care assistants and nurses in hospital could take the time to engage with older people to share their memories, experiences and stories from their past as being in hospital can be long and boring.

~Emotional Needs~

Feel valued and cared
Staff in the hospital should take time to talk to older service users in order to build a rapport with them and help to develop trust in order to relieve any fears or anxiety that they may have about their condition and treatment plan. It Is also important for staff to respond promptly to requests for help as ignoring them can undervalue them.

Dignity and respect
Staff in the hospital should ensure they address the older service users by their preferred name e.g., Tom or Mr Jones. Some older people prefer a more formal title. In addition, if the older service user is being examined the medical staff should ensure they pull the curtain to maintain the patient’s privacy and dignity. The doctor or nurse should ask permission before examining their body. They should also explain to the older service user what procedure they are doing and why, adopting a relaxed, yet professional tone to put the older service user at ease.

Spiritual/ Religious needs
The hospital staff could ensure older service users are able to practise their faith and religion.
They should enable religious leaders to visit the patient and have an area designated for religious practices in the hospital. The cook in the hospital should also ensure the older patient’s special dietary requirements are met, e.g., Halal food for an older service user who is a Muslim.

Autonomy
In hospital doctors and nurses should give the older service users sufficient information and time to process it so that they can make choices and decisions regarding their care and treatment. Their wishes need to be respected. This will increase the older persons
independence and enhance their self-worth making them feel empowered and in control.

~Social Needs~

Contact with family and friends
The staff in the hospital can encourage the older service user’s family and friends to visit by informing them of visiting times and making sure they feel welcome. Some wards have a relative’s room where service users can go with their family member and have privacy to talk. This is useful as some older service users may have difficulty hearing and want to talk about their health or other personal matters and do not want to be overheard.

Interaction with staff and other patients
Staff in the hospital can encourage the older service user to talk to other patients on the ward. By having communal areas in the ward, e.g. dining table and chairs it enables the older service user to socially interact with others preventing feelings of loneliness. Also, staff could encourage older service users to keep their curtain back during the day to encourage conversation with other patients. This can speed up the recovery process as well as motivate them to form friendships.

Communication
If an older service user has hearing problems an audiologist can fit a hearing aid if required. Staff in the hospital can speak slowly and clearly to an older service user who may be hearing impaired. Hearing loss can increase confusion and leave the older person feeling isolated. Staff could use a range of assistive listening devices so that the older person can hear. Staff could offer the use of an advocate who will speak on behalf of the older person. If the older service user’s first language is not English, the hospital should provide them with a translator/ interpreter.

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12
Q

The needs of older people and how these can be met by staff in a Day Centre

A

~Physical Need~

Nutrition
Staff in the day centre should provide healthy balanced snacks and a choice of hot meals to encourage the older service user to eat well. The cook in the day centre should find out the older person’s dietary requirements considering their health, religion, likes and dislikes. Their care plan should document this information and it should be passed on to the kitchen staff so that meals produced are appropriate and appetising. Older people can very quickly become dehydrated so it is important that they are encouraged or motivated to drink plenty while they are there. Some foods can also be used to boost fluid intake, e.g., soup, fruit, custard, jelly, ice cream.

Medication
Many older people have conditions that require medication throughout the day, e.g. medication for arthritis. Staff in the day centre must adhere to the older service users care plan before administering medication to ensure the correct dosage is given.

Safety
Staff in the day centre should ensure the external doors are locked so that the older service
user does not wander off or leave the setting alone. This is particularly important in the care of older people with dementia. Staff ensure equipment is stored safely e.g., knives, scissors etc and supervise the use of sharp tools when completing craft activities. Staff should also carry out risk assessments in the day centre on a regular basis and action taken to remove safety hazards and to protect the older service users from accidents.

Personal Care
Due to ill health and chronic conditions an older person may need support with toileting and personal care. The care assistants in the day centre can help an older person with this to ensure they are clean and that their dignity is maintained. If the older service user has a toileting accident the care workers should ensure that the older person is not embarrassed or humiliated. The situation should be dealt with quickly and professionally and the older service user given support to change into their spare clothes which should be brought with them each day.
An older service user may be unable to bath independently at home so the care assistants will assist them to have a bath or a shower enabling them to be clean and comfortable which helps their self -esteem. In some day centres the older service user can also have their hair washed and blow dried by a hairdresser.

~Intellectual Needs~

Mental Stimulation
The staff in the day centre could involve older service users in stimulating activities, e.g.
board games, table quizzes, art, gardening, crafts, music, bingo, chair-based aerobics and day trips etc. Due to physical problems such as limited mobility or lack of co-ordination or problems with eyesight or hearing some older service users may find it difficult to engage in stimulating activities such as reading. Audio books may be offered or a member of staff in the day centre may read a book to them. They also can engage the older service users in discussions with each other about topics of interest.

Knowledge and Understanding of their condition
Staff in the day care centre should provide the older service user with information about the routine in the day centre and their care plan. This will help them to feel in control and knowledgeable about the treatments and services that will be offered. This can be provided in a variety of formats to meet their individual needs e.g., audio, large print leaflets, pictorial.

Opportunities to share knowledge and experience (reminiscence)
Reminiscence work is also offered by the day centre staff in the form of watching old black and white movies as well as talking about their work experiences, as it can jog an older service user’s memory and brings comfort. Day centres can provide old food packaging and old objects from their childhood (e.g., toys and kitchen objects) thus providing an opportunity for someone with dementia to reminisce e.g., Memory cafes. Staff in the day centre can play old songs from their era whilst the older people listen and sing along.

~Emotional Needs~

Feel valued and cared for
Staff and various health professionals in a day centre can respect an older service user by calling them by their preferred name, meeting individual needs and offering choices in the day centre, e.g. choice of hot meal for lunch and what activity to be involved in. Staff in the day centre can take an interest in their lives by asking them about their life and listening to them. They will be assigned a key worker at the day centre who will get to know them and their individual needs, helping them to feel valued and cared for. Key workers at the day centre can spend time with the older service user and listen to their concerns. Staff could also refer them for counselling or talking therapies to further support and allow the older service user to express their feelings. Staff can acknowledge each service users birthday and celebrate it with a birthday cake.

Dignity and respect
Care workers in the day centre should be kind and compassionate towards the older service users and show them respect by calling them by their preferred name. They must also preserve the older service user’s dignity by closing the door when toileting. If they accidentally wet or soil themselves the care workers should not embarrass or humiliate the older person in front of other service users but help them to change into clean clothing.

Spiritual/ religious needs
The cook in the day centre setting should ensure special dietary requirements are met, e.g. Halal food provided for Muslim service users. The care workers in the day centre should ensure that older service users are able to practice their faith and religion whilst present at the setting by allowing quiet time to pray, providing access to bibles for the older person to read if they wish. Within the day centre there should be an area designated for quiet prayer time.

Autonomy
Staff in a day care centre can promote an older service user’s autonomy by giving them choices, e.g., activities to choose from such as arts, crafts, cooking, gardening etc. This will give the older person independence to select activities that they want to do, thereby raising their self-esteem and their sense of empowerment. This is so important as older people often lose their sense of control as they get older. The staff also give them other choices in terms of what they wish to eat and drink at the day centre, who they sit with etc.

~Social Needs~

Communication
Staff in the day centre can ensure they speak slowly and clearly to an older service user who may be hearing impaired as hearing loss can increase confusion and leave the older person feeling isolated.
The staff could also use a range of technologies such as hearing loops to enable the older service user to hear so that they can socially interact with others in the day centre.

Contact with family and friends
The staff in the day centre can encourage the older service user’s family and friends to visit by making them feel welcome and inviting them to events in the day centre such as a barbecue. They can also invite them to come on day trips with the older service user.

Contact with staff and other service users
The day centre staff can provide opportunities for older service users to socialise with others experiencing age related physical and mental health issues through organising outings and day trips so that the service users can make friends and increase their social circle. Staff could also provide support groups where service users could take part in group sessions where they talk about their issues and personal experiences, thereby sharing alternative coping strategies with others.

Contact with the wider community
The staff in the day centre could encourage the older service users to interact with people within their local community. The day centre staff can invite local school children or playgroup to entertain the service users, they may use pet therapy to help stimulate conversation and bring comfort to the older service users. They may also invite local people from the library, museum, garden centre to give a talk or show slides to help the older service users remain involved in their community. In addition, the older services could be encouraged to give to their local community, e.g., knit squares for blankets for the baby unit in the hospital. They can also organise trips and outings for the older service users so that they can socialise with other service users, staff, family and friends.

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13
Q

Statement 8
(Booklet 2)

A

‘How integrated health and social care services meet the needs of older people’

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14
Q

Integrated Health and Social Care Services

A

This includes:

-Voluntary

-Statutory

-Informal

-Private

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15
Q

A Wide range of Support and Care is Provided to Help Meet the Needs of Older People

A

~Physical Needs~

Nutrition

• provision of home care workers provided by social services, voluntary sector or the private sector who prepare simple meals or heat pre-prepared meals.

• assistance with feeding provided in care homes, supported living accommodation and by home care workers.

• provision of aids by occupational therapists (OTs) to enable older people to prepare and eat meals

• provision of healthy regular meals in care homes, day centres and supported living accommodation.

• assistance from the informal sector-friends, family members and neighbours may shop for food or prepare meals.

Mobility

• provision of adaptations such as handrails or grab rails by OTs.

• provision of aids such as walking sticks or rollator frames by physiotherapists and OTs in hospitals and in the community.

• provision of exercise programmes to improve mobility by physiotherapists in hospitals, the community and in private practices.

Medical Care

• provision of a range of medication and medical interventions to treat and manage conditions associated with ageing by GPs and hospitals.

• provision of medical care at home, for example, by community nurses.

• provision of end of life care, for example, by a hospice.

Personal Hygiene

• assistance with washing, bathing or showering provided by home care workers through social services or by the private or voluntary sectors.

• provision of adaptations such as replacing a bath with a walk in shower and shower seat by OTs.

• assistance with washing, bathing or showering provided in care homes or by family members.

Exercise

• provision of a range of exercise and leisure opportunities provided by the voluntary sector, for example, walking club.

• provision of activities like dancercise in day centres in the statutory and voluntary sectors.

• by family and friends going out for a walk with older person.

Safety

• provision of 24- hour care in residential homes and supported housing by the statutory and voluntary sectors.

• provision of aids and adaptions in the service user’s home by OTs to reduce the risk of accidents.

• assistance from family members who may check that the living environment is safe or stay overnight.

~Intellectual Needs~

Mental Stimulation

• provision of a range of books in larger print or talking books by local library services.

• provision of a range of activities in day centres, for example, table quizzes.

• provision of daily newspapers by family and friends.

• provision of board games etc. in day centres, care home and individual’s home.

Knowledge of Condition

• provision of information about any condition the older person might have by a voluntary organisation.

• provision of information in leaflets and booklets available in GPs and hospitals, for example, on managing type 2 diabetes.

• discussion with the practitioners involved in caring focusing on the treatments and care options etc.

Opportunity to learn new skills

• provision of opportunities to learn new skills provided mainly by the voluntary sector, for example, U3A art classes.

• family, friends and neighbours showing an older person how to use social media.

• provision of classes aimed at all age groups by local further and higher education college.

~Emotional Needs~

Sense of Autonomy

• provision of home care workers, support workers provided by social
services and the voluntary sector to provide support enabling the service user to remain in own home.

• support from family, friends and neighbours to enable service users to undertake everyday activities in their own home.

• provision of aids and adaptions by OTs to enable the service user to undertake everyday activities and retain independence.

• provision of supported living accommodation by the voluntary sector, for example, by Action on Hearing Loss to enable service users to live as independently as possible.

• provision of advocates mainly by the voluntary sector.

• by carers and practitioners listening and taking into account the service users’ wishes and involving them in decisions about their care.

• provision of programmes to enable service users to gain suitable employment and become more independent mainly by the voluntary sector.

Sense of Belonging

• provision of group activities for like-minded older people by the voluntary sector, for example, local history group in U3A.

• by family members making older people feel valued and wanted, for example involving them in family celebrations like birthdays and weddings.

• provision of supported living accommodation by the statutory, private and voluntary sectors where older people are visited regularly.

Feeling care for

• provision of helplines by voluntary organisations like Silverline.

• provision of a befriending service by a voluntary organisation.

• provision of programme of group activities by the voluntary sector, for example, tea dance, lunch club run by a local church or community group.

• support from family, friends and neighbours who take time to listen to an individual’s worries and concerns.

~Social Needs~

Communication
• provision of communication aids, for example hearing aids at local hospital or by a private provider

• through the use of advocates who will speak on behalf of the individual.

• by family, friends and practitioners taking time to talk and listen.

Social Interaction outside the family

• provision of group activities by voluntary organisations.

• provision of a range of activities in day centres and supported living accommodation.

• provision of sport and leisure activities such as swimming, walking, yoga and crafts mainly by the voluntary sector.

• by family, friends and neighbours accompanying or providing transport to community events.

• opportunities to interact with others in supported living accommodation.

Relationships with family and friends

• through open visiting in care homes and visiting hours in hospitals.

• provision of support groups and activities, for example lunch clubs by voluntary organisations.

• by family members and partners encouraging older people to keep in touch with friends by providing transport, accompanying them on visits or to social activities and using, for example Skype or FaceTime

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