Sunday 29 July 2012

Liverpool Care Pathway – In Place Of Ageism


Nearly three years ago, the following report appeared in the Guardian -

The Guardian home

Equality bill takes aim at 'institutional ageism' in NHS

• Older patients face 'rooted' healthcare discrimination
• Most prejudice accidental, critical report concludes






Elderly people
Elderly people. Photograph: Toby Melville/Reuters
Ageism within the NHS and social care is set to be made illegal after a review of the treatment of older people found discrimination was "rooted" in the attitudes of staff and organisations.

The health secretary, Andy Burnham, said the services would be bound by the equality bill currently being debated in parliament from 2012,earlier than had been expected.

The announcement came as Sir Ian Carruthers, the chief executive of NHS South West, and Bristol council chief executive Jan Ormondroyd unveiled the findings of their investigation into the barriers facing the elderly, which was launched amid a spate of ageism claims against health services earlier this year.

Researchers had found that elderly stroke patients received less adequate care than younger sufferers, and a watchdog warned that the over-65s lost out on mental health services. A poll found almost half of doctors who cared for older people believed the NHS was "institutionally ageist".

Carruthers and Ormondroyd found that although much of the discrimination they were told about was indirect, it was still detrimental to patients and carers. "When the shadow of age discrimination hangs over a health or social care organisation … the quality of the service is affected," they wrote. The report noted that the UK has a higher death rate from cancer than the rest of western Europe and the US in over-75s, and that despite progress in reducing mortality levels, younger people had benefited disproportionately.

It quoted research showing that women over 80 had markedly poorer access to investigation and treatment than women aged 65 to 69.

While most examples of ageism were based on thoughtlessness and misplaced assumptions, rather than being the product of avowed prejudice, this meant many of those involved did not recognise their behaviour as discriminatory.

Addressing the National Children and Adult Services conference in Harrogate, Burnham said the timetable for outlawing ageism was ambitious but achievable. "It's vital if a central tenet of the national care service – the pursuit of fairness and equity – is to be upheld," he told delegates.

The equality minister, Harriet Harman, said: "People are not over the hill at 60 – they shouldn't be discriminated against in healthcare or in any other way … with the number of people over 85 set to double in the next 20 years it is essential that older people are not written off because of their age."

Officials made clear that the new rights would still be subject to clinical decisions on questions such as prioritising which patients should get vaccines first, and restrictions would also apply in areas such as fertility treatment.

The deputy director of policy at the NHS Confederation, Jo Webber, said: "The NHS has always cared for older people and will continue to do so but the pressures of an increasingly elderly population, greater expectations of what modern medicine can achieve and a tightening financial situation mean ageism is an issue the service has to think hard about and tackle.

"However, it does need to be understood that a real change in attitudes cannot be achieved without wider changes in society as a whole and the role older people play in it – the NHS does not exist in isolation from the rest of the community."

Burnham told the conference that Labour's proposed national care service, which would integrate heath and care services, was necessary to end the "cruel lottery" faced by the elderly. "In the current care system, people play a random game of chance – with their long-term financial wellbeing as the stake."



So, what’s changed…?
"The NHS has always cared for older people and will continue to do so but the pressures of an increasingly elderly population, greater expectations of what modern medicine can achieve and a tightening financial situation mean ageism is an issue the service has to think hard about and tackle.
"However, it does need to be understood that a real change in attitudes cannot be achieved without wider changes in society as a whole and the role older people play in it – the NHS does not exist in isolation from the rest of the community."

And here is Savista Magazine

Savista Magazine Logo    Issue: August 2012


Report Suggests NHS Is Suffering From Ageism

A review of the NHS by the King’s Fund has suggested that elderly people are being “passed around hospitals like parcels” because of a culture of ageism.
Older patients are often not being given the same cancer and heart disease tests that those younger get, whilst ageist language has also increased, with terms like “bed blocker” being used more by staff.
This report is just the latest from the last few weeks to be critical of the way elderly people are treated by the NHS. It was put together by surveying patients and interviewing staff, and it has prompted the Royal College of Nursing for higher minimum staff levels for elderly care.
The King’s Fund agrees with this assessment, concluding that work volumes and pressure on meeting targets was to blame, and that better training was needed.
Jocelyn Cornwell, who wrote the report, said that the whole system needs “a rethink from top to bottom.
"The health and social care system has failed to keep pace with changing health needs,” she added.
In a BBC interview, Michelle Mitchell from Age UK said of the report, "Health services cannot deliver high-quality services unless older people are treated as individuals and their care is co-ordinated. This is what a modern health service needs to deliver.

When you’re of a certain age, you’re a nuisance; you’re better off out the way, for your own sake as well as those who have the chore of looking after you. And what ‘quality of life’ do you have left..?

The very word ‘geriatric’ is used by some as a slur, a term of abuse.

A Pathway of Care seems the perfect fit solution. And the old, already suffering terminal illness by their very condition, are the perfect candidates for the perfect fit solution.

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