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The article presents the 'five things about me' quality improvement project to contribute to person-centred care for older people on medical wards in Great Britain through the development of patient profiles. Other topics include the project's implementation by the Manchester Royal Infirmary in England, and the benefits of the project like improving mood and memory, bolstering pride in achievements, and strengthening relationships with care staff.

The article discusses research on the early implementation of the Enhanced Health in Care Homes (EHCH) model due to COVID-19. Challenges with implementation of the EHCH model include time taken by staff to fulfill contract obligations, use of technology in care homes and primary care, effectiveness of data sharing and frequency of care home rounds and multidisciplinary team meetings. Also noted are the benefits of EHCH model and its potential expansion to include vulnerable and frail people.

The article provides information on an online survey which aimed to identify the educational status and development needs of nurses involved in continuing healthcare (CHC) assessments. Topics discussed include roles and responsibilities of the multidisciplinary team in relation to National Health Service (NHS) continuing healthcare, involvement of respondents in NHS CHC-associated work, and characteristics of NHS CHC training received by respondents.

This is the introductory article in a six-part series in Nursing Older People exploring the nursing care of people living with advanced dementia. It discusses the complex and progressive array of nursing required to meet the needs of individuals, the provision of personal care, learning and leadership, meaningful activity, and palliative and end of life care. A main theme of the series is the exceptional nursing skills and knowledge required to deliver evidence-informed care with compassion and respect for people living with advanced dementia. This introductory article provides background information to contextualise advanced dementia and identify the main challenges facing nurses, nurse educators and nurse leaders. [ABSTRACT FROM AUTHOR]

Falls in older people are a major cause of hospital admissions. Primary healthcare professionals play an important role in preventing falls, although they experience barriers to achieving this. The aim of this qualitative study was to identify what a sample of primary healthcare professionals in the UK city of Birmingham perceived as barriers to and aids to preventing falls. Analysis of the results identified several major themes in two categories: challenges and opportunities. Challenges included lack of integration between primary and secondary care, poor awareness of services and complex referral pathways. Opportunities included recognition of falls as a priority, risk stratification and improvement of the health of older people. [ABSTRACT FROM AUTHOR]

Care homes are an increasingly important part of the UK's healthcare system. Despite their importance, particularly in providing care for older people with complex needs, the sector is often disadvantaged and overlooked by commissioners, policymakers and researchers. The authors provide an overview of some important challenges for the sector. These challenges relate to funding, education and research, overseas staff, career pathways and staff recruitment and retention. They conclude that recruitment and retention of registered nurses is arguably the greatest challenge, as high staff turnover is the catalyst for other challenges identified. The care home sector should be considered as equal to hospitals, community settings and hospices. Care homes offer registered nurses many opportunities for development of clinical and organisational skills. [ABSTRACT FROM AUTHOR]

This article is the second of a two-part series that explores a programme of culture change in care homes. In this article, the authors describe their independent development and facilitation of a flexible learning programme for care homes, designed to meet a quality improvement request made by a care home company. The two selected care homes' staff conducted a review of their care culture, as a precursor to their creation of a new care philosophy. These activities provided a firm foundation from which the homes could, in theory, become a Remedial Enterprise Active Learning care home. Although the learning programme was not completed due to unavoidable circumstances, the staff's experiences highlight some of the challenges and successes that may be experienced when seeking to improve care homes' learning culture and practice. [ABSTRACT FROM AUTHOR]

Universal health coverage is an ambitious goal central to the eradication of poverty in low and middle-income countries. However, the number of qualified staff working in developing countries is not sufficient to meet the needs of the most vulnerable, and professional development opportunities for nurses are rare or non-existent. This article explores how UK-trained nurses can support the training of colleagues working in regions where resources are limited, and provides examples of current voluntary projects in old age care taking place in Sri Lanka and Nepal. It discusses the contribution that nurses can make to the reduction of healthcare inequalities worldwide and reflects on the benefits that such experiences can have on nursing practice in the UK. [ABSTRACT FROM AUTHOR]

This article is the first of a two-part series that explores a programme of culture change in care homes. A UK care home company sought the authors' expertise to design and facilitate an independent programme of learning to encourage and support staff in two of its homes to become the architects of their own quality improvement. The article reviews the literature that was an essential information base for the authors in their dual roles as designers of the learning programme and facilitators of its delivery to participant staff. The literature is necessarily broad in reflecting the nature and context of care homes, residents' needs and wants from care, and the particular challenges that might be faced by care home staff and managers when making quality improvements. In the second article, the reality of running the programme in the two homes is described. [ABSTRACT FROM AUTHOR]

This article describes digital skills training (DST) for staff and later, residents, as part of a programme of culture change in a large care home with nursing in Glasgow. It presents the successes and challenges arising from DST from the perspectives of the two volunteer information technology (IT) champions (Thomas Sloan and John Thomson), who were also staff members. Using their written reports, questionnaires and subsequent conversations, the IT champions recall the challenges and gains for staff and residents as a result of their initial training. This is supplemented by a follow-up on IT activities in the 18 months after the introduction period. [ABSTRACT FROM AUTHOR]

This article is the third in a series presenting examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. The hospital environment is often disorientating for people with dementia and can be particularly distressing when a patient is admitted in an emergency. Subsequent ward moves can also be disruptive and confusing, especially if they take place out of hours. Two NHS trusts aimed to improve the experience for patients with dementia by addressing the physical environment along with practical aspects of care provision at different stages in the hospital journey. The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust in Norfolk enhanced its emergency department environment by redesigning four bays and an observation area to be dementia-friendly. The hospital has supported these changes by providing dementia awareness training for all staff in these areas. Walsall Healthcare NHS Trust focused on minimising ward moves by implementing procedures to identify patients who should not be moved. Since introducing the new process, adherence has been good and there have been fewer ward moves. [ABSTRACT FROM AUTHOR]

When patients are discharged from hospital they are dependent on the professional and social care delivered by healthcare staff and also on the support provided by lay carers, family and friends. This article describes a method for determining the quality and extent of lay care that may be available to older people to ensure that their discharge is more successful in the long term. [ABSTRACT FROM AUTHOR]

Demographic trends and service reform present healthcare providers with the challenge of developing appropriate resources to manage increasing numbers of sick and disabled older people. But these changes bring increased opportunities for nursing, and the expansion of the nursing role is crucial as health services strive to meet the changing needs of older people. Against a background of reforms in Ireland and backed by an education and training needs analysis of nursing staff, two stakeholders devised a model of education that would best meet identified demands. This article sets out a model for skill attainment that acknowledges the diversity of care settings and improves the sustainability of training provided. Advantages and disadvantages are discussed, and lessons learned are shared. [ABSTRACT FROM AUTHOR]

Rachel Thompson considers the current drive to improve services for older adults with mental health needs and the contribution health care assistants can make to delivering care. The article describes a project aimed at identifying the development needs of health care assistants through consultation with various stakeholders. [ABSTRACT FROM AUTHOR]

This paper describes the findings of a phenomenological study of professional fulfilment in nurses who care for older people. The author sought to uncover what brings career satisfaction to nurses who care for older people and subsequently what motivates these caregivers to continue to care. The findings have implications for clinical nurses who may see reflections of their own approaches to care in the narratives presented. The examples of care reported may inspire nurses who work with older adults by affirming their own nursing interventions. [ABSTRACT FROM AUTHOR]

Around half a million older people aged 65 or over live in care homes across the UK and substantial numbers end their lives in these care settings. The Liverpool Care Pathway for the dying patient (LCP) was developed to transfer the hospice model of care into other care settings. This paper describes a pilot project to introduce the LCP into care homes local to the Queen Mary's Sidcup NHS Trust with a view to reducing the number of very ill elderly patients who are transferred to the acute trust from care homes and then die in A&E. [ABSTRACT FROM AUTHOR]

Loneliness is a complex concept that involves both psychological and social aspects. This article explores loneliness and the impact it can have on older people. It considers the challenges facing nurses and other healthcare professionals in helping older people to deal with loneliness. [ABSTRACT FROM AUTHOR]

The author, with assistance from two course participants, describes a project designed to encourage older people's participation in partnership working. The improvement of the quality of life for older people is high on the agenda of national and local government, funding bodies, the health service and a large number of voluntary and non-governmental organisations. In particular there has been an emphasis in policy documents on the importance of involving older people in the planning and delivery of services and in the research process. In order to ensure older people play an active part in the Scottish Centre for the Promotion of the Older Person's Activities, educational support needs to be provided to enable them to achieve their potential in these roles.

Falls among older people are common, disabling and often fatal. But, says Tony Luxton and Jackie Riglin, an inter-agency approach in which nurses play an important role can help identify risk factors and prevent falls occurring. [ABSTRACT FROM AUTHOR]

In Jane Eyre, Mrs Rochester is shut away in the attic on account of her madness. Recounting experiences from her own family, Gill Parker asks whether, in contemporary Britain, people with dementia are being treated in a similar way. [ABSTRACT FROM AUTHOR]

Laurence Dopson considers the contribution older people are making to the Year of the Volunteer. [ABSTRACT FROM AUTHOR]

The article cites that the single assessment process for older people is a laudable aim. But, say Simon Evans and Robin Means, its success depends on many things, not least better communication and the willingness of health professionals to embrace joint working . The immediate origins of the single assessment process for older people lay in the critique within The NHS Plan of delays in hospital discharge for older people, caused by what was considered to be the failure of health and social services to work together effectively. To tackle this situation the Department of Health allocated monies to new intermediate care services and announced that it would be requiring agencies to 'introduce a single assessment process for health and social care' within their localities.

The article informs that awards for outstanding contributions to older people's care may not be in the same league for glitz and glamour as the Hollywood Oscars but the services they acknowledge have far-reaching consequences for the people they help. At a ceremony in London recently, Help the Aged made seven awards of £ 500 to nurses graduating from the RCN's BSc in gerontological nursing programme. The prizes, presented by Paul Cann, Help the Aged's director of policy, research and international development, mark the end of a successful two-year alliance with the RCN to increase enrolment onto their BSc. Among the award winners is Maureen Catterson, ward sister of the Cathedral Suite, a nurse and therapist-led practice development unit in an acute NHS hospital in Lincolnshire, who also won in the nursing older people category in the Nursing Standard Nurse 2004 awards.

Nursing homes are Great Britain's main providers of continuing care and, because modern healthcare systems involve a complex network of providers, it is essential that the benefits of collaborative approaches to education are recognised across all services. One problem faced by nurses in care homes is professional isolation but study days can provide an opportunity to combat this by meeting others in the same field. The rapid pace of change being experienced in care homes is likely to accelerate as greater numbers of older people with increasingly complex needs enter this sector, and it is imperative that quality and standards are driven by initiatives such as The Essence of Care and benchmarking. The authors describe the development of a training programme designed to educate staff in nursing homes in order to help deliver higher quality care to older people in Great Britain.

The article discusses the impact of the new generation of older adults on medical care systems and the people offering care. The new generation of older people expect a better service and better involvement from the service providers. The impact is one of concordance rather than compliance and acceptance. Health and social care has to recognize a younger old population for whom deference to professionals does not exist. The young old will have higher expectations but more complex family networks.

A new 'map' takes Les Bright down a well worn path in defending advocacy as a necessary and valuable resource for patients who may not be able to express their needs. [ABSTRACT FROM AUTHOR]

The article presents information on a forum known as Ask the Experts. It is a forum in which nurse consultants working with older people debate an issue in older people's care and offer advice. This month they consider a question about the single assessment process (SAP). The National Service Framework for Older People promotes SAP as a key driver in the improvement of older people's services. The purpose of SAP is to ensure that older people receive appropriate, effective and timely responses to their health and social care needs, and that professional resources are used effectively.

Pauline Ford reports on an event that explored the way student nurses are educated to meet the needs of Britain's growing older population. [ABSTRACT FROM AUTHOR]

The article focuses on the abuse of older people. Although the National Service Framework for Older People does not have a standard on elder abuse, the use of the single assessment process — putting the older person at the centre of their care and requiring their consent for intervention — does highlight the ethos of empowering older people. Linked to this, Essence of Care has several standards to promote empowerment of patients. The number of referrals to the Nursing and Midwifery Council for abuse by nurses is much higher among nurses who work in nursing homes. However, this could be because abuse is not recognized in the hospital setting so readily, because poor care is relabeled as 'staff shortages' and because there is not the staffing or management in care homes to protect nurses or to move them elsewhere.

This article presents a narration on her personal experience as a student nurse. A student nurse found that implementing person-centred care was not straightforward. Her experience challenged a belief in the promotion of independence and developed her understanding of professional negotiation. The National Service Framework for Older People (NSF) has person-centred care at its core and using John's, (Johns and Freshwater 1998) reflective model as a guide, the author charted the steps taken to understand the subtleties underpinning the care given to an older person in her placement area. The student nurse is in a unique position to witness a multitude of care-giving examples. Many patients welcome interaction with students and enjoy taking the role of 'tutor' by expressing their views on health and healthcare provision.

All Saints Hospital in Eastbourne, an architectural masterpiece, is about to close after more than 130 years. Journalist Daniel Allen traces its history and its contribution to the care of older people. When the hospital was commandeered by the military during the First World War, a Canadian officer took a note of the hospital's rules, still pinned to the wall after three years of war, among them was this, 'any patient seen going into a public house or heard of there will be instantly dismissed'. The only certainty is that with the hospital's closure a living history book, whose contents describe the evolution of nursing care and changing attitudes to health and sickness over 130 years, will snap shut.

The National Service Framework (NSF) for Older People is now three years into its implementation and this month marks a point at which the achievement of key milestones is being assessed. Ian Philp, national director for older people's services, talks to Hazel Heath about progress so far. Of all the NSFs, the framework for older people has the biggest reach, covering 46 percent of NHS spend, 60 percent of social care spend and the work of over one million health and social care practitioners. Philp was appointed in November 2000 and the NSF was published the following April.

This article reports that four government nurse advisers in Great Britain have challenging but rewarding roles that enable them to raise the profile of the work nurses undertake with older people. Providing expert professional advice to government health departments is a wonderful opportunity to inform the thinking and policy that affects not only thousands of nurses but also tens of thousands of patients. In England, Deborah Sturdy, nurse adviser for older people, has been in post for three years and has been involved in informing the development of substantial policy for the care of older people. INSET: The advisers.

This section offers news briefs concerning research in Great Britain. The study "Quality of Life in Group Homes and Older Persons' Homes" found that older people suffering from intellectual disability have better quality of life outcomes. The green paper "Shaping the Future of Care Together" is open to suggestions on delivery of care and funding for it.

The article offers news briefs related to health care in Great Britain. The British Standards Institute is preparing gold standard guidelines for caring for people with dementia. The Office for National Statistics say that British men and women at pensionable age outnumber children. Researchers at King's College, London, say that people with south Asian or black Caribbean backgrounds, tend to see caregiving as natural, expected and virtuous, but white people derive little reward from it.