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EDITORIALS: Jacqueline Morris, David Beaumont, and David Oliver Decent health care for older people BMJ 2006; 332: 1166-1168 [Full text]

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Decent healthcare for all

Nitika Silhi, Dr Andrew Frank Consultant Rehabilitation Medicine   (4 July 2006)

Decent healthcare for all 4 July 2006
Nitika Silhi, GP Registrar Northwick Park Hospital Harrow Ha1 3UJ, Dr Andrew Frank Consultant Rehabilitation Medicine Send response to journal: Re: Decent healthcare for all	The new National Service Framework for Older People sets out to focus standards amongst others in rooting out age discrimination, promoting person-centred care and promoting health and active life in old age.(1) The image of older people as a problem or burden in health care is widely held including amongst health professionals and older people themselves.(2) This negative image of older people has wide implications for the way that health services are provided, in the same way that negative images of disabled people influence the way they are affected by others. It is this attitude and culture which needs to be challenged and this editorial does little to counter the ageist culture by being ageist itself. We agree that increased longevity is something to celebrate and any impression that older people are a problem should be fought. The person seeking professional help has a disability, or dysfunction, which requires management; therefore it should not matter whether they be 50, 60 or 90. The same respect and dignity is due to all. Why only decent health care for the older person? Why only campaigns among older people to promote greater physical fitness and reduced obesity? Many patients live healthily into old age without any problems and with little contact with the NHS. Those who do have problems have benefited from new targets and protocols within the NHS. We agree that serious illness such as stroke tend to concentrate in later life but their care involving multiple disciplines should not differ from that of the same disease in a younger individual, and vice versa. It may not always be necessary for an older patient to have comprehensive specialist multidisciplinary assessment and care just as it may be necessary occasionally for the younger patient to have this assessment. This editorial highlights that many of the problems of old age are in fact problems of disability in old age and what we should be targeting our energy and resources towards is challenging the attitude and culture towards disability within our population. An ageing population brings new challenges (3) but we should not forget the old challenges in our pursuit of the new. 1. Decent health care for older people BMJ 2006;332:1166-8 2. Time to deliver with dignity BMJ 2003;326:1300 3. Promoting the health and social care of older people:gaining a perspective from outside the UK J R Soc Health 2001;121(3):152-8 Competing interests: None declared