Education And Debate

Caring for Older People: Community services: health

BMJ 1996; 313 doi: (Published 28 September 1996) Cite this as: BMJ 1996;313:805
  1. M Pushpangadan, registrara,
  2. E Burns, consultant physiciana
  1. a Department of Medicine for the Elderly, Leeds General Infirmary, Leeds LS1 3EX

    Many frail or disabled elderly people are now being maintained in the community, partially at least as a consequence of the Community Care Act 1993. This paper details the work of the major health professionals who are involved in caring for older people in the community and describes how to access nursing, palliative care, continence, mental health, Hospital at Home, physiotherapy, occupational therapy, equipment, and optical, dental, and dietetic services. In many areas, services are evolving to meet needs and some examples of innovative practice are included.

    The provision of health care to elderly people in the community is an important aim of the health service, perhaps particularly since the introduction of the Community Care Act 1993. About 8.5 million people over 65 years old are living in their own homes.1Older people comprise 70% of the 6.2 million people with disability, and 92% of elderly disabled people live in their own homes. The general practitioner plays a pivotal role in the delivery and coordination of such patients' health care. This article describes the role of other health professionals in caring for older people at home.

    Nursing services

    After inpatient medical care, rehabilitation and convalescence is often continued and completed in the community. District and liaison nurses provide continuity of care after discharge from hospital.

    Liaison nurses are usually employed by hospitals and provide a professional link between hospital and community health services. They can improve the quality of transfer for patients from hospital to the community; liaise with social service departments and help to assess patients' needs; identify and respond to problems occurring at the point of discharge; and improve communication between services.

    District nurses provide nursing treatment and support to patients and their caregivers within a variety of community settings—patients' own homes, health centres, and residential homes. They are …

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