Care of the Long-Stay Elderly Patient

1. Front Matter

   Pages i-xii

   PDF

2. Preventing Institutionalization: Policy Issues

   1. Front Matter

      Pages 1-1

      PDF

   2. The elderly in continuing-care units

      • Michael J. Denham

      Pages 3-11

   3. Standards of institutional care for the elderly

      • S Haywood

      Pages 12-28

   4. The physician and the continuing-care patient

      • Michael J. Denham

      Pages 29-42

3. General and Specific Aspects of Care

   1. Front Matter

      Pages 43-43

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   2. Quality of life: assessment and improvement

      • C. Twining

      Pages 45-68

   3. At home in hospital or nursing home?

      • T. Dartington, Michael J. Denham

      Pages 69-84

   4. Nursing care

      • P. Hibbs

      Pages 85-108

   5. Nutritional care of the long-stay patient

      • P. J. Brereton

      Pages 109-125

   6. Ward furniture and equipment

      • M. Clarke-Williams

      Pages 126-148

   7. Communication with patients in residence

      • M. Meikle, S. Holley

      Pages 149-160

   8. Education and life in the long-stay ward

      • S. Jones

      Pages 161-182

   9. Art education

      • S. Poulden

      Pages 183-196

   10. Dramatherapy

       • D. M. Langley, G. E. Langley

       Pages 197-216

   11. The value of music to the long-term patient

       • J. Alvin

       Pages 217-230

   12. Continuing care for the elderly mentally infirm — an occupational therapy contribution

       • M. C. Conroy

       Pages 231-242

   13. Continuing care for the elderly mentally infirm — a physiotherapy perspective

       • B. Sutcliffe

       Pages 243-261

4. Improving Quality of Life: Case-Studies

   1. Front Matter

      Pages 263-263

      PDF

   2. Roxbourne Hospital

      • E. Sonia Glossop

      Pages 265-274

Since the first edition of this book was published there have been considerable changes in continuing care. NHS nursing homes have been created, enthusiasts have developed new initiatives, and attempts have been made to improve attitudes. The recent White Paper on Community Care is likely to accelerate the transfer of large numbers of elderly patients from long-stay hospital beds to private-sector accommodation: a move often accompanied by much anxiety about standards of care. Although Health Authorities visit private nursing homes and apply the National Association of Health Authorities' standards to them, anxieties continue. Unfortunately for the patients who remain in hospital, many Health Authorities seem reluctant to apply these same standards to their own long-stay departments, since many would fail abysmally. The 1987 annual report of the Health Advisory Service (see Chapter 3) presents a damning indictment of the care given to old people: A recent review of twelve consecutive HAS Reports on services for older people in hospitals shows that long-stay wards consistently offered environments which were unable to offer privacy, homely surroundings, personal space and possessions or adequate furniture. In the twelve districts there was not one comprehensive personalised clothing service. Half of the reports commented on the lack of effec­ tive management of continence. Catering was often provided according to the needs of the institution rather than those of the resident patients.

• assessment
• communication
• management
• nursing
• nutrition
• occupational therapy
• physiotherapy
• quality of life

• Northwick Park Hospital, UK

  Michael J. Denham

Policies and ethics