Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T17:25:23.418Z Has data issue: false hasContentIssue false

Chapter 3 - Elderly-Friendly Care Settings and Hospitals

Published online by Cambridge University Press:  04 April 2024

By
Khalid Ali
Edited by
George Tadros  and
George Crowther
George Tadros
Affiliation:
Aston University, Birmingham
George Crowther
Affiliation:
Leeds and York Partnership NHS Foundation Trust, Leeds
Get access

Summary

Older people are one of the biggest populations requiring hospital care, and the demand is expected to rise. There is a compelling need to transform hospital environments to meet older-people physical, psychological, and emotional needs. In the UK, certain hospital circumstances such as ward configuration, mealtimes, noise levels, and visiting hours can be detrimental to patients admitted with delirium and to those living with dementia. In rehabilitation settings, lack of meaningful activities, isolation, and boredom are additional key challenges.

Models of good hospital practice catering for old people exist, both in the UK and internationally, and there is strong evidence for their clinical effectiveness. Environmental strategies to maintain orientation and enhance safety in hospital are crucial for a positive experience. Arts-based programmes in acute care settinsg can improve the experience of a hospital admission.

A cultural shift is warranted to champion the delivery an elderly-friendly service. Creating the right environment requires a hospital-wide system, a ward-based service, and a specially trained clinical team. In this chapter we will present examples of essential ingredients for hospitals and wards, and desirable qualities in clinicians who work in collaboration to deliver the best outcomes for an older population.

Keywords

olderpeoplehospitalenvironmentwardadmissionservicedeliriumstrategiesoutcomes
Type
Chapter
Information
Handbook of Old Age Liaison Psychiatry , pp. 38 - 43
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

WHO, National Institute on Aging, and National Institute of Health. Global health and aging. WHO, National Health publication number 11-7737, October 2011. www.nia.nih.gov/sites/default/files/2017-06/global_health_aging.pdf.Google Scholar
WHO. Ageing and health. Fact sheet number 404. WHO, September 2015. www.who.int/news-room/fact-sheets/detail/ageing-and-health.Google Scholar
National Audit Office. Discharging Older Patients from Hospital. Report, NAO 2016. www.nao.org.uk/wp-content/uploads/2015/12/Discharging-older-patients-from-hospital.pdf.Google Scholar
Brennan, T.A., Leape, L.L., Laird, N.M. et al. Incidence of adverse events and negligence of hospitalized patients: Results of the Harvard Medical Practice Study 1. N Engl J Med 1991, 324: 370–6.CrossRefGoogle Scholar
Covinsky, K. E., Pierluissi, E., and Johnston, C.B.. Hospitalization-associated disability: ‘She was probably able to ambulate, but I’m not sure’. JAMA 2011, 306: 1782–93.CrossRefGoogle Scholar
Murray, G.R., Cameron, I.D., and Cumming, R.G. The consequences of falls in acute and subacute hospitals in Australia that causes proximal femoral fractures. J Am Geriatr Soc 2007, 55: 577–82.CrossRefGoogle ScholarPubMed
Covinsky, K.E. Malnutrition and bad outcomes. J Gen Intern Med 2002, 17: 956–7.CrossRefGoogle ScholarPubMed
Berry, J.G., Gay, J.C., Maddox, K.J. et al. Age trends in 30 day hospital readmissions: US national retrospective analysis. BMJ 2018, 360: k497. doi: 10.1136/bmj.k497.CrossRefGoogle ScholarPubMed
Kelly, M.L. Senior-friendly emergency department care: An environmental assessment. Journal of Health Services Research and Policy 2011, 16: 6–12.CrossRefGoogle Scholar
Parke, B., and Stevenson, L. Creating an elder-friendly hospital. Healthcare Manage Forum 1999, 12: 45–8.CrossRefGoogle ScholarPubMed
Parke, B., and Brand, P. An elder-friendly hospital: Translating a dream into reality. Nurs Leadersh 2004, 17: 62–76.CrossRefGoogle ScholarPubMed
Chiou, S.T., and Chen, L.K. Towards age-friendly hospitals and health services. Arch Gerontol Geriatr 2009, 49S2: S3–S6.CrossRefGoogle Scholar
Boltz, M., Capezuti, E., and Shabbat, N. Building a framework for geriatric acute care model. Leadersh Health Serv 2010, 23: 334–60.CrossRefGoogle Scholar
Wong, K.S., Ryan, D.P., and Liu, B.A. A system-wide analysis using a senior-friendly hospital framework identifies current practices and opportunities for improvement in the care of hospitalized older adults. JAGS 2014, 62: 2163–70.CrossRefGoogle ScholarPubMed
Khadaroo, R.G., Badawal, R.S., Wagg, A.S. et al. Optimising senior’s surgical care: Elder-Friendly Approaches to the Surgical Environment (EASE): Rationale and objectives. BMC Health Services Research 2015, 15: 338. doi: 10.1186/s12913-015-1001-2.CrossRefGoogle Scholar
Verma, J. Healthcare for the ageing citizen and the ageing citizen for healthcare: Involving patient advisors in elder-friendly care improvement. Healthcare Quarterly (Toronto) 2017, 20: 14–17.CrossRefGoogle ScholarPubMed
Reid, J., Wilson, K., Anderson, K.E., Maguire, C.P.J. Older patients’ room preference: Single versus shared accommodation. Age and Ageing 2015, 44: 331–3.CrossRefGoogle ScholarPubMed
Van de Glind, I., Van Dulmen, S., and Goossensen, A. Physician–patient communication in single-bedded versus four-bedded hospital rooms. Patient Educ Couns 2008, 73: 215–19.CrossRefGoogle ScholarPubMed
Pennington, H., and Isles, C. Should hospitals provide all patients with single rooms? BMJ 2013, 347: f6333. doi: https://doi.org/10.1136/bmj.f5695.CrossRefGoogle ScholarPubMed
Luker, J., Lynch, E., Bernhardsson, S. et al. Stroke survivors’ experiences of physical rehabilitation: A systematic review of qualitative studies. Arch Phsy Med Rehabil 2015, 96: 1698–708.Google ScholarPubMed
Brereton, L., Gardiner, C., Gott, M., Ingelton, C., Barnes, S., and Carrroll, C. The hospital environment for end of life care of older adults and their families: An integrative review. Journal of Advanced Nursing 2011, 68: 981–93.CrossRefGoogle ScholarPubMed
Ford, K., Tesch, L., Dawborn, J. et al. Art, music, story: The evaluation of a person-centred arts in health programme in an acute care older people’s unit. Int J Older People Nurs 2018. doi: 10.1111/opn.12186.CrossRefGoogle Scholar
Istvandity, L. Combining music and reminiscence therapy interventions for wellbeing in elderly populations: A systematic review. Complement Ther Clin Pract 2018, 28: 18–25.CrossRefGoogle Scholar
Parke, B., Boltz, M., Hunter, K.F. et al. A scoping literature review of dementia-friendly hospital design. Gerontologist 2017, 57: e62–e74.Google ScholarPubMed
O’Keeffe, S., and Lavan, J. The prognostic significance of delirium in older hospital patients. J Am Geriatr Soc 1997, 45: 174–8.Google ScholarPubMed
Vazquez, F., O’Flaherty, M., Michelangelo, H. et al. Epidemiology of delirium in elderly inpatients. Medicina 2000, 60: 555–60.Google ScholarPubMed
Edlund, A., Lundstrom, M., Karlsson, S. et al. Delirium in older patients admitted to general internal medicine. J Geriatr Psychiatry Neurol 2006, 19: 83–90.CrossRefGoogle ScholarPubMed
Campbell, N., Boustani, M.A., Ayub, A. et al. Pharmacological management of delirium in hospitalized adults- systematic evidence review. J Gen Intern Med 2009, 24: 848–53.CrossRefGoogle ScholarPubMed
Lonergan, E., Britton, A.M., Luxenberg, J. et al. Antipsychotics for delirium. Cochrane Database Syst Rev 2007, 18: CD005594. doi: 10.1002/14651858.CD005594.pub2.Google Scholar
McCusker, J., Cole, M., and Abrahamowicz, M. Environmental risk factors for delirium in hospitalized older people. J Am Geriatr Soc 2001, 49: 1327–34.CrossRefGoogle ScholarPubMed
Anon., E.D. Meet the needs of aging patients with a senior-friendly ED. ED Management: The Monthly Update on Emergency Department Management 2011, 23: 85–8.Google Scholar
Missildine, K. Sleep and the sleep environment of older adults in acute care settings. Journal of Gerontological Nursing 2008, 34: 15–21.CrossRefGoogle ScholarPubMed
Flaherty, J.H., and Little, M.O. Matching the environment to patients with delirium: Lessons learned from the delirium room, a restraint-free environment for older hospitalized adults with delirium. JAGS 2011, 59: S295–S300.CrossRefGoogle Scholar
Mazzei, F. Exploring the influence of environment on the spatial behaviour of older adults in a purpose-built acute care dementia unit. American Journal of Alzheimer’s Disease and Other Dementias 2014, 4: 311–19.Google Scholar
Day, J., Higgins, I., and Keatinge, D. Orientation strategies during delirium: are they helpful? Journal of Clinical Nursing 2011, 20: 3285–94.CrossRefGoogle ScholarPubMed
Anon. Specialised environments to meet the needs of older people. Nursing Older People 2007, 19: 39. Abstract at https://journals.rcni.com/doi/abs/10.7748/nop.19.2.39.s25.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×