Older People's Health

Overview

Healthy ageing

Healthy ageing means supporting independence, safety, dignity, physical health, mental wellbeing, social connection and quality of life.

Important checks include:

• blood pressure
• medicines review
• eyesight and hearing
• falls risk
• memory concerns
• mobility
• nutrition and hydration
• continence
• mood and loneliness
• pain
• long-term condition reviews
• carer support

Dementia

Dementia is a group of conditions affecting memory, thinking, language, behaviour and daily functioning. NHS guidance lists common early symptoms such as memory loss, difficulty concentrating, struggling with familiar tasks, confusion about time or place, and mood changes.

Ask the GP for:

• memory assessment
• blood tests
• medication review
• referral to a memory clinic
• carer support
• social care assessment
• advance care planning
• driving advice if needed

Alzheimer’s disease

Alzheimer’s disease is the most common cause of dementia. Early symptoms often include memory lapses, repeating questions, misplacing items, word-finding problems, reduced judgement and becoming less flexible.

Support may include:

• memory clinic diagnosis
• medicines where suitable
• dementia adviser
• occupational therapy
• social care support
• carer’s assessment
• benefits advice
• lasting power of attorney planning
• advance care planning

Falls prevention

Falls are more likely in older people and those with mobility problems. NHS advice says changes can reduce injury risk and help people keep confidence and independence.

Ask for:

• falls assessment
• medication review
• eyesight check
• footwear advice
• strength and balance exercises
• walking aid review
• home hazard assessment
• physiotherapy
• occupational therapy
• pendant alarm or telecare

Call 999 after a fall if there is severe pain, head injury, suspected broken bone, chest pain, stroke symptoms, confusion, collapse or the person cannot get up safely.

Frailty

Frailty means someone may be more vulnerable to sudden changes in health after infection, a fall, medication problems or hospital admission.

Signs may include:

• weakness
• slow walking
• exhaustion
• weight loss
• frequent falls
• confusion or delirium
• reduced independence
• repeated hospital admissions

Ask the GP or hospital team for a frailty review, care plan, falls plan, medicines review and community support.

Care planning

A good care plan should explain:

• main diagnoses
• medicines
• allergies
• mobility needs
• communication needs
• emergency contacts
• carer details
• risk plan
• what to do if health worsens
• preferred place of care
• review dates

You can ask for a care needs assessment from the local council and a carer’s assessment if someone provides unpaid care.

End of life care

End of life care supports people who may be in the last months or years of life. NHS guidance explains it can be provided at home, in care homes, hospices or hospitals, and should include physical, emotional, practical and spiritual support.

For dementia, NHS guidance says end-of-life and hospice care may be provided at home, and GPs can arrange community nursing support.

Ask for:

• palliative care referral
• pain and symptom control
• community nursing
• hospice advice
• carer support
• equipment at home
• night sitting or respite options
• emergency medicines
• bereavement support

Advance care planning

Advance care planning means thinking and talking about future care wishes in case a person later becomes unable to make or communicate decisions. NHS guidance explains that it can include preferences for care, emergency treatment and the ReSPECT process.

Consider discussing:

• where the person would prefer to be cared for
• what matters most to them
• who should be involved in decisions
• treatment preferences
• resuscitation discussions
• lasting power of attorney
• advance decision to refuse treatment
• preferred place of death
• spiritual, cultural or family wishes

Legal rights

Older people have rights to:

• dignity and respect
• safe care
• informed consent
• involvement in decisions
• confidentiality
• access to records
• reasonable adjustments
• protection from discrimination
• safeguarding if at risk of abuse or neglect
• complaint and investigation

Relevant law and guidance includes:

• NHS Constitution
• Equality Act 2010
• Mental Capacity Act 2005
• Care Act 2014
• Human Rights Act 1998
• safeguarding duties

Accessible support

Ask NHS services for:

• Easy Read
• large print, Braille or audio
• hearing loop
• interpreter
• BSL support
• longer appointments
• quiet waiting area
• wheelchair access
• carer involvement
• home visit if clinically needed
• hospital passport
• reasonable adjustment flag

Evidence and accountability

Keep:

• appointment letters
• medicines list
• care plans
• falls diary
• memory concerns diary
• hospital discharge summaries
• test results
• weight, appetite and hydration records
• photos of injuries where appropriate
• names of staff spoken to
• copies of complaints and replies

Ask for:

• written diagnosis
• review date
• medication plan
• discharge plan
• falls plan
• dementia care plan
• crisis plan
• advance care plan
• referral confirmation

If care is delayed, unsafe or inaccessible, contact the GP practice manager, hospital PALS, NHS complaints team, local authority complaints team, safeguarding team, or the Parliamentary and Health Service Ombudsman.

Official links

• NHS dementia: https://www.nhs.uk/conditions/dementia/
• NHS Alzheimer’s disease: https://www.nhs.uk/conditions/alzheimers-disease/
• NHS falls: https://www.nhs.uk/conditions/falls/
• NHS end of life care: https://www.nhs.uk/tests-and-treatments/end-of-life-care/
• NHS advance care planning: https://www.nhs.uk/tests-and-treatments/end-of-life-care/planning-ahead/
• NHS dementia and end of life planning: https://www.nhs.uk/conditions/dementia/living-with-dementia/palliative-care/
• NHS complaints: https://www.nhs.uk/contact-us/how-to-complain-to-the-nhs/
• NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england
• Care needs assessment: https://www.gov.uk/apply-needs-assessment-social-services
• Carer’s assessment: https://www.gov.uk/carers-assessment

Best rule: plan early, keep records, review medicines, prevent falls, involve carers, request reasonable adjustments, and escalate quickly if safety, dignity or care quality is at risk.