Older people

Hello, and welcome to this page which contains learning and resources to help you develop your knowledge and skills to provide effective care to older people.

As the population in the United Kingdom is ageing by five hours each day, demands on current NHS services are growing all the time. The health needs of this ageing population are becoming increasingly complex, which means the way in which healthcare professionals work collaboratively to provide seamless care has never been more important. In January 2019, the NHS published its Long-Term Plan which sets out an ambitious ten-year vision for healthcare in England which amongst other targets, aims to meet the escalating healthcare demands of a growing and ageing population.

On this page you can find a range of learning materials and resources. You can start with the test yourself quiz to identify any gaps in your knowledge then work through the core and foundation learning where we explore issues such as polypharmacy and share some practical tips for managing long-term conditions. There’s an e-learning programme suitable for all pharmacy professionals about optimising medicines for people in care homes. We have provided advanced learning materials where we explore the challenges of communicating effectively with patients living with dementia and discuss the importance of involving them in consultations.

We invite you to use the tools linked to NICE clinical guidelines and resources from organisations that support older people to help you enjoy developing your practice.

Transcript

Welcome to this page that contains learning and resources with a focus on older people.

The United Kingdom is ageing by five hours each day. Currently there are 11 million people over 65 years of age and three million over 80 years of age, and that number is continuing to rise. This ageing population, living with increasingly complex health needs is adding to the pressure on current NHS services and requires us to change the way we work together.

The NHS has set out the Five Year Forward View, as a way to make these changes happen. The report suggests breaking down barriers between care providers, empowering patients to take more control of their own health, increasing support for carers and finding ways to better support the rising number of people living with dementia.

If you are just getting started, the Older People distance learning programme will provide you with a broad overview of the subject which you can then follow up with further learning in specific areas to meet your personal needs.

On completing this learning, you will be able to adapt your person-centred consultation style to support older people with their medicines use, especially those who are frail or have mental health problems. You will also learn about the impact of the physical, behavioural and socio-economic challenges faced by older people on their use of medicines and how pharmacy services can support them.

Learning Outcomes:

• explain the importance of taking a person-centred approach to support older people with their medicines use, which reflects the differing needs of older people, especially those who are frail or have mental health problems
• outline the healthcare settings commonly used by older people, the role of various people who provide care for older people and the role of pharmacy in supporting the safe transfer of care between settings
• describe the impact of the physical, behavioural and socio-economic challenges faced by older people on their use of medicines and how pharmacy services can support medicines optimisation
• describe the effects of ageing on the pharmacokinetics and pharmacodynamics of medicines and the causes and consequences of polypharmacy
• outline the role of the pharmacy team in safeguarding vulnerable older people.

This programme aims to help you to develop your knowledge and skills to improve your confidence and competence in working with patients and other health and social care professionals to enable patients to get the best possible outcomes when they are taking multiple medicines.

Learning Outcomes:

• explain the terminology associated with polypharmacy and what it means for patients and the health and social care team
• list the causes and consequences of polypharmacy in relation to the patient, their carer and the wider NHS
• identify medicines that cause problems for patients with polypharmacy and triggers that may indicate that polypharmacy is problematic
• explain the main considerations when stopping a patient's medicines, what barriers might exist and how to overcome these
• describe how you could use decision-making tools and strategies to support your practice when consulting with patients on multiple medicines
• explain how you could undertake patient-centred discussions about polypharmacy with patients during a medication review or medicines use review
• work in partnership with the patient to prioritise interventions and agree referral strategies
• identify and apply suitable resources and tools to support you in identifying polypharmacy issues and solutions as part of your clinical judgement and experience
• describe the process of shared decision-making and recognise its value in supporting adherence in patients taking multiple medicines
• identify a change you could make to your practice to improve your approach to managing polypharmacy.

The aim of this learning programme is to update your knowledge about working with care homes, the roles and responsibilities of the teams involved and the legal issues, guidance and regulations surrounding medicines in care homes. Through practice-based activities the programme supports you to use that knowledge in care homes and help residents make the most out of their medicines.

Learning Outcomes:

• present an overview of social and healthcare teams involved in care homes, including specific details for your local area
• recognise the responsibilities of the pharmacy team within care homes
• demonstrate an understanding of the policies, processes and legislation relating to care homes by creating a plan to apply in your practice
• describe safe and effective processes for the management of medicines in care homes and understand how these processes link to community pharmacies and general practices
• identify the steps and people involved in the medicines review process in care homes, and how this supports medicines optimisation
• explain the roles of the people involved in the care of residents and the management of their medicines in a care home and describe how the pharmacy team can communicate effectively with them to reduce medicines-related problems.

The Safeguarding adults Level 1 e-learning programme and assessment covers the statutory and mandatory training to meet the learning outcomes in the UK Core Skills Training Framework.

To meet Level 1 safeguarding requirements, you should also complete the Safeguarding children Level 1 e-learning and assessment

If you are required to meet Level 2 safeguarding training and competency, in addition to this Safeguarding adults Level 1 programme, you should also complete the following e-learning and assessments:

• Safeguarding adults Level 2
• Safeguarding children Level 1
• Safeguarding children Level 2

Please note: The Safeguarding children Level 1 e-learning and assessment programme provided by Health Education England’s elearning for healthcare (elfh) hub is accessed by clicking on the ‘Access’ button above. When you reach the elfh webpage, you will need to create an elfh account if you have not already done so. Please be aware that CPPE does not maintain control over the accuracy and currency of this programme.

Learning Outcomes:

• describe the process whereby someone is first alerted to a concern or incident that suggests an adult with care and support needs: is experiencing or is at risk of abuse or neglect, and as a result of their care and support needs, is unable to protect themselves against abuse or neglect, or the risk of it
• describe how to respond to, and report, a concern
• define the term ‘adult safeguarding' and underlying statutory principles that underpin adult safeguarding work
• define abuse and neglect, patterns, types and list possible indicators
• identify why some adults are more at risk from abusive behaviour
• explain the role you must play in recognising and reporting and whom you need to speak to if you have a safeguarding concern.

The Safeguarding adults Level 2 e-learning programme and assessment covers the statutory and mandatory training to meet the learning outcomes in the UK Core Skills Training Framework.

To meet Level 2 safeguarding training and competency, in addition to this Safeguarding adults Level 2 programme, you should also complete the following e-learning and assessments:

• Safeguarding adults Level 1
• Safeguarding children Level 1
• Safeguarding children Level 2

Please note: The Safeguarding children Level 1 e-learning and assessment programme provided by Health Education England’s elearning for healthcare (elfh) hub is accessed by clicking on the ‘Access’ button above. When you reach the elfh webpage, you will need to create an elfh account if you have not already done so. Please be aware that CPPE does not maintain control over the accuracy and currency of this programme.

Learning Outcomes:

• list the principles of the Care Act (2014) which has changed the way people who have care and support needs, including those who are having difficulty understanding what is happening to them and should be assessed and involved in their care and support pathway
• describe the importance of the safety and well-being of people with care and support needs, including making safeguarding personal and the identification of abuse and principles underlying the Care Act 2014 and Mental Capacity Act 2005 and subsequent MCA amendment ACT 2019
• use your local multi-agency policies and procedures to identify the stages under the adult safeguarding process for the protection of adults with care and support needs
• describe your local statutory adult safeguarding board's policy and procedures regarding escalation and challenge if you think that your concerns are not being taken seriously.

This learning will support you to adopt a person-centred approach to involving people with dementia in consultations and decisions about their treatment and health.

Learning Outcomes:

• discuss the importance and benefits of involving people with dementia in consultations and decisions about their treatment and health
• describe the skills and techniques needed to engage and communicate effectively with people with dementia
• identify some key national practice standards most applicable to pharmacy consultations with people with dementia
• recognise and address the challenges of a three-way consultation
• apply the knowledge, behaviours and person-centred skills needed to maximise the effectiveness of your consultations with people with dementia.

The aim of this programme is to support you to apply underpinning safeguarding knowledge and develop the confidence and skills to identify and report safeguarding concerns you encounter in practice. It will enable you to consider how you can take a person-centred approach to safeguarding and understand how you can meet your safeguarding responsibilities in whichever sector(s) of practice you work.

Please note: completion of this programme is not sufficient on its own to meet the core Level 2 safeguarding training requirements. Pharmacy professionals must also complete the elearning for healthcare (elfh) Level 1 & 2 learning and assessments (or equivalent). You can access the elfh safeguarding programmes here:

Safeguarding adults Level 1

Safeguarding adults Level 2

Safeguarding children Level 1

Safeguarding children Level 2

Learning Outcomes:

• explain your role and responsibilities in safeguarding adults, children and young people
• recognise potential signs of neglect and abuse that you may encounter in pharmacy practice across integrated care systems
• use your knowledge of guidance and legislation to identify safeguarding concerns where a person lacks the mental capacity to consent and make decisions for themselves
• take appropriate action when you identify a safeguarding concern, including seeking advice, reporting, appropriately sharing information and recording your concerns
• apply your learning to take a person-centred approach to safeguarding concerns
• build a toolkit of resources to support you and your pharmacy team when dealing with safeguarding concerns.

This guideline covers assessment of falls risk and interventions to prevent falls in people aged 65 and over. It aims to reduce the risk and incidence of falls and the associated distress, pain, injury, loss of confidence, loss of independence and mortality.

The indicators presented in this profile underline the scope to improve health outcomes by ensuring that all older people receive the opportunities, care and support delivered in the best-performing localities.

The Age UK website offers a wide range of information and resources to support people and their carers.

British Geriatrics Society webpage

Caeres Trust offers a wide range of resources and information for anyone who works with carers.