The document discusses services for older people in Ireland. It aims to support older people remaining in their homes and communities, provide family carer support, and ensure high quality residential care. Priorities include hospital avoidance, accelerated discharge, residential care avoidance, and improved quality of care and quality of life. Over 360 million is spent annually on home care services. Main reasons for residential care admission are dementia, falls, and stroke. The Health Service Executive has 20 clinical care programs including care of the elderly to improve quality, access, and cost effectiveness of services. Objectives of the elderly clinical care program include improving management of acutely ill older patients, increasing independence at home, reducing falls, and improving education.

1. Health Services Executive Services for Older People Ann Coyle National Planning Specialist for Older People

2. Services for Older People To support Older People to remain in their own homes and communities Support family/informal carers Provide high quality person centred residential care

3. Priorities Hospital Avoidance Accelerated Discharge Residential Care Avoidance Improved Quality of Care Improved Quality of Life

4. Home Support Services 360 million spent in home care Increase of 131 million since 2006 10 million additional in 2010 8million additional in 2011

5. Main reasons for residential care admission Dementia Falls Stroke

6. HSE StructureClinical Strategy and Programmes 20 Clinical Care Programmes To improve the quality of care To improve access to all services To improve cost effectiveness

7. Clinical Strategy and Programmes Care of the Elderly Diabetes COPD Acute Coronary Syndrome Rheumatology Stroke

8. Objectives of the Elderly Clinical Care Programme Quality Improve the management of acutely ill frail older people in acute hospital Increase independence in the home Reduce the number of falls in older people Improve education

9. Access Every patient has quick access to right care Integrate acute and community services for older people Integration with the private sector

10. Cost Overall reduction in ED attendances Readmissions Hospital Bed Days Nursing Home bed days

11. Falls Falls Strategy Environmental Sub Group –telecare identified as an enabler Implementation of the Falls Strategy is a key priority for the Elderly Medicine Clinical Care Programme

12. Interagency working group on Telecare Driven by the HSE Connected to the Housing Aid Grant process DOHC,DEHLG,HSE and user representatives Home Solutions Report

13. Recommendations Should be a substantive part of Home Care Services HSE and DEHLG should develop Assessment processes for Telecare Training and Support for staff Effective commissioning processes

14. Challenges Cost containment Return on Investment Integration Change Management User involvement

15. Challenges No new monies. Any new initiatives must show clear return on investment in hard evidence i.e. reduction in home help hours, reduction in attendances in out patients

16. Integration End to end solutions Any new systems would need to address the whole pathway i.e. provide monitoring systems plus alert follow up Collaborative solutions

17. User Involvement Simple devices Multipurpose Continuous feedback on compliance, ease of use

18. Governance All projects including pilots need to Involve all relevant stakeholders Ensure compliance with relevant legislation and international standards Ensure Procurement Protocols are adhered to

19. Ageing Challenges Demography Image of ageing Encouraging innovation at a time of shrinking resources Balancing Health and Social Care Fragmentation

20. Ageing Opportunities Innovative solutions to our problems Opportunities for collaboration Culture Change