Over the last few decades, the numbers of people in the over 65 year age group in Ireland has demonstrated an upward trend and is anticipated to continue along this trajectory. It is estimated that by 2041, the over 65yrs age group population will further increase to 1.4 million, which would make up 22% of the overall population (Source: McGill, P. Illustrating Ageing in Ireland North and South: Key Facts and Figures, 2010). Specific to the greater Dublin area the >65 year age group is expected to increase from 160,000 persons in 2006, to 332,000 in 2026 (Central Statistics office, 2008). This increase is visible at hospital demographic level, with significant changes in the age profile of both attendances and complex discharges from Beaumont Hospital.
Beaumont Hospital has recently embarked on a journey to become the first Age Friendly Hospital in Ireland. The initiative is embedded in an Organisational commitment to the development of comprehensive, integrated and patient focused services for Older Persons – guided by both WHO Age Friendly Principles (2004) and the key tenets of the National Care of the Elderly Programme (NCPOP, 2012).
Beaumont Hospital has recently established a collaborative partnership with Age Friendly Ireland to support the Age Friendly Hospital initiative. Beaumont Hospital has previously been linked with the Fingal Age Friendly County Alliance through a number of projects including OPRAH and the Fingal Health Route, and as a result became aware of the opportunity to collaborate with the Age Friendly Programme.
In tandem with the Older Persons consultation process the Organisation continues to strive to progress implementation of the Care of the Elderly Model of Care (NCPOP, 2012). To date we have built a new offsite Day Hospital for Older persons (May 2014) that provides Comprehensive Geriatric Assessment 2 days/week with auxiliary services on the remaining days, expanded our rehabilitation bed base, improved the efficiency of our first Care of the Elderly ward and begun a pathway for the admission of Frail older people from time of arrival to the Emergency Department to discharge from hospital. It is acknowledged that further progression of the above pathways present significant challenges for the system in terms of both resources and service capacity to support the changes required. In the short term, the establishment of a second Specialist Geriatric Ward and expansion of day hospital services is planned to help realise these goals.
Despite these challenges, there is an Organisational acknowledgement that establishment of an Age Friendly Hospital goes beyond the remit of easily accessible infrastructure and readable signage – but rather an organisation-wide cultural change is required to fully embrace development of a hospital system and environment that adequately supports and promotes Age Friendly Care. The nature of hospital care dictates that expertise in clinical aspects such as disease progression, treatment regimens, needs and outcomes is a necessity – however to be truly Age Friendly, there is a requirement for experience-based knowledge and in -depth understanding of what it means to be old, struck by illness, and being rushed to an unfamiliar hospital environment (Edvardsson and Nay 2007).
Beaumont Hospital recognise the importance and absolute necessity of a collaborative approach to delivery of Care of the Elderly services across Acute and Community Care providers, with effective integration and amalgamation of services a crucial component of Age Friendly Care. The Organisation is committed to delivering on the objectives of the Age Friendly Hospital initiative in tandem with the clinical objectives of the National Care of the Elderly Programme and in doing so seeks to substantially improve quality and efficiency of care for Older People with complex care needs.