Better communication with elderly in hospitals 'key' this winter

Bernard Gloster: 'The reality is that care in the community is where they should be. It would be preferable to be out of the acute hospital.' 

Communication with older patients in hospitals about further care options is critically important this winter, Nursing Homes Ireland have said.

The comments come amid growing concern over HSE advice to hospitals around speeding up the discharge of older patients.

In a memo last week from HSE chief Bernard Gloster, hospitals were advised that if older patients were in need of nursing home care after hospital and a bed is not available locally, they could be discharged to another location temporarily.

“One of the issues for us really is around communication,” Tadhg Daly, Nursing Homes Ireland ceo said.

“The key thing for me is communication with the older person early on. Choice is reduced in some areas anyway because of the closures (of nursing homes) across the country. Choice isn’t always possible.” 

He added: “The principle of residents’ choice is critically important obviously.” 

In these situations, he said: "The reality is that care in the community is where they should be. It would be preferable to be out of the acute hospital.” 

About 220 people are discharged monthly from hospitals to nursing homes, he said.

He noted that under the Fair Deal, monies can be transferred if a patient prefers to move.

However, he echoed concerns expressed by Professor Des O’ Neill, Irish Society of Physicians in Geriatric Medicine, around gaps in older people’s care.

“We are not planning for the ageing population,” he warned. “Des’ point is well-made. 

"Do we need step-down facilities, do we need rehab? Absolutely we do. But do we need them as part of the nursing home offering, or do we need them separate?”

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HSE chief clinical officer Dr Colm Henry defended the plans on Monday, saying: “We are not in the business of forcing and we won’t be in the business of forcing. We are in the business of working compassionately with patients.” 

He said the policy is driven by concern for two groups. This includes 22,000 over-75s who spent longer than 24 hours on trolleys last year: “The group of people who do not need to be in hospital and it is not in their interest, indeed it is arguably unsafe for those people to have a protracted stay in hospital.” 

In reference to criticism, he said: “We take any concerns seriously and I will be meeting some of these groups to explain what we are doing.”