Assessing the mental health needs of older people
Effective assessment of needs requires appropriate services to meet those needs. Most older people wish to stay in their own homes and remain independent for as long as possible, with the right support, and this is also true of older people with mental health needs. Older people with mental health needs are entitled to the full range of community care and health services available to other older people, but this may require specific planning or special services. Increasingly, mainstream services such as sheltered housing are recognising that they have a role to play. Other services are adapting, or new services are being developed, to meet the particular needs of, for instance, older people with dementia.
Key research findings
For a more detailed account, see Research Summary 4 .
While there has not been a great deal of systematic evaluation in recent years of which services work best for older people with mental health needs, there is some evidence to suggest that community care services such as home care and day care can be effective in supporting people with a range of needs and preventing deterioration. Services targeted at specific needs and involving continued contact appear to show greater success.
The following are some of the key findings from research:
- Older people with mental health needs want the
same from services as other older service users.
- to be treated as an individual
- access to social contact and company
- access to meaningful activity, stimulation and integration
- to feel safe and secure
- to feel valued and respected.
- Services for older people with mental health
needs are more effective when they are:
- Specialist services targeted at particular groups
- Provided as the result of a comprehensive assessment
- Associated with follow up visits and ongoing support.
- Service users rate highly 'low level' preventative services for their impact on quality of life, although organisations have doubts about cost effectiveness.
- No single service is the key to meeting needs.
A range of good quality care services all make
a contribution. For instance:
- Specialist home care services
- Extended hours day care provision
- Respite and sitting services in the person's own home.
- Older people and their families do not get access to the right sort of information early enough.
- Make sure you are well informed about older people's mental health needs.
- Have useful information available for sharing with older people and families.
- Think widely when planning to meet needs - consider all types of services and organisations.
- Ensure all aspects of need are covered.
- Take time to build trust and ensure that service providers do too.
- Stay involved yourself, or make sure that someone else is appointed to do so.
- Aim for continuity of services and staff.
- Be prepared to accept an element of risk.
- Keep positive and imaginative: you can make a difference.
Alzheimer's Scotland has summarised the range of needs experienced by older people with dementia and their families as follows:
- health care needs, including diagnosis, assessment and treatment
- information on the illness, coping techniques, financial and legal issues, services available and planning ahead
- advocacy support to assist in accessing services
- practical support including rehabilitative approaches to managing memory loss, disorientation or difficulties with daily living skills
- emotional support including one-to-one support and support groups
- social support to combat isolation and stigma, and to ensure that they can continue their usual level and range of activities or even develop new initiatives
- financial support to offset income loss for younger people with dementia or relatives who give up work.(31)