Solutions for Out-Patient Care with Emphasis on the Care for the Elderly

Many western countries, Canada included, are experiencing an increasing aging population, putting substantial pressure on the available healthcare resources. Communities and governments are looking for new and economical ways to provide for the elderly.

Home care is one of the most desirable solutions by elderly, theirs families, and government agencies. Most people prefer the comfort and familiarity of their own home to living in a communal long-term care homes. It reduces unnecessary pressure on hospitals and emergency departments and releases more funds that can be oriented towards preventive and acute care.

But loneliness among elderly, particularly if they are single, has a very negative effect on their well-being. There are many emergency department visits by the elderly for no other reason but to talk to someone. Carla Perissinotto who led the 2012 study at the University of California at San Francisco, said she once encountered an elderly patient in a hospital emergency ward who seemed to have nothing wrong with her. She soon realized the woman was so lonely that she just wanted someone to talk to .
In a 2013 report by Central East LHIN (p.16) a nurse Jill Hall states “Drawing on my experience as a front line nurse, this topic is of a personal interest to me as I have witnessed first-hand the impact of loneliness among seniors visiting the emergency department.”

In UK the National Health Service (NHS) is realizing the effect of loneliness on the elderly : “The rising phenomenon of loneliness among older people needs to be addressed urgently otherwise the NHS risks being crippled by the costs of caring for isolated elderly patients in hospital, the NHS’s most senior acute care doctor has warned. Failure to concentrate on this issue will lead to hospitals being transformed into “dormitories for older people” who have often been dispatched to A&E because they have no support structure at home.”

From the article in UK’s Nursing Times : “The impact of loneliness and isolation on older people at Christmas can cause a major spike in admissions to accident and emergency departments, according to a leading urgent care doctor. Professor Keith Willett, NHS England’s director for acute care, said studies showed that patients left on their own over the festive period were more likely to end up in A&E with worse problems. He cited a recent study in the south west, which showed a clear link between social isolation and care needs in people over 75 admitted to A&E. In the study, carried out by the South West Academic Health Science Network, frailty was not a key reason for being admitted, but 86% were admitted from their own homes and 45% said they were socially isolated.”