The Health Service Executive Older Persons Service will implement a revised model of Homecare in collaboration and consultation with the National Clinical programme for Older Persons, National Older Person’s office and other divisions within the community Health Organisation, hospital groups and older people. This is directly in response to the National Positive Ageing Strategy 2013 goal 3 “enabling people to age with confidence, security and dignity in their own homes and communities for as long as possible”
The Health Service Executive Older Persons Service will build capacity and reform existing Service Providers by reviewing unmet need in local communities in the areas of Day Care, Meals on Wheels and other community support services.
The Health Service Executive will continue to support the development the Day Hospital and Memory Clinic at Sacred Heart Hospital to ensure that older people from Carlow can have access to a comprehensive geriatric service.
St. Luke’s General Hospital will continue to provide its Geriatric Emergency Medicine (GEMS) team whose aim is to:
To provide access to Comprehensive Geriatric Assessment (Multidisciplinary) for patients over 75 years old presenting to ED and AMAU (Acute Medical Assessment Unit).
To improve functional outcomes for older people attending the hospital
To increase discharges from acute floor and reduce numbers of patients admitted
To reduce re-attendance rates of non-admitted patients
To reduce Length of Stay of admitted patients
To reduce readmission rates
To reduce the institutionalisation of older people
The Health Service Executive will support, directly and indirectly, through the Service Providers Forum, the roll out of the national advocacy programme,
SAGE (Sage Support and Advocacy Service for Older People) into the community to ensure older adults have access to supports and information and an independent advocate volunteer that will support their independence and wellbeing.
Carlow Volunteer Centre will continue to support organisations by the referral of volunteers, provision of information, training and capacity building in the area of effective Volunteer Management. Carlow Volunteer Centre continues to promote volunteer opportunities and promote the positive impacts of volunteering via traditional media to reach older people. Carlow Volunteer Centre provides this service to a range of existing organisations which support older adults for example Day Care Centres, Carlow Libraries, Meals on Wheels, St. Fiacc’s House. Carlow Volunteer Centre supports other organisations across the Disability, Mental Health and Social Inclusion sectors.
Carlow County Development Partnership will continue to operate the Care and Repair programme. They will also continue to support the Carlow Older Persons Forum in its work with the Health Service Executive and other stakeholders
St. Catherine’s Community Services, and other providers in Carlow, will continue to coordinate the provision of Monitored Alarms to older people in Carlow enabling them to feel secure and remain in their homes independently.
Kilkenny & Carlow Contact Befriending and Support Service will form partnerships with local Public Health Nurses and community groups who provide alarms in Carlow Town and County to ensure that older people will be able to access Socially Monitored Alarms and any additional telecare devices to encourage ongoing independent living.
St. Catherine’s Community Services Centre and other Meals on Wheels providers, will help meet the need of older people to live independently through the provision of Meals on Wheels. St. Catherine’s will do so directly and via Outreach services such as Leighlinbridge and Fenagh in collaboration with Public Health Nurses. They will also promote and support other Meals on Wheels services in Carlow to adopt the Quality Standard framework to help services develop and benchmark their service.
The Health Service Executive will progress the Respiratory COPD (Chronic Obstructive Pulmonary Disease) and Asthma Integrated Care initiative across
Carlow / Kilkenny with the aim of providing support for up to 24 GP practices across the two areas.
The Health Service Executive will establish and maintain a register of patients with COPD / Asthma within the Clinical Nurse Specialist caseload and facilitate the development of registers within GP practices in Carlow.
The Health Service Executive will deliver a Clinical Nurse Specialist (CNS) led clinic COPD / Asthma clinic. The CNS will focus on patients over 16 with a confirmed diagnosis of COPD/Asthma who are poorly managed as evidenced by their attendance with an Asthma exacerbation, GP/Out of hour’s service, Emergency Department and or admission to hospital in the previous 6 months. Each patient will have a comprehensive assessment including a spirometry test and in conjunction with MDT individual care plans will be developed. Patients with specific symptoms will be provided with specific symptom management strategies.
The Health Service Executive will deliver 4 physiotherapy pulmonary rehabilitation programmes weekly for people with COPD in Carlow and Kilkenny. Each programme will provide for 10 people attending, this will include 2 groups attending twice weekly in Carlow over an 8 week period. Each group has an excerise session twice weekly and one educational session. Pre and post programme assessments are done on an individual basis for each person and every person has an individualised plan.
The Health Service Executive will enhance the Respiratory Integrated Care programme in Carlow through the provision of Occupational Therapy education on fatigue management and energy through the delivery of one session on each of the 2 pulmonary rehabilitation programmes to be delivered in Carlow.
The Health Service Executive will progress the Heart Failure clinical programme with the aim of providing support to up to 24 GP practices as follows:
The Health Service Executive will provide a point of care testing for natribretic peptide and ECG within GP practices.
The Health Service Executive will set up referral pathway for heart failure patients for the Virtual Heart Failure Clinic in St Luke’s Hospital which will provide support and guidance to GP in managing heart failure patients.
The Health Service Executive will assist participating GP practices in setting up a register for Heart Failure patients.
The Health Service Executive will complete recruitment of a second Clinical Nurse Specialist post in Carlow / Kilkenny in 2017
Carlow Older Persons Forum will continue to collaborate with service providers, particularly the Health Service Executive, to help provide information of services to the older population and to those who are most isolated. Carlow Older Persons Forum will continue to work with all service providers, particularly the Health Service Executive to improve facilities.