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important aspect is that it is an integrated approach to thinking about the places where people live and how best to promote older people’s wellbeing and engagement with their physical and social environments.
Maintaining connection and community contribution
Ageing Well in Wales defines loneliness and isolation as cross-cutting issues that seriously impact on the health and wellbeing of older people in Wales (Ageing Well in Wales, 2015: no pagination). Research shows that loneliness and social isolation are harmful to health: lacking social connections is a comparable risk factor for early death as smoking 15 cigarettes a day, and is more detrimental to health outcomes than well-known risk factors such as obesity and physical inactivity.
Effective access to treatment for ‘minor’ needs that may compromise independence
Many older people experience needs that tend to be characterised as ‘minor’, but which can significantly affect their independence and wellbeing if not supported effectively. These can include mobility problems, foot health, chronic pain, sensory impairment, incontinence, malnutrition and oral health. Proactive, early identification of such problems, using structured assessment tools coupled with tailored interventions, can have significant benefits for older people’s wellbeing and independence. (Melis et al, 2008).
Older people with more complex needs are likely to require a range of care and support, which will include:
Effective management of frailty
based on a population-led approach that prevents or delays the onset of the condition through early identification and anticipatory care management across the primary and community sectors, integrated assessment and care planning, measures to avoid inappropriate hospital admission and targeted falls prevention programmes. Evidence shows these can reduce the incidence of falls by between 15 and 30%.
Holistic support for dementia and cognitive impairment
including improved rates of diagnosis, quality support in a range of settings and the development of dementia-friendly communities.
Appropriate and efficient intermediate care services
including rapid response care and support, therapeutic rehabilitation, reablement, step-up/ step-down placements and supported discharge schemes, in which the third sector can play a major role.
Person-centred, dignified long-term care which optimises independence
which requires outcomes-focused assessment and care management and domiciliary care, appropriate residential provision based on an enablement approach, effective
West Wales Population Assessment March 2017 Older people