高血压英文课件WorkingwithOlder

Working with Older drinkers:-the Hidden ProblemGreg Scott,Sean Dudley,Hammersmith and Fulham Older Peoples service,20 May 2010.Working with Older drinkers:.Alcohol&older people17%of population is over 65Alcohol related deaths in UK doubled form 1991-2005Highest death rate from alcohol among those aged 55-7Older Men drink nearly as often as all adults.Alcohol&older people17%of pDetectionGPsA&E admissions/Nurse LiaisonHousingSocial Services.DetectionGPs.Vulnerability to alcohol related harmReduced tolerance to effects Mistaken for common physical or psychiatric conditionsAlcohol medication interactionsInadequate screening&reportingMasked by co-morbid physical or psychiatric illnessAgeismBelief in positive health benefits?Age group less likely to discloseRisk of abuse and neglect.Vulnerability to alcohol relatEngagementNot presenting to servicesHome visits yielding good outcomesGood outcomes generally,more resources,life experience etc.EngagementNot presenting to seEducationAlcohol awareness is keyFamily membersGPs Housing workers.EducationAlcohol awareness is BarriersBarnes Ward research in Brighton:Practitioners:Difficulties in knowing how to approach the issue with older peopleInability of older people to acknowledge problemLack of appropriate services for referralThe issue of rights should we intervene?.BarriersBarnes Ward research iMyths about alcohol and older peopleAt your age what does it matter?You cant teach an old dog new tricks!The issue of rights no right to intervene.Myths about alcohol and older Changes in alcohol related admissions for 65+%increase 2002-2007Malignant neoplasm of oesophagus6.6Fall injuries19.3Liver disease45.9Epilepsy and Status epilepticus51.8Cardiac arrhythmias70.9Mental/behavioural disorders76.9Hypertensive diseases119.4.source:NHS Information centre for Health and Social CareChanges in alcohol related admImplications Evidence of significant unmet need for servicesDemographic projections suggest rising need for alcohol interventions with 65+age group Need to develop data and experienceOlder people appear to welcome appropriate help Alcohol related harms are often reversible.Implications Evidence of signiHammersmith and Fulham Older Persons Alcohol ServiceOne Year On.Hammersmith and Fulham Older POut of 49 clients fully assessed by the service between June 09 and March 201042 drank at home alone19 bought alcohol direct from shops8 had alcohol delivered to their home15 had alcohol bought for them by carers or relatives27 clients drank in excess of 70 units per week.Out of 49 clients fully assessReasons for not accessing services30 out of 49 clients had not accessed services previously27 clients were physically unable to access building based services easily15 clients said they would feel intimidated or stigmatised by accessing alcohol services7 clients said they did not feel alcohol was an issue in their lives.Reasons for not accessing servReasons for drinking22 clients stated social isolation and loneliness19 clients stated anxiety and depression8 clients said they drank very little before they retired.Reasons for drinking22 clientsThe Older Persons Team ResponseEssential to work alongside front line workers,carers,family to raise awareness of issues involving alcohol and older peopleProvide advice,information,support and training.The Older Persons Team ResponsThe Training SessionLooks at basic alcohol awareness and how alcohol affects the older communityPlaces alcohol firmly in the context of general physical and mental well being breaking the taboo of raising the subjectIncreases referrals to the service before the client reaches crisisEncourages effective joint working.The Training SessionLooks at bHow should we address alcohol use amongst older people?More research&better data Guidance on development of local treatment pathwaysCross-authority co-operation to develop servicesGreater awareness amongst health&social care staffGreater attention to drinking habitsSome increase in treatment capacity.How should we address alcohol www.foundation66.org.ukinfofoundation66.org.ukFoundation66 7 Holyrood St London SE1 2EL 020 7234 9940.www.foundation66.org.uk.References&other background info:ANARP Alcohol Needs Assessment Research Project DH 2005MoCAM Models of Care for Alcohol Misusers DH 2006Review of the effectiveness of treatment for alcohol problems(NTA 2006)Fillmore K M et al 2006 Addiction Research&Theory 14(2)101-132Fillmore K M et al 2006 Addiction Research&Theory 15(1)35-46 Alcohol consumption among elderly EU citizens Hallgren et al 2009National Statistics Online:Population estimates-27 August 2009National Statistics Online:Ageing 27 August 2009Robinson S and Lader D.General Household Survey 2007:Smoking and drinking among adults,Newport Office for National Statistics 2009.Joseph Rowntree Foundation:Drinking in the UK:An exploration of trends May 2009.References&other background