An “integrated care center” brings doctors, physiotherapists, social workers and pharmacists under one roof. It won’t solve Britain’s underlying social care crisis — but it could help.
By Megan Specia
Dec. 29, 2023
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For 12 years after her husband died, Norma Fitzgerald tried to maintain her independence, living alone in an apartment on the outskirts of Hull, in northern England, despite her mobility worsening as she reached her mid-80s.
Then one day in the spring of 2022, she suddenly grew dizzy. Her legs gave out, and she collapsed on her apartment floor, unable to find the strength to get up.
She lay there for two days.
Eventually, a neighbor realized she hadn’t seen her for some time and called an ambulance.
“They had to force the door open,” Ms. Fitzgerald, who is now 87, recalled. She was severely dehydrated and spent the next five days in a hospital.
As Britain’s population ages, with almost 19 percent of the population over 65, according to the 2021 census, up from 16 percent a decade before, the needs of an increasingly frail older population are weighing on the country’s health care system.
Along with the National Health Service, or N.H.S., many older people also rely on what is known as social care, a mosaic of private and public support that is plagued by chronic staffing shortages, a lack of nursing home beds and slashed local budgets.
The lack of easily accessible social care, which encompasses everything from home health aides who help with washing and dressing to full-time residential care, means that falls or treatable health conditions can lead to extended hospital stays. That is piling pressure on the N.H.S., when earlier intervention or home support would have been more appropriate.
But what happened to Ms. Fitzgerald after she was discharged from the hospital is an example of an approach that could transform the way that older adults living with complex health conditions are cared for, experts say.
In the past, she would likely have been sent home with little continuing care aside from her family doctor. Or she might have had to move into full-time residential care, losing her independence.
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Instead, she was referred to the Jean Bishop Integrated Care Center in Hull, a facility that opened five years ago as a one-stop shop for frail older people. The first of its kind in Britain, it brings together doctors, physical therapists, social workers and other professionals under one roof. In the course of a few hours, a patient can see a number of clinicians and have diagnostic tests if needed, including X-rays and blood tests, and receive a personalized care plan — all free of charge.
On a sunny morning in June, Ms. Fitzgerald sat knitting a red-and-gray blanket in the center’s bright and cheerful waiting room. She had been brought by ambulance — all patients are offered transportation if needed — from her assisted-living apartment, to see a doctor specializing in geriatric care, a pharmacist, an occupational therapist and a social worker.
Many geriatric health experts believe this https://fokuslahlagi.com kind of “integrated care,” with a multidisciplinary team addressing all the issues that can impact well-being, from loneliness to immobility, is the future for older people with complex health needs in Britain.