The Health of Older People Strategy (Associate Minister of Health 2002) signalled work to review and develop a nationally consistent framework for specialist mental health services for older people (action 3.3) and to review specialist health services for older people (action 3.5). This guideline completes stage one of those reviews. Stage two will be the development of service specifications that set out the minimum requirements for specialist health services for older people.
The Ministry of Health, the Accident Compensation Corporation (ACC) and District Health Boards New Zealand jointly sponsored development of this guideline because they recognised the need for an integrated approach to planning and providing these services. The guideline is designed to provide District Health Boards (DHBs) with a framework for developing and delivering these highly specialist services to best meet the needs of an ageing population, and to support implementation of the Health of Older People Strategy by 2010.
The guideline is based on an analysis of a stocktake of current service provision (Ministry of Health in press b), research evidence where this is available, expert opinion from a technical advisory group (see Appendix 1 for membership of the advisory group), and from the international literature.
The target audiences for the guideline are DHB funders and planners, service providers and health practitioners. The target population is people aged 65 and over who have high or complex health or disability support needs and who will benefit from multidisciplinary assessment, treatment and rehabilitation. Some people under the age of 65 with complex conditions and needs similar to those of older people can also benefit from these services.
The aim of the guideline is that older people and their families, whānau and others who could benefit from specialist health services have timely access to quality, culturally appropriate services and advice. The rationale underpinning this aim is that adequately resourced, culturally competent and appropriately skilled specialist health services for older people will improve the health and wellbeing of older people, enabling them to have a better quality of life, and, as a result, reduce overall health and disability costs for this age group. The specialist services will do this by:
- early identification and assessment of medical and psychiatric conditions that can either be reversed or their progression slowed by treatment and/or rehabilitation
- developing and implementing treatment and rehabilitation plans with the older person and their family, whānau and appropriate others
- collaborating with other services or health practitioners to provide integrated services for older people and their family or whänau.