Caring for older people in acute settings: Lessons learned from an action research study in accident and emergency

The health and social care of older people has never been so high on the political agenda. In particular, there has been growing concern about the care of older people in acute settings. This paper reports the findings of an action research study which explored the organisation of care for older people in an accident and emergency (A&E) setting. Although the findings cannot be generalised directly to all acute settings, the action research methodology generated unique exploratory data, which suggest older patients arrive at hospital with low expectations of care and appear to understand many of the constraints under which staff are working. However, while patients appear to be able to identify small ways in which care could be improved easily, staff instead appear to blame the wider organisation for poor care and give the impression of being disempowered to care. This is despite findings which suggest nurses could make changes in the priorities they give to different aspects of care. The lessons learned from this action research study suggest that nurses may need to work more closely together to foster the much-needed improvements in care of older people. With the National Service Framework for Older People on the horizon, nurses cannot afford to ignore the needs of such a significant group of patients under their care.