Older age is changing.
In the twenty-first century, our later years can be as dynamic and productive as our younger years. Today, travel vaccinations and sexual health advice for older people are common. For many, age really is just a number.
Yet some older people do have complex needs. A small but significant group of older people require 24 hour nursing with highly intensive and sometimes ethically challenging care. We are also seeing newly emerging diagnoses and cutting edge treatment plans delivered at home. Nursing older people demands a deep understanding of the physical, emotional and social worlds of individuals.
The history of caring for our older generations is not always an easy one. It is a story shaped by how we view older people in society, and how we value the role of those that care for them.
In an ageing population, how much have we learned from the attitudes of the past?
In the nineteenth century, the elderly and chronically sick were too often left to the mercy of the workhouse and the Poor Law system. Here, conditions were squalid and facilities scant. A form of nursing care did exist in the workhouse, but was often delivered by older female inmates. Treatment of the elderly was fast becoming a national scandal. Following a barrage of bad press revealing the crowding, death and disease of the workhouses,the Local Government Act in 1929 saw the Poor Law disbanded. The municipal hospital system was established and local authorities became responsible for those in need of health care.
In 1936, Matron Eva Huggins was working alongside Dr Marjory Warren, the geriatrician at Middlesex County Hospital. They pioneered a change for both the elderly and chronically ill, providing proper diagnoses for those in their care and discharging people who did not need to be in hospital beds. Yet this pace of change was not universal. Despite attempts to improve the care of older people, accommodation continued to be substandard and ward equipment poor. As a profession, older people’s nursing struggled to detach itself from the low status reputation it had gained over the past century. There was no encouragement for bright young doctors and nurses to pursue older adult care. It was simply not a popular place to be.
Did you know?
The term ‘geriatric’ comes from the Greek for ‘old age’ and ‘physician.’ (It technically means old physician!) So it makes sense that this term is not used anymore. Instead ‘care of older people’ is widely used in health care settings.
![Four specimens of sea skink, late eighteenth century. On loan from the Royal Pharmaceutical Society. Believed to be an aphrodisiac, sea skink was reported to 鈥榬estore warmth in old age [and] decays of nature鈥� and increase 鈥榯he Semen Virile鈥�.](/library-exhibitions/-/media/Royal-College-Of-Nursing/Images/Library-exhibitions/Aspects-of-age/Image-gallery/Sea-skink.JPG)
1. Extract from ‘Old people'. Report of a survey committee on the problems of ageing and the care of old people, Published for the trustees of the Nuffield Foundation. 1947. Read by Kat Black.
2. News clipping in the Evening Standard, and letter to the Editor from Pauline Blight, 1986. Read by Alan Chalkley and Dianne Yarwood.
3. Hospital Hilton! Workhouse stigma a thing of the past. The Reporter, 6 February 1987. Read by Razwana Akram.
Important progress began to happen in hospital settings across the UK by the latter decades of the twentieth century. At the forefront of this progress was the Nursing Development Unit at Tameside Hospital’s Department of Care for the Elderly, established in 1985. Within this, nurses could take part in an international exchange programme, attend ‘survival skills’ courses and use a new on-site staff library. The aim? To enhance the development and the status of nursing older people.
What these units could not temper however, was the increasing numbers of the very old. A hospital setting was not right for many of these patients. Additionally, people with dementia needed professional support, either at home or in a facility, with the right nursing care.
