Humanising healthcare education: Engaging undergraduate nursing students in the care of older people within a pre-registration nursing curriculum Sarah Burden, Senior Lecturer / Teacher Fellow Faculty of Health Leeds Metropolitan University s.burden@leedsmet.ac.uk

Introduction Growth of an increasing elderly population is having a direct effect upon nursing practice. Nurses are significant providers of healthcare for the elderly and thus in a position to influence quality of care. Care interactions for this group often evaluated as ageist and disempowering Nurses’ attitudes towards older people have long reflected wider societal values on ageing. Caring for older people has been perceived as low status work, requiring limited skills and offering few educational opportunities.

Purpose of Presentation To share an innovative approach to older adult practice learning in a pre-registration nursing curriculum which places the diversity of ageing and associated health and social needs at the centre of the student experience. To promote discussion of person centred practice learning experiences that positively engage students in older adult care.

The need to change students’ experience of older adult care Increasing diversity of older adult population Plurality of services for client group not being fully explored by students Policies to support workforce development in the delivery of compassionate and dignified care Existing placement model did not have sufficient capacity to allocate all students

The Older Adult Framework Independent Sector: 6 days residential / nursing home care Statutory Sector: 4 days in either a secondary care ward, A Community Matron, Rapid Response or Intermediate Care Team. Voluntary Sector: 2 days minimum with an approved service or charity that focuses on care provision for the older adult. Self-directed enquiry: students to select 3 activities from a range provided , to include The Dignity Challenge (DH Dignity in Care 2006).

Assessment Portfolio assessment against specified learning outcomes Written evidence for each element of the framework matched against National Service Framework for Older People standards. These standards include Rooting out discrimination, Person Centred Care, Mental Health and the Promotion of health and active life. Personal reflection of overall experience using Driscoll’s (2000) What model of reflection.

Volunteering Infrastructure to support volunteering: health & safety expectations Employer & Public Liability Insurance Organisation contacts database Age UK Café & drop in advice centre Live at home schemes Breakfast/Luncheon clubs Befriending services Neighbourhood network schemes

A self directed activity: The Dignity Challenge Reviewing care against a particular statement and associated tests The Dignity Challenge High quality care services that respect people's dignity should: have a zero tolerance of all forms of abuse. support people with the same respect you would want for yourself or a member of your family. treat each person as an individual by offering a personalised service. enable people to maintain the maximum possible level of independence, choice and control. listen and support people to express their needs and wants. respect people’s right to privacy. ensure people feel able to complain without fear of retribution. engage with family members and carers as care partners. assist people to maintain confidence and a positive self-esteem. act to alleviate people’s loneliness and isolation.

Independent Sector: examining the resident experience Positive Can socialise Play games Balanced diet encouraged 24hr assistance Well staffed Negative Lack of privacy Lonely at times Noisy residents Follow routines Loss of independence Move from house to a bedroom

Student learning from experience Understanding and attitude development “helped me to understand how illness / loss of independence in older age can affect a person.” “it has also shown me how vulnerable some older adults are.” “given me a chance to work with the older population and given an insight into how these people view the care they receive and what it means for them.” “the volunteer sector helped my understanding of how older people manage and live at home.”

Student learning from experience “Felt I had an understanding of what the needs and requirements of older adults were. However these experiences have shown me some of the barriers that can prevent people from accessing these services such as mobility problems or communication difficulties.” “The opportunities given to spend more time to talk and enter into the daily activities of older people has helped me to be more sensitive to their needs.”

Student learning from experience Skills development & knowledge of services “older adult experience has allowed me to find out about and participate in a range of services aimed at older people.” “a greater awareness of services available so that I am able to discuss options with people and their families and support informed decision making.” “healthy eating in elderly and the assessment of weight loss and the need to maintain weight for better health.”

Implications for future practice “I aim to spend more time listening to older people’s wishes for the care they receive. “I will focus more on how the families and carers feel about the care their relative is receiving and if they feel supported themselves.” “From this experience I will not automatically assume that someone cannot do something because of their age but will take into consideration that by communicating better I can understand better the limits that the person may have and how they adapt themselves to ensure that they can carry out the tasks that they want to.”

The Next Steps Opportunities to integrate volunteering experience across a full year of the programme Skills development : Dementia Care End of Life Care in care homes Nutrition in the elderly Supporting carers