{"id":859,"date":"2015-03-23T17:17:21","date_gmt":"2015-03-23T17:17:21","guid":{"rendered":"http:\/\/blogs.scotland.gov.uk\/health-and-social-care-integration\/?p=859"},"modified":"2022-01-26T15:31:42","modified_gmt":"2022-01-26T15:31:42","slug":"helping-people-to-live-well-at-home","status":"publish","type":"post","link":"https:\/\/blogs.gov.scot\/health-social-care\/2015\/03\/23\/helping-people-to-live-well-at-home\/","title":{"rendered":"Helping People to Live Well at Home"},"content":{"rendered":"
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NHS Forth Valley<\/a> are working in partnership with Falkirk Council<\/a> to test new ways to support people to live well at home in Bo\u2019ness .<\/p>\n

Phase 1<\/strong> of the project initially looked at patients over the age of 85 with dementia and or multiple health related problems. It was noted that while most people in this position seemed to be relatively resilient with a good support network, there was a high incidence of Emergency Department (ED) attendance normally by ambulance.<\/p>\n

Over an 18 month period 50 patients visited the ED 188 times.\u00a0 We believe that at least 45% of these visits could have been dealt with at home if an alternative was available.\u00a0 People told us that they called 999 as they did not know what else to do.<\/p>\n

\"\"Phase 2<\/strong> provided 200 people over 75 years (Scottish Patients at Risk of Readmission and Admission risk 40-60%) with a new package of support.\u00a0 Firstly we gave them ‘Your Plan’<\/strong> \u2013 an informal anticipatory care plan owned by the individual and developed with their family or carer. \u00a0This helps them plan for what they need to help them live well and what they should do if their needs increase. They are encouraged to consent to share this with health and social care staff. \u00a0Secondly we established ‘ALFY<\/strong>‘ \u2013 A<\/strong>dvice L<\/strong>ine F<\/strong>or Y<\/strong>ou \u2013 a nurse led telephone line which is available 24 hours a day.<\/p>\n

ALFY doesn’t replace 999 or NHS24, and will redirect people if appropriate.\u00a0 ALFY nurses who deal with the calls can offer a range of services:<\/p>\n