Best Care for Older People (BCOP)

Best Care for Older People (BCOP)  is Western Health's approach to implementing the Victorian Department of Health's Improving Care for Older People Policy (IC4OP). The main aim of the policy is "minimising functional decline and improving care of older people who require hospitalisation".

On a typical day at Western Health, 70% of inpatients are aged 65 years and over (Census Data, 2011).  Research suggests that functional decline occurs in 34-50% of hospitalised older patients. At Western Health this means almost 200 inpatients aged 65 years and over are at risk of functional decline each day. Research also indicates that only 50% of older patients will recover from functional decline 3 months after leaving hospital.

Providing evidence based care, at the right time and in the right place for older people is everyone's responsibility at Western Health.

Functional decline is the reduced ability to perform activities of daily living, due to a decrease in physical and, or, cognitive functioning and is an important issue for older people in hospital.

Functional decline:

• Can occur as early as day 2 of a hospital admission
• Can occur in addition to the patient's presenting problem
• Can affect health outcomes and length of stay
• Can affect  a patient's choice of discharge destination and their ability to return to their preferred setting 

As part of IC4OP policy the evidence-based resource, Best Care for Older People Everywhere - The toolkit, has been developed to assist staff working in health services to identify and minimise functional decline of older people in hospital.

The Toolkit is a practical resource for health care professionals, developed by health care professionals across the state in collaboration with the National Ageing Research Institute (NARI).

The toolkit addresses functional decline, through the following domains of functional decline:

• Person - Centred Practice
• Advance Care Planning
• Assessment
• Communication
• Mobility / vigour / self-care
• Nutrition & Swallowing
• Cognition: Delirium, Dementia and Depression
• Continence
• Skin Integrity
• Pain
• Medication
• Palliative Approach to Care