Anticipatory Care Planning Stories

We commissioned a series of films to introduce anticipatory care planning, how it can help to deliver person-centred care, and its benefits for people, families and their carers.

If you want to know more about anticipatory care planning or the making of these stories you can email Sheila Steel, Associate Improvement Advisor for ACP or follow her on twitter @SheilaSteel2.

A homeless person’s story – Duncan is 41 and has been in children’s homes, hostels, psychiatric care or homeless for most of his life.

A child’s story – Jack has a life-limiting condition. His parents have been told it is unlikely he’ll get to school age.

A carer’s story – Fiona was caring for her husband with cancer until he died. Now she is caring for her father alone.

An individuals story – Jim is in his fifties and is in the late stages of kidney failure caused by diabetes. His condition is terminal.

An ACP nurse’s story – Evelyn was admitted to hospital for the fourth time and diagnosed with Menieres diease. She is focussed on her illness rather than her recovery.

Find out more about Anticipatory Care Planning at


A Living Well in Communities Event: Behind The Scenes

This post was written by Sara Turner, the Living Well in Communities Admin Officer. You can follow Sara on Twitter @turnersara99.

The day has come.

It’s something you have been planning (so much planning…) for weeks, if not months and it’s finally here!

For me, there’s usually a dash of excitement as you jump out of bed. Sometimes it’s the sleepless night, tossing and turning, panicking that you are going to sleep through your 3 alarms, or that you’ve forgotten something and need to get to the venue to put your mind at rest.

You have been hawk-like, watching Eventbrite, monitoring numbers and answering queries, making sure those registered have included all the relevant details, but most importantly spelt their name correctly.

Continue reading “A Living Well in Communities Event: Behind The Scenes”

Older People and The Outdoor Gym: Will Green Prescribing Offer an Alternative Path?

As a district nurse for over twenty years I have mainly cared for older people in their own homes. The  challenge with an ageing population is supporting older people to self-manage their healthcare and stay well through exercise.

john-and-his-dog-archieThis is my neighbour John and his dog Archie. John is 82 years old, and though he can’t walk the Eildon hills anymore, he still manages to take Archie out for short walks down the street. Archie gives him a reason and motivation to get out and about.

There is an abundance of evidence on the benefits of outdoor activity.

Research at the James Hutton institute identifies multiple, inter-related barriers that reduce the opportunities for older people to participate in outdoor activities: poor health, immobility, limited social relationships and fragility.

The Green Gym

As health professionals how can we engage with patients and their families to make green prescribing, and the use of our great outdoor ‘green gym’, a real choice?

We can’t do anything about our Scottish weather but we can use green prescribing as an additional choice to the traditional hospital based exercise care pathways for falls and post-op rehabilitation.

Interventions need to be offered which suit people’s ability and preferences. They don’t need to be based solely around exercise and can be seen as an option to alleviate social isolation, the profound loneliness many older people feel. Research by geriatrician Dr Carla M. Perissinotto at University of California has linked loneliness to physical illness and early death, a real health challenge for Scotland, with so many elderly people living alone. Continue reading “Older People and The Outdoor Gym: Will Green Prescribing Offer an Alternative Path?”

Our Intermediate Care and Reablement Work



In 2011 the Scottish Government published the document, The Reshaping Care for Older People: A Programme for Change 2011-2021. It outlined the policy goal to “optimise the independence and wellbeing of older people at home, or in a homely setting. This will involve a substantial shift in focus of care from institutional setting to care at home – because it is what people want and provides better value for money.”

An NHS HEAT target was introduced from April 2012 to reduce 75+ emergency bed day rates by at least 12% nationally between 2009/10 and 2014/15.

Intermediate Care services offer alternatives to emergency inpatient admission and deliver person-centred outcomes for people, whilst improving whole systems flow.

What is Intermediate Care & Reablement?

Our workstream will support partnerships to better understand and maximise the impact and effectiveness of their intermediate care and reablement services. These services:

  • offer alternatives to emergency inpatient care
  • support timely discharge from hospital
  • promote recovery and return to independence
  • prevent emergency admission or early permanent admission to a care home

Intermediate care and reablement can be delivered at home or as locally as possible by multi-professional, multi-agency teams and include settings such as: individuals’ own homes, sheltered housing complexes, care homes, and community hospitals. Continue reading “Our Intermediate Care and Reablement Work”