Integrating Care for Older Persons in the Midlands Conference

Chaired by Dr Teresa Donnelly and Dr Jerry O’Flynn, the conference brought together leading clinicians across geriatric medicine, palliative care, psychiatry of later life, pharmacy, and advanced nursing practice. A consistent theme throughout the day was the complexity of caring for older persons in nursing homes and the need for integrated, anticipatory, and person-centred approaches. 

Presentations covered key areas including medication management in advanced Parkinson’s disease, deprescribing to reduce tablet burden, falls prevention and orthostatic hypotension, bone health, and the management of responsive behaviours. Notably, there was strong emphasis on recognising deterioration, early identification of palliative care needs, and the importance of Advance Care Planning (ACP). The Grand Rounds initiative presented by ANP Ann Gilliard in older persons and palliative care demonstrated measurable progress, with significant numbers of residents now having documented ACPs, including clear ceilings of care and DNACPR decisions.

Across all sessions, there was clear alignment with the Department of Health’s Age Friendly Health System framework (the 4Ms: What Matters, Medication, Mind, and Mobility). Importantly, A recurring theme throughout the event was the strong reflection of Caru principles in practice — promoting early conversations, collaborative working, inclusion of all staff roles, especially healthcare assistants, and prioritising the individual needs and wishes of residents.

Sharon’s engagement at the conference highlighted the strong resonance of the Caru programme with frontline clinicians. Nursing homes with established Caru groups spoke very positively about Caru’s impact, with several requesting further training. There was also notable interest from GPs seeking to better understand how Caru can support communication and decision-making in residential care.

This event provided a platform to promote the Irish Hospice Foundation’s broader work and strategic pillars:

1. Conversations about Death – evident in the growing emphasis on early ACP and shared decision-making.
2. End of Life and Dying – reflected in clinical focus on recognising dying and delivering comfort-focused care.
3. Bereavement and Grief – acknowledged through the importance of relationships, continuity, and staff insight, particularly from healthcare assistants.

Although regionally focused, the learning and approaches discussed are clearly scalable at a national level. The conference reinforced that Caru is not an adjunct, but a key enabler of best practice—aligned with current policy, clinical priorities, and the evolving needs of older persons in residential care.

It was a valuable opportunity to represent the Irish Hospice Foundation and to demonstrate how our work meaningfully supports healthcare professionals across disciplines.