Thursday 20th June 2013
Francesca Durrell, Macmillan Healthcare Project Officer, speaks with Tess Cann, a Breast Care Nurse, about a pilot project to transform cancer care for older people.
In December 2012, Macmillan Cancer Support published the Cancer services coming of age report in conjunction with the Department of Health and Age UK.
The report was written as a result of learning from pilot projects across five cancer networks in England. The North East London Cancer Network was one of the pilot site areas.
Tess Cann is a Breast Care Nurse based at Homerton Hospital in north east London, and was involved in the local pilot.
The project was established as there is growing evidence to suggest that older patients are less likely to receive clinically effective treatment for their cancer. The project found, as Tess explains, that simple measures can be put into place to optimise cancer treatment for older people.
The pilot at Homerton Hospital involved breast and colorectal cancer patients aged over 70. Tess was working with the older patients who were diagnosed with breast cancer. She says: ‘I undertook a comprehensive geriatric assessment to identify any issues that may need resolving to optimise their cancer treatment. This could be a geriatric referral due to their physical health, or just arranging practical support for the patient, such as home support like general home help or gardening, and transportation that is more suitable to them.’
Many older patients experience social isolation, as they find it difficult to get out of their homes, and into the community whilst undergoing treatment. Tess found that, ‘Getting practical support to attend treatment is normally a big issue, the hospital’s transport system isn’t always ideal and finding a transportation system that works for the patient, for example by using a taxi, can be really beneficial.’
Many older patients also have coexisting health problems. Tess explains that using a holistic approach, and doing simple assessments can help.
Tess advises other healthcare professionals: ‘Consider the involvement of geriatricians, and develop your awareness of the facilities you can signpost patients to in the community. For example, we worked closely with Age UK during our project. I learnt so much about how they help older people, and will definitely be signposting people to them in the future. It also quickly became apparent that a tailored holistic needs or comprehensive geriatric assessment are vital in providing quality care for older patients.’
This pilot has illustrated that, given the right support, cancer clinical nurse specialists can take a role in screening older patients for practical support needs and identifying issues that need specialist evaluation. Tess says, ‘The project led me to focus more on the individual needs of older patients diagnosed with breast cancer. As a consequence of how services were organised within the pilot, I was able to deliver more personalised support during their treatment more effectively and efficiently.’
Email Francesca Durrell, Macmillan Healthcare Project Officer.