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The National Institute for Health and Clinical Excellence (NICE) has today (22 October 2008) published new public health guidance on occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care

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There are 9.7 million people aged 65 and older in the UK and by 2020 one in five UK citizens will be aged 65 or older. Though many older people lead happy and independent lives mental health in later life can be affected by many factors, including physical health, financial security, societal attitudes, geographical location, access to support and services and responsibility for the care of others1. This guidance focuses on the role of occupational therapy interventions and physical activity interventions in the promotion of mental wellbeing for older people.

Recommendations include:

• Occupational therapists and other professionals who provide support and care services for older people should offer regular group and/or individual sessions to encourage older people to identify, construct, rehearse and carry out daily routines and activities that help to maintain or improve their health and wellbeing.

• Physiotherapists and other professionals with the qualifications, skills and experience to deliver exercise programmes appropriate for older people should, in
1 Age Concern England and Mental Health Foundation 2004
collaboration with older people and their carers, offer tailored exercise and physical activity programmes in the community, for example, dancing, walking and swimming.

• GPs, community nurses, public health, local authorities, leisure services and voluntary sector organisations working with older people should promote regular participation in local walking schemes as a way to improve mental wellbeing for older people and provide health advice and information on the benefits of walking.

• Health and social care professionals, domiciliary care staff, residential care home managers and staff, and support workers, including the voluntary sector should be trained in the knowledge of (and application of) the principles and methods of occupational therapy and health and wellbeing promotion as well as effective communication skills to engage with older people and their carers.

Dr Gillian Leng, Executive Lead for the guidance, and NICE Deputy Chief Executive said: “A decline in mental wellbeing should not be viewed as a natural and inevitable part of ageing. We all need to raise both older people’s and societal expectations for mental wellbeing in later life. This guideline outlines ways in which mental wellbeing can be promoted in older people and is anticipated to be the first of a range of NICE public health guidance on the health and wellbeing of older people”.

Professor Catherine Law, Chair of the Public Health Interventions Advisory Committee (PHIAC) at NICE and Professor of Public Health and Epidemiology, UCL Institute of Child Health said: “Despite longer lives and and increases in wealth over the last 50 years, there is evidence that many older people live with low levels of life satisfaction and wellbeing. Forty per cent of older people attending GP surgeries, and 60% of those living in residential institutions are reported to have ‘poor’ mental health. All people coming into contact with older people, including health and social care professionals, have the potential to promote and maintain physical activity, health and independence, factors frequently mentioned by older people as important to their mental wellbeing.”

Julia Scott, Chief Executive , College of Occupational Therapists said: “The College of Occupational Therapists welcomes the recognition this strategic guidance gives to the part occupational therapists play in maintaining the mental well being of older people. The document highlights how participating in everyday activities really does enable older people to restore, maintain and improve their health and well- being. Engagement in meaningful activity is core to the philosophy of occupational therapy practice. 

Notes to Editors

About the guidance

1. The guidance on occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care guidance is available at: www.nice.org.uk/PH016 .

About NICE

2. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

3. NICE produces guidance in three areas of health:

• public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS
• clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS