Safety of older people living at home

September 5, 2018

An interim report from Age UK is warning that the 'safety net' we expect for older people living at home has become dangerously weak. The report has found that older people living alone in declining health, without a network of support from family and friends, are at particularly high risk.

Age UK estimates that roughly half a million people (465,000) aged over 65 in England are living with three or more significant health conditions and have personal care needs.

However, the report suggests that around one in three receives care at home, with the remainder relying on family or managing without. Among those who have support from family, nearly two in three depend on a partner who is often an older person themselves with their own increasing health needs, according to Age UK.

More broadly, Age UK says that nearly a third of those aged over 65 in the UK – more than 3.6 million people – live alone, while around one in ten (1.2 million people) are ageing without children. These numbers are expected to rise as the population ages, and Age UK is calling on people to strengthen the support on offer to older people living at home.

The report argues that, while people assume that health and care professionals monitor the wellbeing of older people who live at home and whose health is of concern or in decline, this is not always the case. It explains that deficits within over-stretched health and care services, plus fragmentation between them, mean that a loved one needs to chase progress and join up services for the person who requires them.

Age UK suggests that many older people living at home do not have someone like this to help them and without this support they risk failing to get the treatment and support they need. The report shows that the end result is often an unplanned and avoidable admission to hospital, or worse.

This latest analysis from Age UK shows the health and care system has failed to keep up with the ageing population, piling pressure on hospitals as the rate of avoidable emergency admissions of older people has more than doubled over the last 13 years.

Overall, England has seen a 63% rise in the overall rate of these avoidable admissions since 2003. These rates have increased by 107% for those aged 65-69, and by 119% for people aged 75-79.

Caroline Abrahams, Charity Director of Age UK said, 'The NHS long term plan which is currently being developed must grip this situation and put in place a raft of measures to restore the safety net for older people living at home. Care navigators, multi-disciplinary teams operating in the community, more ‘hospital at home’ type services, and the stronger involvement of the voluntary sector should all be part of the mix. Nor can the NHS create a stronger safety net on its own; social care must play an equal part – and yet is currently so underfunded it is in no position to do so.

'This can’t go on: we need to build up all our community health and social care services once again, gradually fill the yawning workforce gaps in both health and care, and do more to support the family members who step in to ‘hold the ring’ of a system under huge pressure – often ageing partners with their own health problems. In addition, policymakers must wake up to the reality that increasing numbers of older people are ageing alone and design services and approaches that are effective at reaching and supporting them too, rather than expecting a committed relative or friend always to be on hand to do this for them.'

Councillor Ian Hudspeth, Chairman of the LGA’s Community Wellbeing Board, said, 'This report is a further warning of the crisis in adult social care and the urgent need to plug the immediate funding gap and find a long-term solution on how we pay for it and improve people’s independence and wellbeing.

'With people living longer, increases in costs and decreases in funding, the system is at breaking point and is ramping up pressures on unpaid carers who are the backbone of the care system.

'Over recent years, councils have protected adult social care relative to other services. But the scale of the overall funding picture for local government as a whole means adult social care services still face a £3.5bn funding gap by 2025, just to maintain existing standards of care. The likely consequences of this are more and more people being unable to get quality and reliable care and support, which enables them to live more fulfilling lives.'

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