Abstract
Backgroundthe number of people requiring care home support is projected to rise in future years, but little information is available on the needs of new care home residents.Objectiveto measure the health and functioning of people moving into care homes and how they have changed between 2002 and 2015.SettingEnglish Longitudinal Study of Ageing.Participantstwo hundred fifty-four of the 313 (1.99%) individuals who moved from the community into a care home, and were interviewed in the survey wave prior to entry.Main outcome measureschanges over time for number of health conditions and functional deficits (deficits in activities of daily living (ADL), and instrumental ADLs (IADLs)), assessed in the survey wave prior to admission.Resultsover time there were significant increases in the total number of health conditions and functional deficits amongst soon to be care home entrants (P = 0.0011), the proportion with high blood pressure (OR 1.37, 95% CI: 1.17–1.62, P < 0.0001), memory problems (OR 1.33, 95% CI: 1.11–1.61, P = 0.0021) or total number of IADL deficits (P = 0.008). Non-significant increases were observed in the proportion of care home entrants with cancer (OR 1.23, 95% CI: 0.93–1.65, P = 0.15), lung disease (OR 1.21, 95% CI: 0.85–1.75), heart disease (OR 1.12, 95% CI: 0.95–1.30) and arthritis (OR 1.11, 95% CI: 0.95–1.30). Stroke and ADL deficits did not increase. No differential ageing effect was observed.Conclusionsthe support needs of care home entrants in England appear to be increasing over time. This has important implications for the provision and funding of care home places and community services.
Highlights
400,000 people aged over 65 years live in care homes in England [1]
Female care home entrants were older than men across all waves (P < 0.0001) and no differential ageing was observed
Using data from a nationally representative study, we have shown that the health and functioning of older adults soon to enter care homes declined between 2002 and 2015
Summary
400,000 people aged over 65 years live in care homes in England [1]. As life expectancy continues to rise, the number of people in England who may need the level of support provided by a care home is projected to rise to almost 500,000 by 2030 [2]. The number of care home beds is not expected to rise to meet this demand and the future funding and stability of long-term care sector is uncertain [3]. Understanding the changing nature of demands on care homes and community services is important for service planning and the development of a skilled workforce. Data from the national census show that the care home population aged between 2001 and 2011 [1]. The limited available evidence suggests that residents are increasingly dependent [5], living with a growing number of long-term physical health conditions and are frequent users of NHS services [6]
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