Abstract

A community care scheme was designed to provide an alternative to residential care by the flexible use of informal paid carers to supplement or replace formal care. We report details of client problems and dependency, outcomes and use of hospital inpatient beds for the first 92 clients. The mean age was 83 years (28 men, 64 women). In all, 88/92 suffered from dementia. The CAPE survey dependency of the clients was A 2%, B 8%, C 23%, D 40%, E 27%. The 1-year outcome was 50% at home, 25% died, 10% part III, 15% long-term care; at 3 years: 24% at home, 64% dies, 7% part III, 6% long-term care. In the year before admission to the scheme, 58% were admitted to hospital, totalling 139 patient months in hospital, and in the first year of the scheme 55% were admitted, spending 82 patient months in hospital. Frail elderly people supported at home have a significant mortality and morbidity rate, and continue to need a high use of NHS inpatient resources.

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