Abstract
BackgroundThere have been fundamental shifts in the attitude towards, access to and nature of long term care in high income countries. The proportion and profile of the older population living in such settings varies according to social, cultural, and economic characteristics as well as governmental policies. Changes in the profiles of people in different settings are important for policy makers and care providers. Although details will differ, how change occurs across time is important to all, including lower and middle income countries developing policies themselves. Here change is examined across two decades in England.Methods and FindingsUsing the two Cognitive Function and Ageing Studies (CFAS I: 77% response, CFAS II: 56% response), two population based studies of older people carried out in the same areas conducted two decades apart, the study diagnosis of dementia using the Automated Geriatric Examination for Computer Assisted Taxonomy, health and wellbeing were examined, focusing on long term care. The proportion of individuals with three or more health conditions increased for everyone living in long term care between CFAS I (47.6%, 95% CI: 42.3–53.1) and CFAS II (62.7%, 95% CI: 54.8–70.0) and was consistently higher in those without dementia compared to those with dementia in both studies. Functional impairment measured by activities of daily living increased in assisted living facilities from 48% (95% CI: 44%-52%) to 67% (95% CI: 62%-71%).ConclusionsHealth profiles of residents in long term care have changed dramatically over time. Dementia prevalence and reporting multiple health conditions have increased. Receiving care in the community puts pressure on unpaid carers and formal services; these results have implications for policies about supporting people at home as well as for service provision within long term care including quality of care, health management, cost, and the development of a skilled, caring, and informed workforce.
Highlights
Long term care changes as the population of a country ages
The proportion of individuals with three or more health conditions increased for everyone living in long term care between Cognitive Function and Ageing Studies (CFAS I) (47.6%, 95% CI: 42.3–53.1) and CFAS II (62.7%, 95% CI: 54.8–70.0) and was consistently higher in those without dementia compared to those with dementia in both studies
The proportion of people living in long term care dropped from 5% to 3% between studies
Summary
Long term care changes as the population of a country ages. As the cost of long term care increases and welfare systems have withdrawn from supporting long term care provision as well as closure of long stay hospitals, admission to long term care becomes more income dependent. Policies that influence the proportion of people who enter long term care are likely to affect the characteristics of residents in such settings and their needs will change Caring for those living in the community can, and often does, place major demands on unpaid carers and costs for local authorities whilst some older people continue to require housing that includes care due to cognitive or functional impairment [4,5,6]. Older people in the UK live in many types of accommodation ranging from being in their own homes to staffed long term care where they receive 24 hour care Between these is a category of “assisted living facilities”, housing encompassing warden assisted housing and “granny flats”, the latter being self-contained living areas attached to ordinary homes.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
