Age and Ageing Advance Access originally published online on August 12, 2004
Age and Ageing 2004 33(6):561-566; doi:10.1093/ageing/afh177
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Age and Ageing Vol. 33 No. 6 © British Geriatrics Society 2004; all rights reserved
Research Paper |
A national census of care home residents
BUPA Care Services, Bridge House, Outwood Lane, Horsforth, Leeds LS18 4UP, UK
Address correspondence to: C. Bowman. Fax: (+44) 113 381 6250. Email: bowmanc{at}bupa.com
Abstract
Background: the medical and dependency characteristics of UK care home residents have not been well described. This undermines care commissioning, development and regulation. Data to inform policy and practice are needed.
Objective: to survey the dependency and clinical diagnoses of 16,043 people resident in the 244 care homes distributed across the UK managed by the largest provider of care in the UK.
Results: (i) Return rate of 97% (15,483 returns suitable for analysis). (ii) 25% were ‘residential’ and 75% in ‘nursing’ care. (iii) Medical morbidity and associated disability rather than non-specific frailty and social needs had driven admission in over 90% of residents. (iv) More than 50% of residents had dementia, stroke or other neurodegenerative disease. (v) Overall, 76% of residents required assistance with their mobility or were immobile. 78% had at least one form of mental impairment and 71% were incontinent. 27% of the population were immobile, confused and incontinent. (vi) Considerable overlap in dependency between residential and nursing care observed: only 40% of those in residential care were ambulant without assistance and 46% were incontinent.
Conclusions: the practicality of acquiring information on care home residents has been demonstrated. The care needs of people in care homes are largely determined by progressive chronic diseases. A single assessment and commissioning at the point of entry to care services is unlikely to address changing needs. Alternatives to institutional long-term care should only be considered in the context of current resident profiles, the practicality of providing alternative models and likely projected population needs.
Keywords: geriatric assessment, long-term care, diagnosis, dependency, public policy, elderly, residential care, nursing home care
Received January 13, 2004; accepted in revised form April 19, 2004.
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