'Beyond heart-breaking': Unnecessary hospital admissions for elderly at record levels

Avoidable hospital admissions for the elderly are at record levels, with people over 65 seeing over a hundred per cent rise, according to an interim report by Age UK.

The charity has warned that readmissions are happening every 90 seconds and is now calling for a shakeup of the home care system, as it says the “safety net” for older people living at home has now worn “dangerously thin”.

Its figures have shown a 107 per cent rise in avoidable hospital admissions since 2003 in England for those aged 65-69, and an 119 per cent rise for older people aged 75-79.

In the most recent year for which figures are available (2016/17) they found there were 341,074 avoidable emergency admissions for people aged 65 and over.

‘It will live with me forever’

The story of ‘Gary’ is a striking example of how the lack of a care ‘safey net’ can lead to escalating bad health for older people. His mother was diagnosed with dementia in 2012 and died three years later. Her condition had deteriorated very badly towards the end, and Gary blames himself to this day for the way in which she died very quickly after eventually being admitted to a care home.

He explained that when carers originally came to look after her at home they would ask him to be there with them because they found it difficult to deal with her outbursts of anger and frustration. He explained how he felt “they weren’t trained properly for dealing with her situation”.

Furthermore, he noticed his mother rarely saw the same carers twice in a row, and this was disorientating for her with her condition, and so he eventually moved into his mother’s house to look after her.

Gary never expected that he would have to deal with his own mother’s incontinence and personal care, saying how he would often need to undress his mum and “hose her down”. This is something he didn’t feel prepared or trained for.

Dorothy had been admitted to hospital several times because of UTIs, and her son spent a lot of time trying to get her into a care home because he felt he couldn’t look after her in the way that they could in a designated care environment.

By the time Gary could get the council to agree that a care home would be the best place for his mother, it was too late, and she died a few months later in hospital. Talking about the experience, Gary said: “I felt annoyed, angry, disappointed. At times it was very demoralising and exhausting. It will live with me forever”.

Accessing ‘joined up care’ without dependents

The Age UK report estimates there are roughly half a million people aged over 65 in England living with three or more significant health conditions who need help with at least three essential daily activities, such as getting out of bed, going to the toilet or getting dressed.

But of this half a million, only one in three receive care at home. The remainder have to rely on family or are managing without any care at all.

Many older people who end up being admitted to hospital are often those who don’t have family to oversee their care.

More than 3.6m people are living alone and another 1.2m are ageing without children according to Age UK, and these numbers are only expected to rise over the coming years as the population gets older.

Caroline Abrahams, charity director of Age UK said: “The case studies in our report show just how difficult it can be to get the joined-up health and care services you need at home if you are an older person, especially if there is no one around to help you.

“Our GP and community health services like District Nursing are understaffed and overstretched, and yet many older people are completely dependent on them to sustain their independence, health and wellbeing.

“Older people with multiple health problems also often have associated care needs, and we already know many don’t get all or sometimes any of the care support they require. Yet without this kind of help, properly coordinated and designed to tackle their specific health conditions, which may be quite complex, small health problems can escalate rapidly into crises.”

‘The social care crisis is a dementia crisis’

Sally Copley, director of policy, campaigns and partnerships at Alzheimer’s Society, said many of those who feature in the new report will have “ended up” in hospital merely because they have dementia. She said: “With the majority of those receiving adult homecare and in care homes living with dementia, there is no question that the social care crisis is a dementia crisis.

“This needless care gap in the system is leading to the human cost of people with dementia being pulled from pillar to post in search of adequate care, disrupting their home life and forcing them to struggle in crowded hospital wards.”

She added that the much anticipated "green paper is a chance for our current government to outline measures to deliver high quality social care to everyone with dementia who needs it, without spending everything they have to receive it".