Care Home Residents: Out of sight, out of mind?
Researchers from the University of York have been investigating the extent to which care home residents are included in studies about older people’s health. Their findings are published today in Age and Ageing and Dr Barbara Hanratty from the University of York and Hull York Medical School summarises the results here.
Nearly 400,000 older people live in care homes in the UK, and more than half of residents are aged over 85. Their health and social care needs are complex. All have some disability, many have dementia, and collectively they have high rates of both necessary and avoidable hospital admissions. Despite this, the UK has no easily accessible source of national data on the NHS care received by residents, and collectively, we know relatively little about their health and well-being. This absence of routine data sources prompted an examination of information provided by other studies.
The UK has a number of longitudinal studies that follow the same people over time, (such as Understanding Society) and other repeated cross-sectional studies, that gather data from a different group of people each time (e.g the Health Survey for England). Our research found that in the UK and Ireland, most epidemiological studies that collect information on older people’s health either exclude care home residents at the outset or omit people from the survey when they moved into institutions. Furthermore, when information from people in care homes is available, it has often been collected through a proxy.
The paucity of data available from participants in care homes is understandable, when the challenges to conducting research are considered. Many residents have poor mental and physical health; levels of cognitive impairment and dementia are high. However, the absence of systematic data collection compromises our ability to monitor the outcome of health care in this population. Other countries with different health systems have tackled this issue. In the US there is a Nursing Home Minimum Dataset and the Australian Institute of Health and Welfare regularly publish information on demographics, length of stay and needs of residents. Better data in the UK could answer important questions about the way NHS services are delivered to care homes, the impact of different models of care on patients’ health and which services are most needed by residents.
The University of York is holding a one-day seminar Out of sight, out of mind? Promoting the health of residents in UK care homes on 27 September 2013.