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Longer lives mean more care home places are needed

WebMD UK Health News
Medically Reviewed by Dr Rob Hicks

16th August 2017 – People are living longer than ever – and this is leading to extra health and care needs in older age. Now experts are predicting that England will need an extra 71,215 care home places by 2025.

As life expectancy increases, so too have the number of years that older adults spend with substantial care needs. According to a new analysis of care needs published in The Lancet, in people 65 years old and older, women need an average of 3 years of care and men 2.4 years. Even with the community increasingly being responsible for the care of older people, placing a significant burden on families, the study warns that based on recent rates of provision, an additional 71,215 care home places will be required in England by 2025.

An increase in life expectancy – and dependency

The study analysed the extent to which the current care crisis is due to greater levels of dependency than in previous generations or simply greater numbers of older people. The researchers used data from two different Cognitive Function and Ageing Studies (CFAS), one made in 1991 (CFAS I) and the other in 2011 (CFAS II). These studies only included people 65 years old or older. The participants were assessed in their place of residence, whether in their own home or a care home.

For their new study, the researchers looked at life expectancy of more than 15,000 adults from data taken during the two previous studies, choosing it from three areas in England (Cambridgeshire, Newcastle and Nottingham). They also looked at the participants' levels of dependency and classed them as:

  • High dependency – required 24-hour care (for example, they may be unable to get to or use a toilet, be confined to bed or a chair, may need help feeding or dressing, or have severe cognitive impairment)
  • Medium dependency – required care at regular times each day (they may need help to prepare a meal or put on socks and shoes)
  • Low dependency – required care less than every day (they may need someone to cut their toe nails or bathe them, shop for them or do housework)
  • Independent - not in one of the above categories

When comparing the data, the researchers found that over the two decades between 1991 and 2011, life expectancy has increased. In men it increased from 77.9 to 82.6 years, and in women from 81.5 to 85.6 years.

The study found that in 2011 men who were 65 years old:

  • Had an average further life expectancy of 17.6 years
  • An average of 11.2 years of this time was spent independent

Women who were 65 years old:

  • Had an average further life expectancy of 20.6 years
  • An average of 9.7 years of this time was spent independent

During the same period, however, the proportion of years that a 65-year-old adult could expect to live independently declined, from 73.6% to 63.5% in men and from 58.0% to 47.3% in women. Between 1991 and 2011 the number of years living with dependency increased in all categories for both men and women. The number of years in which people with medium or high dependency with substantial care needs more than doubled in men increasing from 1.1 years in 1991 to 2.4 years in 2011. In women, it almost doubled increasing from 1.6 years to 3 years.

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