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Care home residents health needs 'poorly met', claim geriatricians

The health needs of elderly people in care homes are being met “poorly”, experts have warned.

More must be done to ensure that residents have access to high-quality healthcare, the British Geriatrics Society (BGS) said.

Around 400,000 older people live in care homes across the UK and healthcare providers must ensure that they are not ignoring the needs of this “frail and vulnerable” group of people, the society said.

Issuing new guidance for healthcare commissioners, the BGS said there is “no reason” why older care home residents should be missing out on the best care.

The BGS said that the needs of residents must be met from a “co-ordinated input” from GPs, specialists, social care workers and care home staff.

Services should be “shaped to suit patients” and they should have “reliable” access to familiar health professionals, the guide says.

Among other recommendations, the society - which represents specialists who care for elderly patients - also said there should be regular scheduled visits to the home from a GP or specialist nurse and advanced planning for health emergencies.

The guidance states: “Standard healthcare provision meets their needs poorly, but well-tailored services can make a significant difference”.

BGS spokesman Professor Finbarr Martin said: “There is no reason why older care home residents should be missing out on high-quality healthcare.

“The NHS can play an important role in supporting care home staff to ensure that older residents have a better quality of life. The evidence shows that health care services can be designed to deliver better care.

“Those responsible for planning what health services are needed locally must take notice of this evidence and ensure that they are not ignoring the needs and rights of this frail and vulnerable patient group.

“Commissioners and health service planners must involve representatives from the care home sector early on when considering what services need to be considered for older residents. This is more likely to ensure that services are designed appropriately and are sustainable.”

Readers' comments (9)

  • michael stone

    I seem to remember a report about a year ago, which concluded that GPs were not caring for patients in care/nursing homes as well as they cared for their other patients (I think the issue was the level of contact - inadequate visits to patients who had moved to care homes).

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  • I work in a care home for dementia and would agree that their needs are not being met. BUT, whilst the needs of the company, financial always come first there will never ever be good care. Staffing levels are the key, working on minimum staffing levels and at times below, with agency staff being used on every shift. It is impossible for the nursing staff to the job they want to do, we are stressed to unbelievable levels and know that when things go wrong, we are the ones to be blamed

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  • I entirely agree, i have managed a care home for years, and struggled to get even a GP visit at times, let alone a specialist. Some areas have community geriatricians, which must be a great blessing. I also agree that these people are the most frail and vulnerable, and say that how we treat them reflects on us as a society, and impacts us as a society. The hard facts are that this work must be done at commissioner level, care home staff cannot refer and cannot prescribe, so the work we can do at ground level is limited with respect to pure health needs, which need a wider input. we have also found in the last couple of years our GP services have become more reluctant, and we have one surgery that has openly admitted they are trying to get care home residents "off their books", because they are hard work. Even little steps forward would help greatly with this issue. And commissioners, please do consider that even outpatients appointments are too hard for some of our precious frail people.

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  • After looking after my Dad at home for years and following a dramatic deterioration in his Alzheimer's, we very reluctantly placed him into a care home last year. We visit my Dad daily, we are welcomed by hard working and caring staff who go out of their way to make us welcome and talk to us about my Dad.

    Whilst the staff within the home are heroically caring and are attended by a good local GP Practice, other health services like dentist, podiatrist, optician, etc, frequently cancel visits and don't reschedule. The Home Manager has to find replacement services and this all takes time. As a family, we have been able to take my Dad to the dentist, optician and podiatrist because he is physically fit. However, since he has been living in the home, we have all returned to full time work and taking time off to attend to basic health needs makes me wonder about what is actually being provided for the fees we pay. More to the point, what about the residents who are physically unwell and or have no family fit enough to take them out to attend services.

    I agree completely with Anonymous | 12-Oct-2013 8:23 am. More emphasis and importance must be directed towards healthcare needs of those in care homes.

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  • At a care home where I was deputy manager and head of nursing care I had great difficulty in getting the GP further than a seat in the office where she wrote out prescriptions on her brief visits at her own convenience. she seemed to think her duty ended there and was very reluctant to go and see any of her patients or others who needed medical attention. if it was urgent, on a couple of occasions, we had to wait until out of hours and call another GP.

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  • As a full time agency staff nurse I have worked in more than 200 care homes for different providers. In my opinion most homes provide an acceptable standard of care for their (elderly) residents while a few are outstanding and a few are well below par, some desrving to be closed.

    Some homes have weekly GP clinics, while others are lucky if a GP returns a phone call. I honestly don't know what the answer is. Overall demand on all professionals increases inexorably upwards while resources dwindle. Something has to and will break.

    On a selfish point: no one who hasn't worked in a Care Home can appreciate the volume of paperwork which nurses have to complete for a single resident which has to be regularly updated. Multiply this by 30 or so and you get the picture of why I have seen so many poor often foreign care home nurses at breaking point.

    Be under no illusion: no matter what their advertising blurb tells you most care providers are as profit making as Debenhams or Asda These providers are in it purely for the money which is why they pay mostly their care staff "washers". This may be immoral and wrong but the questions is: how much more are WE prepared to pay for care of the elderly through taxation if say all care homes were to be handed over overnight to charities or local authorities?

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  • The above comments are all interesting.
    We will all be elderly one day. ..if we are lucky.

    I have observed in the past that younger, healthy retired people are a very effective pressure group, because they have the time and the energy to intervene. How to mobilise them??

    I have no objection to care homes making a profit, because that would be an incentive to providing good care; but I don't think the national standards and monitoring systems are particularly effective, are they?

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  • Charlotte Peters Rock

    My experience, following a couple of elderly people through their need for care, is that:

    In a care home Community Health services will try to fail, if they can get away with it. Audiologists will refuse to make hearing tests, or fix hearing aids.. because of the perennial elderly problem of ear wax. They will not clear the wax (why not?) and will not deal adequately with the District Nurse, whose job it is said to be. nor will she deal with them. So the old person can remain deaf forever, as far as they are concerned. Certainly, I have observed this to go on for months of wrangling, whilst the elderly person sits in a silent world.

    Podiatrists seem to be non-existent. Why? Aren't they paid well? Yet their work is absolutely vital to the current crop of elderly, who suffered lack of decent footwear, from early on in their lives, and are now paying the price. Feet are a health matter.

    Mention the word therapy, to the dementia specialist, and he smiles wanly, and leaves. Yet the elderly benefit greatly from careful therapies, which keep them included in life, and increase their cheerfulness levels, keeping them from depression, boosting their health, and keeping them from more rapid slide into dementia.. Why are the old thought unsuitable for therapies? Is it that they do not complain enough?

    People living in care homes are a trapped, silent, uncomplaining group, whose needs are being trashed by the very NHS which was set up to ensure that such needs are met.

    The elderly, suffering from dementia find that all appointments are made to suit the GP or the Consultant, and the 'system'. Whereas it is the patient's needs which should be paramount.

    Hello system!! Those with dementia also have other health problems. Wake up and deal with them!

    We need full assessments of those with dementias, so that their lives can be enhanced, giving them the hope that they are alive, whilst they yet live.

    And where such elderly patients still live at home, the health and wellbeing of their family carers must also be taken fully into account. At the moment we can register our 'caring status' with the GP, hospital, social care.. and the end result is..? .. that it is an interesting statistic. Ask for or expect help.. and you might as well just throw confetti into the air.

    If this is the best we can expect, then it really is time for a great number of sackings, of those who are wasting our public resources rather than using them to best effect.

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  • This needs to be explicit within CCG commissonig plans and allocated to a lead clinician who is accountable be that a GP/practice nurse/district nurse/community matron or who ever to coordinate. How can this have gone on for so long without being clear were the bck stops for these most vulnerable in society?Out of sight out of mind but they appear regularly at hospitals and have done for years. Nurses who work in homes have to be part of the wider team and not isolated.

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