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'Plan needed' for centenarian surge

The health service should prepare for the rise in the number of people who will live to be 100 or more, experts have said.

In the last decade there have been more than 35,000 centenarians in England and the number is set to grow, end-of-life care researchers said.

Health officials should plan services to meet the “hidden need” of people who reach the milestone age, according to the experts from King’s College London.

They said that more needs to be done to enhance GP and community services so those in this age group can remain in a “comfortable, familiar” environment in the last few months of life.

High-quality care home capacity also needs to be increased, the palliative care experts said.

The latest Office for National Statistics data show that the number of people living over the age of 100 has reached a record high - in 2012 there were 13,350 centenarians living in the UK.

The new centenarians research, published in the journal PLOS Medicine, examined the cause and place of death of 35,900 people aged 100 and over.

The authors found that “old age” was the most common cause of death, followed by pneumonia.

Three-fifths of centenarians died in a residential or nursing care home, a quarter died in hospital and one in 10 died at home, they said.

“Centenarians have outlived death from chronic illness, but they are a group living with increasing frailty and vulnerability to pneumonia and other poor health outcomes,” said Dr Catherine Evans, clinical lecturer in palliative care at King’s College London.

“We need to plan for health care services that meet the ‘hidden needs’ of this group, who may decline rapidly if they succumb to an infection or pneumonia. We need to boost high-quality care home capacity and responsive primary and community health services to enable people to remain in a comfortable, familiar environment in their last months of life.

“Compared to other European countries the proportion of people aged 90 years and over dying in hospital in England is high, and the number dying in care homes is low. For example, in the Netherlands and Finland more than three-quarters of people aged over 90 die in a long-term care setting such as a nursing home; far fewer die in hospital.

“Hospital admission in the last weeks of life accounts for a third of the total cost of end-of-life care per patient. Increasing the number of care home beds could reduce the reliance on hospital care, but we need to ensure calibre services are provided by GPs, community nurses and other healthcare working with social care providers to enable people to remain in their usual residence at the end of life if they choose.”

 

Readers' comments (5)

  • We need to be very careful to ensure the 'high quality care homes' are there before we start rationing hospital care and treatment for anyone over a certain age I think !

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  • Put another way, the proportion of over 90's NOT living in care homes is higher in the UK than elsewhere - and such people are more likely to need hospital admission. So to address the 'problem' would mean massively increasing the number of elderly people being moved into care homes: is this really a preferred solution?

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  • Does choice play any part in what is provided? Choice seems important to other age groups - why wouldn't it be important to the over 100s - or is this more about reducing expense?

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  • I don't always get it. Why encourage healthier life styles for you to become a 'problem' if you live longer. What is the governments agenda here? We should be aiming for community support (if needed), not getting people into hospital and nursing homes, out of sight, out of mind!!

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  • Anonymous | 5-Jun-2014 1:07 am

    paradox! I don't always get it either. it would be helpful if the government would clearly state their aims!

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