An extra 71,000 care home places will be needed to be created in England over the next decade, as care needs rise in line with increased life expectancy, according to predictions.
The number of years that older adults spend with substantial care needs has now reached an average of 3 years for women and 2.4 years for men, according to the new analysis of care needs.
“Our study suggests that older people today are spending more of their remaining life with care needs”
The study, published in The Lancet, warned that, at current rates of provision, an additional 71,000 care home places would be needed by 2025 in England.
It is the first time that researchers have looked at the extent to which the current care crisis is due to higher levels of dependency than previous generations, rather than simply greater numbers of older people.
The study, led Newcastle University and funded by the Medical Research Council, compared levels of dependency in adults aged 65 and over in Cambridgeshire, Newcastle and Nottingham in both 1991 and 2011 – around 15,000 adults in total.
Adults were classed high, medium or low dependency – defined, respectively, as requiring 24-hour care, care at regular times each day or requiring care less than daily – or as independent.
“Expenditure on the care of older people will need to increase substantially and quickly”
Between 1991 and 2011, life expectancy increased for men from 77.9 to 82.6 and for women from 81.5 to 85.6.
Meanwhile, the proportion of years that an adult aged 65 could expect to live independently declined from 73.6% to 63.5% for men, and from 58% to 47.3% for women.
In contrast, the proportion of years living with low, medium or high dependency increased. In 2011, on average, men aged 65 spent the next 11.2 years living independently, followed by four years with low dependency, 1.1 with medium dependency and 1.3 with high dependency.
For women, those aged 65 spent an average of the next 9.7 years living independently, 7.8 with low dependency, 1.1 with medium dependency and 1.9 with high dependency.
In addition, the number of years spent with substantial care needs – medium or high dependency – nearly doubled between 1991 and 2011, from 1.1 to 2.4 for men and from 1.6 to three for women.
The researchers also analysed whether people lived in care homes or the community. They found older people with substantial care needs were less likely to be in a care home in 2011 than in 1991.
“The government and sector as a whole must act now to ensure we have future-proof plans”
For example, 73.5% of adults aged 85 years who required 24-hour care were living in a care home in 1991, compared to 51.8% in 2011.
The authors estimated that, compared to 2015, there could be an extra 19,0000 over 65s with medium dependency care needs and 16,3000 with high dependency needs by 2025.
While around half of these people will live in the community – based on current rates of provision – this means an extra 71,215 care home spaces will be needed by 2025, said the researchers.
Additionally, the study predicted an increase of 885,000 in the number of people with low dependency – generally looked after in the community – by 2025.
Lead study author Professor Carol Jagger said: “The past 20 years have seen continued gains in life expectancy, but not all of these years have been healthy years.
Extra 71,000 care home places needed in England by 2025
“Our study suggests that older people today are spending more of their remaining life with care needs,” she said.
“This finding, along with the increasing number of older adults with higher rates of illness and disability is contributing the current social care crisis,” she noted.
Professor Jagger added: “While many of these people will live in the community, at current rates of provision, this will mean a shortfall of over 71,000 care home places by 2025.”
The researchers highlighted the implications for health and social care services of the rise in care needs, with a need for adequately trained professionals to care for older adults with complex needs.
They also noted that early interventions for those with low dependency – such as structured exercise, rehabilitation or assistive technology – could potentially slow down decline.
Commenting on the findings, Sir Andrew Dilnot, who chaired the government’s Commission on Funding of Care and Support from 2010-11, said: “Expenditure on the care of older people will need to increase substantially and quickly.
Extra 71,000 care home places needed in England by 2025
Source: Chemical Engineer
“It will be important to ensure that this expenditure is managed efficiently, and in particular that the boundary between health care and social care is well handled,” he said, highlighting the “substantial difficulty” caused by delayed discharge as an example of this.
“Although the overall amount of care needed will increase substantially, this increase does not mean that every individual will need large amounts of care,” said Sir Andrew in an editorial in The Lancet.
“On average… high dependency will last for only about a year. But for a minority it will last for much longer, and the fear of that is a powerful one,” he added.
Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said the study reinforced the “need to reform adult social care and deliver a long-term sustainable solution”.
“While the £2bn announced in the spring budget for social care was a step in the right direction, it is only one-off funding and services still face an annual £2.3bn funding gap by 2020,” she said.
Ms Seccombe said it was “absolutely critical” that the government bring forward the consultation for social care that was announced in the Queen’s Speech.
“This must address the issue of long-term funding, but it must also create the conditions necessary to ensure the development of the right kind of care and support services, that can meet the demand of an increasing number of adults with care needs,” she said.
Rob Burley, director of policy at the Alzheimer’s Society, highlighted that people with dementia were the “biggest users” of the social care system.
“The government and sector as a whole must act now to ensure we have future-proof plans to accommodate the enormous rise in demand,” he said.
Nick Sanderson, chief executive of developer Audley Retirement, argued that it was “crucial” to support more older people to remain living at home if they preferred.
“Both the NHS and local authorities are struggling to cope with the mounting pressure and traditional care packages are coming under increasing strain,” he said.
“We know the retirement village model is one that works, and we have a responsibility to drive that forward,” he claimed.