'Home safety net for elderly people has become weak', Age UK warns

The home safety net we expect to be there for us as we age has become dangerously weak, Age UK has warned.

This latest analysis from Age UK shows the health and care system has, to date, failed to expand or change fast enough to support our ageing population, piling pressure on hospitals – as the rate of avoidable emergency admissions has more than doubled for older people over the last 13 years.

Older people living alone in declining health, with no family and friends to support them, are at particularly high risk.

Age UK estimates there are approaching half a million people (465,000) aged over 65 in England living with three or more significant health conditions, who are also in need of help with at least three essential daily activities, such as getting out of bed, going to the toilet or getting dressed.

Of these half a million individuals, only about one in three receives care at home, with the remainder relying on family - or managing without.

Even among those fortunate enough to have family support, nearly two in three depend on a partner who is often an older person themselves with their own increasing health needs. 

The report argues that while we may all assume that health and care professionals will keep a gentle eye on the wellbeing of older people who live at home and whose health is of concern or in decline, this can no longer be guaranteed, because of deficits within our over-stretched health and care services, plus fragmentation between them.

The end result is likely to be an unplanned and otherwise avoidable admission to hospital.

Overall, England has seen a 63% rise in the overall rate of these avoidable admissions since 2003. But for older people, these rates have increased by a staggering 107% for those aged 65-69, and by 119% for older people aged 75-79.

In the most recent year for which figures are available (2016/17) there were 341,074 avoidable emergency admissions for people aged 65 and over, Age UK found.

Caroline Abrahams, Charity Director of Age UK, said: “The safety net for older people living at home has worn dangerously thin after years of underfunding and an absence of workforce planning across both health and care – this is why the numbers of older people whose emergency admissions to hospital could have been avoided are rising so fast.

“Our GP and community health services like district nursing are understaffed and overstretched, and yet many older people are completely dependent on them to sustain their independence, health and wellbeing.

“Yet without this kind of help, properly co-ordinated and designed to tackle their specific health conditions, which may be quite complex, small health problems can escalate rapidly into crises. Then, if they need to be admitted to hospital the full extent of their difficulties may finally be recognised, but it would be so much better for them and for all of us if they had got the help they needed earlier on.”

She added: “We need to build up all our community health and social care services once again, gradually fill the yawning workforce gaps in both health and care, and do more to support the family members who step in to ‘hold the ring’ of a system under huge pressure – often ageing partners with their own health problems.

“In addition, policymakers must wake up to the reality that increasing numbers of older people are ageing alone and design services and approaches that are effective at reaching and supporting them too, rather than expecting a committed relative or friend always to be on hand to do this for them.”  

Rob Behrens, Parliamentary and Health Service Ombudsman, said: “We know from our casework that a fragmented health and social care system means vulnerable older people are often falling through the cracks.

“This is all the more alarming given older people’s reluctance to speak up when things go wrong. The NHS must ensure that services co-ordinate and communicate with one another and families, as well as making patients aware of how to complain.”