The NHS is rarely out of the news; reports of delays in care and support as well as continuing issues with workforce recruitment and funding put further pressure on a system already at crisis. NHS chiefs agree that more needs to be done to support people to leave hospital and suggest that one of the solutions is home care. We discuss home care and how it can benefit the system, older people and their families.
Winter pressures is a popular term heard this time of year across health and social care. It refers to the additional demand on health and social care services during the winter period. We've already seen hospitals across the country announce they are struggling with data showing A&E waiting times are at their worst level on record with just 83.6 per cent of patients being seen within four hours on average. Transfers of care (people leaving hospital onto other types of care) are also being delayed with 149,400 total delayed days in September 2019, of which 30.9% were attributable to social care. The main reason for the social care delays during the month was because patients were waiting for a package of care in their own homes. Keeping people at home and independent for longer is the aspiration for health and social care services. However the challenge is in trying to find the right care at the right time for people in their own homes. Care at home is the preferred option, it is what people and their families want and it is also what the evidence recommends, so what is the solution?
In home care / Live in care
Traditionally, care at home for people has been in the form of carers visiting over the course of a day to complete social care tasks. In home care or live in care as it is also known is where the carer (s) live in the same house as the person who needs support. This type of support is beneficial on a number of levels, not least because the delays in discharging people from hospital are in large because of complex packages of support that home care agencies are not able to provide or source carers for.
The aim for health and social care statutory services is to provide the right care and support for people to maximise their independence, taking into consideration their personal wishes. Live in carers offer consistency of support and a better opportunity to regain daily living skills. The carer is able to really get to know the person and tailor the individual care and support plan accordingly. Live in carers arguably have more time to spend with people supporting them with routine tasks and the process is more efficient as there is no time wasted getting to know different carers or getting to know the person.
Having a live in carer can boost an older person's recovery phase making it less likely for them to require additional services or the unfortunate event of suffering another illness period, especially if they are prone to falls or have a complex mental health diagnosis.
The cohort of older people that frequently access the NHS are in the 80-90 age group. Evidence shows this ageing group is also expected to have a high level of dependency, dementia and comorbidity making it more of a challenge to find a home care agency that can meet their needs. Live in care can be the answer to finding carers that are specially trained and skilled in supporting such conditions, managing deterioration effectively. Some live in care providers can also offer nursing staff.
The older person
Live in care is ideal for older people that want to stay in their own homes, close to loved family, friends and pets. Being able to maintain connections and be an active member of a community is an important life goal for many older people. In fact the Better at Home Report produced by the Live In Care Hub (www.liveincarehub.co.uk)found that 20% of elderly people would put their health at risk by refusing to go into care without their pet. Live in care also means that if the older person lives with others, these relationships can be maintained and offer peace of mind to both.
Having carers 24-7 in your own home ensures the older person receives dedicated 1-1 care rather than having to share resources, as would be the case in a care home or risk having different carers visiting as with home care. Loneliness and isolation is an increasing concern for older people, a live in carer would reduce the risk of this happening, especially for people that live on their own or have significant mobility issues preventing them from accessing the local community without additional support.
Family and friends
Having to choose care for family members is one of the most difficult decisions to make; increasing the chances of a delayed discharge from hospital. Live in care can help to ease concerns that loved ones may have, especially knowing that there will always be someone with their family member no matter the time of day. Family and friends will want to support where they can and having a live in carer allows existing relationships to develop and flourish without any added pressure or guilt.
Unlike being in a care home, no matter how good the care home is, dignity and choice is compromised. Due to the nature of live in care, family can be reassured that their loved one will be happier having a sense of freedom and still being able to make simple decisions such as what time to go to bed or when to have a cup of tea.
Live in care can also be an intermediate solution, allowing people to stay in their own homes for longer which can be of great comfort to families, safe in the knowledge that they were able to honour their loved ones wishes for as long as possible.