Thereare approximately 410,000 elderly people in residential and nursing homesacross the UK according to the Department of Health. Nursing homes were developedduring the late 19th century while Thatcher was in power and theconservative government acknowledged that they had to provide care for thosewho needed it; especially those who were poor. Over the years, the number andcondition of these homes improved drastically.
Towards the end of the 20thcentury, England and Wales had a number of 3335 residential homes accommodating110 767 people with 86% of these being elderly according to Townsend. With lifeexpectancy improving constantly, this number will continue to rise. Care homeshave been a good invention over the years but they do; however, come with anumber of both benefits and drawbacks leading to the ultimate question of ‘arethey the best choice of care for the elderly’? When a person moves into a care home, they mayfeel like they have lost their friends, family and those they are used toseeing on a daily basis. Many older people are admitted to a care home for endof life care. Many care homes wish for their residents to be happy in the lastchapter of their life and help to do this by keeping their social life active. Healthand Social care provider-Evolving Care, make it their priority to providecompanionship.
They accompany the residents on trips, holidays and dailyoutings as well as encouraging them to participate in hobbies and crafts withother residents. Christchurch care home in Bournemouth recently opened a cafésituated in the home for both residents, their friend’s and family and localpeople. With the use of designs and pictures from the village, the residentswere able to stay connected to the local community and interact with peoplethey knew and recognised. In addition; in 2014, the care quality commission(CQC) began to inspect how well care homes were creating an environment to makethe resident feel at home. Resident’s with dementia, which many of them have,definitely struggle in an environment that is not familiar to them. Carecompany Anchor, encourage residents to bring their personal items with them tomake them feel more settled. According to the dementia centre at StirlingUniversity, some care homes have even allowed the residents to paint their ownbedroom doors so they feel the place is their property. With CQC reports eachyear, care home staff are making sure that their institutions are a relaxingand comfortable environment for the residents.
Care homes also need to make sure that theresidents’ nutritional needs are being met. The British Association for Parenteral and Eternal Nutrition (Bapen), statedthat 30% of the elderly who are admitted are either at risk of malnutrition orare obese. By following the Food Standards Agency guide on ‘Food Served toOlder People in Residential Care’ which contains menu examples and advice onspecial requirements, it is possible for care homes to keep these health risksunder control.
A care home in Wimbledon has been named the ‘academy ofnutrition’ as a result of responding to what the residents are wanting while maintaininga good quality. 96% of the residents andtheir families see their catering service as highly favourable. Due to theirstandard of food, the residents’ GP has rarely had to prescribe foodsupplements. If all care homes can get to this high standard care homes willmost likely be the best option of care. Onthe other hand, although care homes do provide more benefits such as safety,supervision and erasing the need for the resident to upkeep household bills,there have been a few cases when care homes standards have declined andresidents have suffered. In the past couple of years, the CQC found 11 carehomes in England to be inadequate and 9 to have low or worrying staffinglevels. According to Merrifield, due to shortage of money, no agency staffcould be hired at a home in Dudley, which ultimately led to the same staffworking long hours several days in a row. This is dangerous for the residentsas the staff are more likely to make a mistake when tired.
Low staff numbershave also led to medication being prescribed and administered incorrectly,therefore becoming ineffective. At Harmony House in Nuneaton, staff did nothave time to check if medicines were in stock resulting in one resident missing8 doses of their medicine as the care home did not have it. This shows thatcare home staff could actually contribute to the decline of a resident’shealth. Moreover, moving an older person into acare home can have a huge psychological impact on the elderly. With theconfusion, loss of independence and the realisation that this step is the endof their road in life; it is a very distressing time for them.
Sollito tells usthat 40% of residents in care homes are likely to suffer from depression due toa huge life change and lack of socialising and stimulation. Some care homesprepare therapy for the resident but a lot of them won’t go without theirfamily which isn’t always possible according to Dr. Sakauye told Aging Care.Home care, an alternative care option, allows the elderly to stay in their homeand in an environment they are used to which could have less of negative impacton their mental health.
Caregivers are also able to spend as much time with theresident as they need; whereas low staffing levels in care homes, result in alot of the residents being left alone for large amount of time. Family can alsofeel guilty about shipping their relatives off to a care home; care homes havespecific visiting hours which family members may find difficult to fit in with theirlives. Fortunately, home care allows them to see their relative at any time. Itis clear here that other methods of care can be more beneficial. In 2016, the cost of care home rooms is nowmore than £30,000 a year according to Ruddick.
Figures have shown that theaverage pensioner’s income would struggle to cover even 6 months of care.Prestige Nursing and Care state that the cost of care homes has risen by 5.2%in the last year. This highlights the financial crisis in the care homeindustry. Britain’s biggest care home group, Four Season’s Health Care haveended up in £500 million of debt. Although many are trying to combat the crisisthe majority are not coping and have resulted in closure. This currentsituation makes care homes an unreliable care option for the elderly. Bad treatment in care homes has been aproblem over the recent years with one case putting the reputation of carehomes in a very bad light.
Southern Cross Healthcare, the largest provider ofcare homes and long term care in the UK were forced to close one of their carehomes, Orchid View, after some staff were arrested on suspicion of illtreatment and neglect of residents. The coroner’s ruling in 2013 found that anumber of the resident’s deaths were unexplained and the home was mismanagedand understaffed. With the risk of these events happening, elderly may not beentirely safe and should choose an alternative option of care. In conclusion, although there are manybenefits of care homes, there is evidence of bad mistreatment along with socialand mental issues which may affect the elderly.
Therefore, without doubt; analternative method of care such as home care in which less impact will be madeon their mental and social health due to one to one time and the option to stayin familiar surroundings could definitely be more beneficial for the elderlyand their families.