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One-third fewer falls for live-in care

Falls – the quiet menace. They may sound relatively innocuous, but research undertaken by Age UK shows that every minute, six people over the age of 65 suffers a fall and fall-related injuries are a common and serious problem for older people.

According to further research by the Royal College of Physicians, 30% of over 65 year olds and 50% of over 80s fall at least once a year – and eight per cent of the 80+ population in England and Wales were admitted to hospital in 2014.

However, research has shown that there are up to one third fewer falls for live-in care vs residential care. (See research papers below)

Along with hip fractures and other injuries, falling also affects family members and the carers of people who fall. It has an impact on quality of life, health and healthcare costs.

People often experience a loss of independence and confidence after a fall and some become housebound. This is a vicious circle because anxiety about the fall, pain and lack of activity can reduce quality of life further and make people weaker and often more vulnerable to further falls.

It’s a massive problem that can only increase with an ageing population – but live-in homecare can reduce the incidence and a growth in the sector can deliver a real cost saving in both human and financial terms.

Live-in home care offers an effective solution to the issue of hospital bed blocking, which, according to the BBC, currently costs £900m a year for NHS England alone. Early discharge from hospital is thought to save around £700 per bed per night. Live-in homecare means clients have an evolving personal care plan and ongoing bespoke, person-centred attention means they’re far less likely to suffer from falls. This releases pressure on NHS A&E departments and significantly mitigates the risk of readmission.

Live-in homecare also means, even if someone has been in hospital, they are able to be discharged quickly and rehabilitation at home is far less traumatic and more comfortable in familiar surroundings. There’s also less chance of contracting the ever-present risk of a hospital  infections.

Due to age, advanced frailty and medical conditions, people who are in a residential care or nursing home, or who have full time live-in care at home are among the group with the highest risk of falling. In fact a major reason for someone needing to have full time care is a fall, or a history of falls.

The worst falls result in serious injury, including hip fractures of which there are about 60,000 a year (across all ages) in England, Wales and Northern Ireland (excluding Scotland). According to the Royal College of Physicians: “hip fracture patients face a significant risk of dying or of losing their independence.” Further research is sobering, showing that one month after suffering a hip fracture 1 in 12 people will have died and only half will have returned home.

According to NHS Choices, the annual cost for all hip fractures in the UK, including medical and social care, is about £2 billion.

 

Research papers

Research from The Live-in Care Hub: . An analysis of falls and their outcomes (including hip fracture rates) from Live-in Care Hub members’ anonymised client data over 1,498 person-years. Following method outlined in Rapp 
et al (2012) except using Hub’s own incident data (collected and anonymised by UKCHA). The Hub has data for 1,498 person-years. Out of these, there have been 1636 falls. Therefore 1636/1498 = 1.09 falls per person-year. ‘Person-year’ definition: number of full years measured, per individual, ie: a person’s health recorded in April 2013, 2014 and 2015 would give three person years, but they are not necessarily recorded over a different period as another’s person years, which may have been recorded in, say May 2011, 2012 and 2013

Research paper: Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med 1994;121:442-451

Research paper:  Todd C, Skelton D. (2004) What are the main risk factors for falls among older people and what are the most effective interventions to prevent these falls? Copenhagen, WHO Regional 
Office for Europe (Health Evidence Network report; http://www.euro.who.int/document/E82552.pdf, accessed 5 April 2004

Research paper: Rapp K, Becker C, Cameron ID, König H-H MD, Büchele G Epidemiology of Falls in Residential Aged Care: Analysis of More Than 70,000 Falls From Residents of Bavarian Nursing Homes; 
JAMDA 13 (2012) 187.e1 – 187.e6