Survey of Admissions to Residential Care: Analyses of Six Month Follow-Up

Abstract

In the autumn of 1995, the PSSRU began a longitudinal survey of elderly people admitted to residential and nursing home care with local authority financial support. The survey was commissioned by the Department of Health, initially to help to improve the Standard Spending Assessment (SSA) formulae for allocating funds to local authorities for the support of elderly people. Information was collected from social workers in 18 local authorities in England about the circumstances of admission and the level of dependency for 2544 elderly people admitted during a three-month period from mid-October 1995. Follow-up studies have been planned for six, 18, 30 and 42 months after admission, when the managers of the homes will be asked to provide information on mortality or the current location of the elderly people, and, for those still resident in the home, information on dependency corresponding to that collected on admission. If the elderly person moves to another home, the new home will be asked to provide the same information. A separate exercise is being conducted to follow up those elderly people who returned to a private household or who were discharged to hospital. This paper presents results from the follow-up six months after admission, and includes information about those admitted to a private household or who were discharged to hospital. The paper includes a section on the relationship between the characteristics of individuals included in SSA analyses and their location at six months. Information on location or mortality at six months was obtained for 84 per cent of the original sample; of these, 65 per cent were still in the original home and 24 per cent had died. Higher death rates were found for nursing homes (37 per cent) than for residential homes (14 per cent). In general, those who had died were older and were more likely to be male and to have been admitted from hospital, and they were substantially more dependent on admission. Approximately 50 per cent of survivors were classified in the same category of physical dependency and mental confusion at six months as at admission. Slightly higher proportions had higher levels than lower levels of physical dependency at six months, while the converse was the case for mental confusion. However, similar proportions of individuals exhibited sufficiently large increases (22 per cent) or decreases (21 per cent) in physical dependency to suggest a genuine change over six months. For elderly people who had left residential or nursing home care, the main reasons recorded for their departure were: their acceptance of the home; changes in their functional abilities; and the ability of the home to provide the appropriate care, such as for those exhibiting behavioural problems associated with dementia