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Reducing older people's need for care: exploring risk factors for loss of independence

Report | May 2019

The report proposes, and explores in detail, three risk factor ‘domains’:

  1. Social and Psychosocial Domain
  2. Long term or Personal Conditions Domain
  3. Life Events Domain

Risk factors are then further grouped as follows:

  • Modifiable risk factors such as depression or loneliness, where specific support or services can be offered to minimise their impact.
  • Non-modifiable risk factors such as age or history of falls; whilst these cannot be changed, they can help identify older people at greater risk and who may potentially benefit from some preventative services and support. In this case, the risk factor is not modifiable however, the outcome may be.

In no particular order, IPC proposes 1 to 7 below as being the most significant, primary risk factors to older people’s independence and institutionalisation:

  1. Dementia with co-morbidity
  2. Co-morbidity
  3. Carer burden
  4. Fall
  5. Social isolation / loneliness
  6. Poor confidence / self-esteem / self-image
  7. Poor perception of own health status

IPC also highlights a range of examples of preventative tools and interventions where there is evidence that, if accessed by older people, could stop, delay or defer the need for long-term institutional care. Whilst it is currently difficult to indicate the level of absoluteness of each risk factor, IPC proposes the tools and interventions in this report as a helpful starting point in working this through.

NCC will use these findings, as it strives to adapt to the growing complexity of needs of its older population, to inform the ongoing local development of an “early warning system” which identifies residents whose combination of health, social and environmental indicators mean they are at higher risk of losing their independence.

The Executive Summary can be downloaded above.