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What makes older people choose residential care?

Survey, report | November 2004

This article, produced by the Institute of Public Care, summarises the results of a survey of older people recently admitted to care homes in a unitary authority, which was intended to estimate how many could have taken advantage of the greater flexibility and independence of Extra Care provision as an alternative. Information on 36 clients - average age 86 years 5 months at admission – was collected via interview and semi-structured questionnaire, and/or via case notes and interviews with care managers and relatives.

The report looks at where individuals were living prior to admission and assesses the volume of formal and informal care each was receiving. Findings show almost all had already moved from their family home, often to be closer to family carers, and emphasise the vital contribution of informal carers.

The survey also examines decisive factors that directed people towards residential care, finding that in over three quarters of cases the decision followed a critical event such as a fall and/or hospital admission. However, it notes that while only one client surveyed said the decision to enter care was their own, case notes showed all clients as having made the decision themselves. It is hypothesised that in the absence of community-based 24 hour care, residential care was seen by relatives and professionals as the option of least risk, and clients acquiesced in order not to become a burden. Sensitive `hidden factors` in admissions are suggested, and the prospect that different choices would have been made had these been addressed openly is discussed.

After case-by-case analysis, it is estimated that two thirds of the people in the survey could have benefited from Extra Care provision, either currently or at the time of an earlier move. The importance of targeting Extra Care preventatively is emphasised.

For further information please contact Juliet Bligh at IPC

Email: ipc@brookes.ac.uk

Tel: 01225 484088