Crisis for home alone elderly out of hospital
PENSIONERS left alone to cope after being discharged from hospital are more than twice as likely to be re-admitted than those who have help to get back on their feet, a new report has found.
In the last five years almost 200,000 people aged 75-plus returned home from hospital without the support they needed to look after themselves.
Yet many thousands of re-admissions could have been prevented if these vulnerable older people had received more help at discharge and the saving to the taxpayer for the NHS in England would have been around £40m a year.
Now a campaign has been launched to prevent this abandonment of the frail and elderly, many of whom may have had painful operations and are severely physically limited as to what they can do for themselves.
The Royal Voluntary Service, assisted by The King’s Fund, wants the ‘Let’s End Going Home Alone’ initiative to increase the number of volunteers coming forward from communities, local authorities and NHS Trusts to go into the homes of pensioners when they leave hospital.
David McCullough, the charity’s chief executive, said: “The population is living longer, an achievement which should be celebrated, yet it is presenting a challenge for the very organisation that has helped people live longer lives.
“With local authority and hospital trusts facing budget cuts, we believe greater volunteer support through Home from Hospital schemes can improve the quality of older people’s lives long after a hospital stay and save the NHS millions of pounds.
“Placing a caring volunteer at the centre of an older person’s recovery plan dramatically improves their experience, their confidence and their well-being, and helps them continue to live independent fulfilling lives.
“It also drives important efficiencies in hospitals enabling swift, well-managed discharge from wards. A strong warning sign identified in the report is the link between early discharge and readmission.”
The population is living longer, an achievement which should be celebrated, yet it is presenting a challenge for the very organisation that has helped people live longer lives
Minister for Care and Support Norman Lamb said: “I am delighted to give my support to this campaign – it’s absolutely right older people are given the support they need when they leave hospital and volunteers have an essential role to play.
“Our £5.3billion Better Care Fund will mean 163,000 fewer A&E visits next year and more people helped to live independently at home for longer after leaving hospital, giving older people the dignity they deserve.”
Increased longevity is putting pressure on health and social care and over the last decade hospital admissions for those over 75 have been rising four times faster than ageing trends in the population (38 per cent versus 10 per cent). The growth in hospital readmissions has been higher still, up by 86 per cent.
Kings Fund analysis of hospital readmissions and the cost of ‘excess admissions’ in England, estimated that providing volunteer support to older people could save the NHS £40.4m each year through reducing unnecessary readmissions.
Currently, 13 per cent of over-75s are re-admitted within three months of discharge adding pressure to already stretched A&E services.
Among those, a greater need for support at discharge was reported with 43 per cent saying they had needed “a great deal” or “quite a lot” more, compared with only 27 per cent of those who were not readmitted within three months.
More than a quarter (26 per cent) said they simply did not feel well enough to go home in the first place.
Those living alone can feel particularly vulnerable – in Britain, 46 per cent of over-75s who have been in hospital in the last five years live on their own.
Since the establishment of the Royal Voluntary Service Home from Hospital scheme in Leicestershire in 2012, over 600 older people have been supported, with very low readmission rates to hospital among those who used the scheme (7.5 per cent within 60 days, half the national average).
Volunteers support older people after a stay in hospital, making sure their house is safe and warm, helping with meals and transport to follow-up GP appointments.
David Buck, senior fellow at The King’s Fund said: “Well targeted Home from Hospital support schemes could reduce the need for inappropriate and avoidable hospital readmission and other forms of care.
"This may save the NHS significant sums, however their ultimate objective is better health and wellbeing of elderly people, for which there is good evidence.”
When Sylwestra, 89, from Leicestershire, first came out of hospital after a fairly long spell, she had no one local to call upon.
Fortunately for her, the local branch of the Royal Voluntary Service was on hand after being alerted by nurses that there was someone who would benefit from the help of a volunteer.
Since that phone call, Sara Fenwick, a local volunteer has visited her almost daily, helping her get back on her feet by doing her shopping and laundry and by sitting down and chatting with her.“We have fun times together, we chat and she has become a good friend,” Sylwestra said.
“Until the voluntary service started I had no transport to get to appointments. Now I can just call Sara and she takes me and waits for me and another gentleman also takes me to hospital appointments. I really like the friendliness and genuine friendship of the volunteers. It’s an excellent service.”
Sylwestra’s son, Andrew, who lives over 100 miles away in Sussex has found the service invaluable too. “My mother was offered everything she needed by Royal Voluntary Service to get settled back at home,” he said.
“I try to visit her regularly but in reality it’s only every few weeks due to work commitments, and it’s the day-to-day things that are the problem; such as visits to the GP and odd bits of shopping.
“It’s a great comfort to know that the little things are being catered for. In fact they’re not really little things at all for a housebound person.
“With volunteers they really care about what they are doing and I’m most grateful. My mother has lived in her house for 50 years, she loves the garden and this wonderful help means she can stay at home which is what she wants. ”
Sara, 57, has been a volunteer for a year after moving from Scotland to Melton: “I visit Sylwestra two or three times a week at home. She knows if she is anxious she can ring me and I will come and sort things out. I also keep in direct touch with her son,” she said.
“I am absolutely passionate about volunteering. I trained as a nurse and my vocation is to look after people, I need to do it. I searched online for local volunteering opportunities and found the Royal Voluntary Service website. I applied, went for training and the CRB checks, and got started. It was so simple.”
