Do we really need almost 200,000 more care home beds over the next 20 years to support Britain’s ageing population? That’s the arresting projection of new research suggesting that the typical 65-year-old can expect to live with significant care needs for two to three years of the rest of their life.
The study is one of the biggest of its kind and has been welcomed by Sir Andrew Dilnot, author of the shelved 2011 blueprint for care funding reform, as evidence that spending on older people’s care “will need to increase substantially and quickly”. But what kind of spending should that be?
By simply equating care with care homes, there is a danger of shutting down debate about other forms of support for older people. We risk locking ourselves into a model too often found wanting by regulators and watchdogs.
The research is not the first in recent days to make a leap from the growing numbers of older people to a need for more care home beds. Earlier this month, a property consultancy commissioned by the BBC warned that the UK was building only half the required number of new care homes, sparking headlines that up to 3,000 older people would fail to get a bed by the end of next year.
The new study, by universities making up the Cognitive Function and Ageing Studies Collaboration, is based on interviews with almost 8,000 older people in Cambridgeshire, Nottingham and Newcastle upon Tyne, and a comparison of the results with those of a similar exercise in the same areas 20 years previously.
It concludes that the typical 65-year-old woman can now expect to have “substantial” care needs for three years of the rest of her life and a man for 2.4 years – an increase of up to a year on findings from the 1990s. On this basis, it calculates that the number of people needing care at regular intervals or round the clock will rise by almost two-thirds by 2035.
If present patterns of care and support remain unchanged, the researchers say an extra 71,000 care home beds will be needed by 2025 and an extra 189,000 by 2035. There are currently around 400,000 in total.
Dilnot, a former chair of the UK Statistics Authority, writes in a comment article accompanying the research that the projected increases in care needs “are very large and although there is uncertainty about such projections, their broad outline seems likely to be accurate”.
This does not mean that the extrapolated demand for care home beds is likely to be accurate, however. As the researchers themselves acknowledge, many more older people with significant support needs are living independently today than was the case 20 years ago.
Of those aged 85 or over with substantial needs, more than 73% were in care homes in the first wave of the research but less than 52% were in homes in the second.
We can, and should, expect this trend to continue. Older people are being supported in increasingly innovative ways to continue living independently, and it is imperative that this is a central plank of the government’s promised green paper on social care.
There will always be a role for care homes. Many people will make a positive choice of good residential care – there is lots of it about – and it is encouraging to see homes making the effort to open their doors to the wider community. But we should not make the mistake of equating old age with moving into – or worse, being placed in – a care home.
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