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Is it time for a new elderly care model?

Updated: Mar 20

Given the Covid-19 pandemic has caused unimaginable pain for residents and their families, is it time to rethink how elderly care is delivered to meet new infection control and health and safety standards. While, protecting the resident’s rights to independence, space, privacy and dignity following domiciliary care policies and procedures.

An insight article by Kirk Taylor in property week suggests in the wake of Covid-19, there is an opportunity to develop new care models that improve best practice.

Shift towards sheltered accommodation or retirement living facilities

Clearly there is a growing need to expand capacity. Without establishing new facilities, the strain on existing services may well be exacerbated in years to come, especially as Covid-19 exposes the health risks of high-density environments.

Even prior to the pandemic, expectations of elderly residential living were shifting towards new sheltered accommodation or retirement living facilities. Covid-19 has led to new health and safety standards that are likely to increase demand for facilities such as en-suite bathrooms. Such amenities could play an important role in mitigating against future outbreaks, while also addressing the need for more personal and private spaces within communal residential homes.

A trend towards de-densifying spaces could spur the creation of new, better-designed spaces with facilities such as living rooms and kitchens shared by small groups of residents needing more care than they could access if they lived independently.

Pressure on care home capacity

The pressure on care home capacity and lack of suitable intermediary care between hospitals and nursing homes is a long term problem that clearly must be addressed. The number of hospital beds blocked by patients with no suitable care accommodation to be discharged to in the community rose to a record high last summer. Without suitable accommodation allowing patients to regain independence safely, this ‘bed blocking’ will continue.

There is a growing dialogue about shifting from one-level approaches to extra-care housing that adapts to evolving needs and makes it easier to plan for a short period of isolation or more intensive care. This could also play a role in protecting mental health by providing a transition that mitigates distress or confusion.

According to Kirk, there should not be a rush to deliver new nursing homes without careful consideration. Extra-care living creates a more empowering environment that encourages people to have as much independence and privacy as possible. But too often, nursing or residential homes on the edge of towns and cities can be alienating for older people. Carefully considering site location and layout of homes can ensure that older people stay connected to the wider community in line with CQC policies and procedures.

Use of technology 

Covid-19 has shown us that the use of technology in care facilities is sorely lacking, with criticism of the sector’s ability to track data on the pandemic. I don’t subscribe to this view as the government despite spending billions, have failed to establish an affective tack and trace system.

Centrally held digital care notes, for instance, could make it far easier to track and share changes in a resident’s condition between caregivers. Virtual access to medical professionals could aid people managing long-term conditions, especially where they must maintain strict social distancing. Sensor technology, such as motion-controlled doors and contactless interfaces, could also encourage independence while minimising any infection risks at touch points.

The pandemic has enhanced the argument for extra-care facilities and the need to design spaces and leverage technology that improves residents’ health, wellbeing and dignity. It has prompted a new era for care, and developers must take this opportunity to deliver improvements and efficiencies.

Summary

There is more than sufficient evidence that suggests going forward we will lack capacity to care for the elderly in care homes. Kirk Taylor believes that the COVID-19 pandemic provides an opportunity to plan an alternative to the current over reliance on care homes. He argues the case for extra care housing that adapts to evolving needs of smaller groups of people. Personally, I do not see extra housing schemes providing a scaled quick fix alternative. This approach however along with care homes and domiciliary care can make a valuable contribution to care of the elderly in the community.

Planners need to take account of the pressure on care home capacity and address the lack of suitable intermediary care between hospitals and care homes, we also need to embrace what technology has to offer if we are to meet the challenges of a new era of care.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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