News, Culture & Society

More dementia patients in A&E over lack of care home beds

A lack of care home beds means more than three in four dying dementia patients end up in A&E, shocking new figures show.

The number of later-stage patients making emergency visits to hospital jumped by 62 per cent in just five years between 2008/09 and 2012/13, research by King’s College London found.

Doctors warned many of the visits were preventable, unnecessary and distressing for patients and their families – as well as putting greater strain on overstretched emergency departments.

They blamed falling numbers of care home beds for the problem as the study found people in care homes were much less likely to go to A&E.

Three in four dying dementia patients are ending up in A&E due to a lack of care home beds, a new study has found (file picture)

The ageing population and an increase in the number of people with dementia was also a factor.

Lead author, Dr Katherine Sleeman from the Cicely Saunders Institute at King’s College, said: ‘Recognition of the need to improve end of life for people with dementia has been increasing. This includes enabling them to be cared for in their home or a care home.

‘However, our results show a worrying increase in the reliance on emergency care. In light of the current pressures on the health service, our ageing population and the associated increase in deaths from dementia, there is an urgent need to look at ways we can provide better support for care in the community.’

Researchers examined medical records from 4,867 dementia patients in the UK who died between 2008 and 2013.

They found 78.6 per cent of the patients ended up in A&E at least once in the last year of their lives.

Emergency hospital visits were more likely the closer patients was to death, with nearly half attending A&E in the last month of their lives and a fifth attending in their final week.

Experts warned it was difficult for patients to experience a dignified death if they were being rushed in and out of a busy A&E department in their last days.

Professor Robert Stewart, consultant old age psychiatrist at King’s College and co-author of the paper, said: ‘Most people with dementia have a number of other health problems as well as difficulties arising from the dementia itself.

‘Sometimes people do need to be taken to A&E and sometimes time in hospital is needed; however, this is often distressing and disruptive and most people want to keep it to a minimum.

‘A lot of hospital use could be avoided if there was a higher level of support in the community.

‘This includes clearer plans in place for dealing with illnesses when they occur and when they don’t necessarily need hospital services.’

The study found people who were in care homes were 19 per cent less likely to go to A&E.

Being in a care home could help ‘protect’ patients as they were more likely to have a care plan and support in place that meant they avoided attending hospital unnecessarily.

The paper, published in the Alzheimer’s and Dementia journal, said: ‘Increasing care home bed capacity is likely to play an important role in reducing pressure on emergency hospital care… Although care home capacity has increased in some parts of England in recent years, other areas have seen a loss of care homes.

‘Given the projected increase in prevalence of dementia with population aging, this issue requires urgent attention.’

Figures from the OECD show there were around 8.8 care home beds per 1,000 people in the UK in 2008 but this had dropped to 8.6 by 2013 and 8.3 by 2016.

The study found people in care homes were much less likely to go to A&E (file picture)

The study found people in care homes were much less likely to go to A&E (file picture)

Last week, researchers from Newcastle University warned Britain was facing a desperate shortage of care home places.

An extra 71,000 beds would be needed in England alone by 2025 – nearly a third more than were available in 2015.

And by 2035, demand will have grown by 86 per cent, meaning 189,000 extra beds would be needed.

That study, published in the Lancet journal, warned people will need to spend more of their lives in care as life expectancy increases.

A Department of Health spokesman said: ‘We want England to be the best place in the world to live with dementia. 

‘As part of this, the implementation of our Dementia 2020 challenge will ensure that everyone can be supported to be as independent as possible and get the care and support they need, wherever they live.

‘High quality care isn’t just about care home beds – 61 per cent of people are cared for in their own home and since 2010 there has been a growth in home care agencies of more than 2,900.

‘We’ve given local authorities in England an extra £2billion.