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. 2021 May 5;50(3):921-927.
doi: 10.1093/ageing/afaa227.

Changes in health and functioning of care home residents over two decades: what can we learn from population-based studies?

Robert O Barker  1 , Barbara Hanratty  1 , Andrew Kingston  1 , Sheena E Ramsay  1 , Fiona E Matthews  1
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Changes in health and functioning of care home residents over two decades: what can we learn from population-based studies?

Robert O Barker et al. Age Ageing. .

Abstract

Background: Care home residents have complex care and support needs. There is a perception that the needs of residents have increased, but the evidence is limited. We investigated changes in health and functioning of care home residents over two decades in England and Wales.

Methods: We conducted a repeated cross-sectional analysis over a 24 year period (1992-2016), using data from three longitudinal studies, the Cognitive Function and Ageing Studies (CFAS) I and II and the English Longitudinal Study of Ageing (ELSA). To adjust for ageing of respondents over time results are presented for the 75-84 age group.

Results: Analysis of 2,280 observations from 1,745 care home residents demonstrated increases in severe disability (difficulty in at least two from washing, dressing and toileting). The prevalence of severe disability increased from 63% in 1992 to 87% in 2014 (subsequent fall in 2016 although wide confidence intervals). The prevalence of complex multimorbidity (problems in at least three out of six body systems) increased within studies over time, from 33% to 54% in CFAS I/II between 1992 and 2012, and 26% to 54% in ELSA between 2006 and 2016.

Conclusion: Over two decades, there has been an increase in disability and the complexity of health problems amongst care home residents in England and Wales. A rise in support needs for residents places increasing demands on care home staff and health professionals, and should be an important consideration for policymakers and service commissioners.

Keywords: CFAS; English longitudinal study of ageing; care homes; disability; health; older people.

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Figures

Figure 1
Figure 1
Prevalence of severe disability amongst care home residents from 1992 to 2016 in CFASI/II and ELSA studies. Severe disability defined by difficulty in two out of the three domains (washing, dressing and toileting).
Figure 2
Figure 2
Prevalence of complex multimorbidity amongst care home residents from 1992 to 2016 in CFASI/II and ELSA studies. Complex multimorbidity defined by medical conditions in at least three out of six domains (cardiovascular, cerebrovascular, musculoskeletal, respiratory, endocrine and cognition).
Figure 3
Figure 3
Prevalence of fair/poor self-reported health amongst care home residents from 1992–2016 in CFASI/II and ELSA studies.
See this image and copyright information in PMC

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