![]() Keeping people in hospital is costly, and people over 85 account for a quarter of all bed days in the NHS. There are also financial as well as personal costs associated with hospital care. It’s not known exactly why hospital admissions should lead to delirium, but the unfamiliar and stressful surroundings of the ward and loss of a comforting home routine doubtless plays a part. It can have serious effects, such as accelerating or triggering dementia, and often leads to people spending a longer time in hospital and eventually ending up in residential care. A little-known but common condition in the elderly, delirium is a state of acute confusion. Older people are also at significantly increased risk of developing a condition called delirium if they are admitted to hospital. And if someone is already receiving regular care at home, sending someone into hospital can interrupt the relationship with their carer. There’s also a risk of picking a hospital-acquired infection, which can cause serious complications or even death. Small studies have suggested that admitting frail older people to hospital can lead to a decline in their physical ability. Working out how to solve this challenge is a major concern for the 21 st century, if we want to provide the best healthcare for as many people as possible with dignity, respect and compassion.Īt first glance it might seem obvious that hospital would be the best place to look after someone, but in fact there is evidence to show that this may not be the case. One way to cope with this problem is to cut the length of time that people stay in hospital, but this duration is actually rising for people over the age of 85. At the same time, there are a third fewer emergency hospital beds than there were 25 years ago, despite the fact that these admissions rise at a rate of 2 to 3 per cent every year. Today, nearly two thirds of the people admitted into hospital are over 65 years old, and an increasing number are frail or have dementia. Not only is the number of older people in the population increasing, they also have complex health needs – including physical frailty, decreasing mental ability (cognitive decline) and dementia – on top of any long-term health conditions. So is hospital really the best place for them, or would they be better cared for at home by a specialist team? Professor Sasha Shepperd and her team at the NDPH want to find out. But there are concerns that this may not provide the right kind of care that they need. In an emergency situation, such as a fall or sudden illness, doctors may recommend that a frail older person should be admitted to hospital. Older people are being admitted to hospital in ever greater numbers, putting increasing pressure on an already stretched service facing ever tighter budgets. This growing elderly population is one of the biggest challenges facing the NHS today. Currently there are 10 million people in the UK who are over 65 years old and three million over the age of 80, and these figures are set to double over the next 20 years. Thanks to advances in medical care and public health, we’re lucky to be living longer lives.
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