What percentage of UK over 65’s are in a care or nursing home? Is that number increasing or declining?

The more melodramatic writers describe going to a care home as a “life sentence”. Once you are in you won’t be coming out again. It is a fear that haunts us all as we get older. To spend the last few years of our life in an “institution”. What was your answer to my opening question? Would it surprise you to know that only 2.5% of over 65’s are living in a care or a nursing home. That number is falling. It is down from 3.2% in 2011. Did you think the number was larger and growing? What does your answer tell you about your view of your own ageing?

The US numbers are only slightly higher. 5% of the population live in some kind of care home. 83% of them are over 65. A third of all residents are over 85.

The Market is Not Booming

The number and percentage, of over 65’s in the population is increasing. One might expect the market for care homes to boom. In fact, the market is increasing at a much slower rate than expected. Last week’s Newsletter pointed out that the period of frailty at the end of life is not increasing. In fact, it is reducing. Very few people go into care if they are fit and healthy. Only 19% of UK residents claim to be in “Good” or “Very Good” health.

The numbers reflect that we are living healthier for longer. Below the age of 85 very few men and women are care home residents. Even in the 80-84 age band only 3.9% of women and 2.4% of men. This is down from 5.1% and 3.0% in 2011. That means that 96% of women between 80 and 84 are living at home.

It is only at ages above 90 that 21% of women are in a home. Half of the over 65 who are in care are over 85. Women outnumber men significantly. Across all age groups your chances of ending up as a resident are going down. The total numbers hide another surprise. The proportion of all people in care that need nursing is going up. The overall numbers are going down and concentrating in people in need of much more help.

Why Do People Go into Care?

There is a group for whom this is not a life sentence. They are convalescing from an illness or an operation. When they are better, they will leave. There are residents who see themselves as healthy. They have chosen this lifestyle. However 89% of residents are suffering from a debilitating disease. This limits their ability to live a normal life to a greater or lesser extent. They need to be there. Unfortunately, 70% of UK and US residents suffer from dementia or severe memory problems. It is easy to forget that for many being a resident is a relief.

The scale of the dementia problem is shown in the portfolio of homes. In March of this year there were 16,566 care or nursing homes in the UK. Of this only 5041 are nursing homes. There are 9518 homes specializing in the care of individuals with dementia. The total number of homes declined in the UK last year. Across all this, half of all residents are self-funded. The balance are funded by the State.

Are We Overreacting

Why are we so afraid of going into care? We are certainly double counting. Dementia is a terrifying disease. It often ends in an average of 2-3 years in a residential care home. Should we be afraid of both? Your chances of getting dementia are going down. Sadly, your chances are higher if you suffer deprivation.

The number of people going into residential care is going down. More and more people are aging at home. This is the case across all age groups. It is the case across all Regions of the UK. London is an affluent City. It has only 1.9% of its over 65s in care. Even that small number is going down. The average stay in a care home is only 18 months. Within that 43% stay for less than 100 days. Within nursing homes, the number is shorter.

Age at Home but in a safer home.

Across the US and UK particularly, sheltered housing has emerged as an alternative driven by ageing baby boomers. Accommodation that is purchased and can be resold. That is specifically designed for ageing well. It offers independent living but with a safety net. Staff are available to help. Most do not offer sufficient “care” to be regulated. People can age at home but in a different safer home.

Facing the Future

There is only way to stop ageing. In reality nearly all of us will spend all of our days at home. Supported by technology, good home design and care services. A few of us may be faced with the decision to go into residential care. If we make that decision ourselves, we will live longer. It is our last chance to demonstrate that we are in control of our lives.