10. Care Home Medicine

Question 1

What percentage of people over the age of

a) 65 years

b) 85 years

live in a care home?

Answer 1

a) 4%

b) 15%

Question 2

What are the differences between a residential home and a nursing home?

Answer 2

Residential homes provide accommodation and personal care (e.g. help washing, dressing, taking medications, toileting).

Nursing homes provide personal care, and there will be always be ≥1 nurse on duty to provide nursing care (e.g. NG tubes).

Question 3

How much does a care home cost?

Answer 3

£800pw for a residential home.

£1000pw for a nursing home.

Question 4

How can people pay for their care?

Answer 4

• self funding
• family funding
• financial help from local authority via Adult Social Care (care needs assessment)

Question 5

What are some common health problems in care homes.

Answer 5

• dementia
• frailty
• post-stroke
• heart failure
• cancer
• osteoarthritis

Question 6

What is the prognosis following care home admission?

Answer 6

Most patients remain in care till death.

Average life expectancy:
- 24 months in residential care
- 12 months in nursing home

Question 7

How do people enter care homes?

Answer 7

• following medical crisis (unforeseen)
• planned admission
• personal preference
• respite care
• short term admission for rehabilitation

Question 8

What is the process of admission to a care home?

Answer 8

1) referral (self, local authority, family member)

2) visit homes interested in

3) pre-admission assessment by staff from the home, to determine they are able to meet the individuals needs

4) funding agreement

5) admission

6) six-week review

Question 9

Give some examples of supportive care in residential homes.

Answer 9

• washing and dressing
• helping take medication
• changing dressings
• preventing pressure sores

Question 10

What are the ceilings of care in a nursing home?

Answer 10

ReSPECT form and DNACPR discussions need to be had.

Need to determine escalation preferences of patients, to determine ceiling of care (ie. admission to hospital?)

Question 11

What is a carer?

Answer 11

A person of any age who provides unpaid support to a person, who wouldn’t be able to manage to live independently or whose health would deteriorate without this help.

Question 12

What are some reasons someone may need a carer?

Answer 12

• frailty
• disability
• serious health condition
• mental illness
• substance misuse

Question 13

Carer job description.

Answer 13

Question 14

What are some challenges for carers?

Answer 14

Impact on health:
- chronic stress / burnout
- mental health problems
- lack of sleep
- self neglect

Social impacts:
- lack of assistance
- isolation

Financial strain

Question 15

What is the carer’s allowance?

Answer 15

Allows carers to claim £76.75 per week provided they are for someone at least 35 hours a week, and they get certain benefits.

Question 16

What are some common signs and symptoms of caregiver stress?

Answer 16

• anxiety
• tiredness
• difficulty sleeping
• trouble concentration
• feeling resentful
• drinking, smoking or eating more
• cutting back on leisure activities

Question 17

What are some suggestions to help with caregiver burnout?

Answer 17

• keep on top of own health
• exercise
• eat well
• join a caregiver support group
• look into respite care

Question 18

What are the types of respite care?

Answer 18

• day care centres
• homecare from a paid carer
• short stay in care home
• respite holidays
• sitting services

Question 19

What is emergency respite care?

Answer 19

Encourage carers to consider who they can contact in an emergency if they cannot care for an individual, for example due to carer accident or illness.

Ensure:
- contacts have door keys or know the code to a key safe
- contacts know the type of care the person you look after will need

Question 20

What are the funding options for respite care?

Answer 20

• council (needs assessment, carer’s assessment)
• charity
• self-funding