Independence in older age

Introduction

As people get older, it becomes harder to remain independent because of the increasing risk of ill health, poverty and social isolation.

Most people would prefer to remain living in their own homes for as long as possible. Whilst a key measure of successful joint working is the ability of local health and social care services reduce avoidable admissions to hospital and residential care, there are a range of valuable community services and support which seek to support people and maximise their level of independence, in order to minimise their need for ongoing support and dependence on public services. 

Key inequalities and risk factors

  • Gender - Men are more likely than women to readmitted to hospital within 30 days of the previous discharge from hospital and less likely to remain at home 91 days after discharge from hospital
  • Deprivation - there is social gradient to readmissions to hospital with people living in more deprived circumstances being readmitted to hospital within 30 days of the previous discharge from hospital than those who are better off.
  • Age - People aged 85+ are more likely than other people to remain at home 91 days after discharge from hospital

These can be reduced by environmental influences such as falls prevention, betterment of housing conditions and a whole range of health improvement programmes to prepare for or whilst in older age which focus on physical, emotional and social wellbeing.

Facts, figures and trends

Although the percentage of over 70 year olds is relatively low in Bracknell, their needs for Social Care and Health can be high due to poor health and increasing frailty. 

By 2021 the population in Bracknell Forest is estimated to increase by almost 12,000 people. Figure 1 shows the percentage change in population for each age group and gender. The lines to the left of the vertical line show population groups which are estimated to decrease in size and these are mainly the 40 to 54 year old population and teenage children. All other age groups are estimated to have an increase in size as is shown by the bars to the right of the vertical line on the chart. The older population is expected to increase at the greatest rate followed by the younger adult population and the child population aged 5 to 14

Figure 1: Percentage change in population estimated from 2012 to 2021

Population change

Source: Office for National Statistics

Information from Projecting Older People Population Information show that around 6,000 people aged 65 and over living in Bracknell Forest are estimated to be unable to manage at least one domestic task on their own, with this figure estimated to increase to just fewer than 7,000 by 2020. The number of older people estimated to be unable to manage at least one self-care activity task on their own also rises from 5,000 people in 2012 to 5,500 by 2020.

Keeping people safe and well

Avoiding permanent placements in residential and nursing care homes is a good measure of delaying dependency.  The council has looked at the wider support enviroment and has invested in extra care housing, an independence at home service, supports a range of voluntary and community sector organisatiions to support people directly in their homes either practically or with emotional and social support, but also indirectly, through resilience building programmes including a conversation models of care focussing on early intervention and social capital development progammes that help people to connect to community to reduce social isolation and build local support networks. 

Reducing the digital divide

Academic research funded by the RCUK Digital Economy programme (2013) found that information communication technologies (ICT) and in particular broadband can benefit areas and people experiencing economic and social disadvantage by connecting people and places, businesses and services. 

Broadband and superfast broadband is now considered to be essential to the economy and should be treated as a necessary infrastructure for new and existing communities. It may also increase access to remote educational and employment opportunities and from a wellbeing perspective, education and employment are both important determinants of health.

As the “internet of things” progresses, interconnection via the Internet of computing devices embedded in everyday objects, enabling them to send and receive data will become common place, e.g. delivering live and instantaneous remote patient monitoring and health related information and education for patients and professionals and vulnerable residents will be digitally connected and monitored by health and social care professionals through internet enabled assistive technologies. It can help to reduce social isolation and loneliness in communities, supporting improved mental health and wellbeing.

Want to know more?

Department of Health (2009), Intermediate Care – Halfway Home: Updated Guidance for the NHS and Local Authorities

Health and Social Care Act 2012

National Service Framework for Older People 2007

Local Action on Health Inequalities: Improving access to green spaces (Public Health England, 2014) - a summary of evidence about the positive impact of access to green spaces on self-rated health, wellbeing, obesity and overweight levels, reduced social isolation and independence.

 

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