One million elderly will need 24-hour care by 2035

The number of people aged 85 and over needing 24-hour care is set to almost double to nearly half a million over the next 20 years, while the number of over 65s needing 24-hour care will rise by over a third to a million, according to new research.

There will also be an increase in the number of elderly living with multiple long-term conditions, with 80 per cent of adults with dementia needing 24-hour care, also having two or more diseases.

However the study published in The Lancet Public Health also found there will be a rise in the number of adults aged 65 and over living independently (without care needs) from 5.5m in 2015 to 8.9m in 2035. Researchers from Newcastle University Institute for Ageing revealed this increase of over 60 per cent will mainly be in men.

The authors of the study are urging health and social care services to adapt to the burgeoning older population with complex care needs and stop relying on informal carers.

'Considerable' challenge

Professor Carol Jagger from the Newcastle University Institute for Ageing called the challenge “considerable” and said: “Our study suggests that older spouse carers are increasingly likely to be living with disabilities themselves, resulting in mutual care relationships, that are not yet well recognised by existing care policy and practices.”

She points out that “on top of that, extending the retirement age of the UK population is likely to further reduce the informal and unpaid carer pool, who have traditionally provided for older family members. These constraints will exacerbate pressures on already stretched social care budgets”.

To improve the precision of social care need forecasts, researchers from Newcastle University and the London School of Economics and Political Science developed the Population Ageing and Care Simulation (PACSim) model which accounts for multiple risk factors for dependence and disability including a wide range of sociodemographic factors such as education and health behaviours. They found very different scenarios for men and women.

Men's life expectancy age catching up with women

Life expectancy for men aged 65 over the next two decades is predicted to rise by 3.5 years to 22.2 whereas women aged 65 will see their life expectancy rise by three years from 21.1 years to 24.1 years.

The average time for men aged 65 without care needs will rise by 4.2 years, from 11.1 to 15.2 years, whilst time spent living with substantial care needs (medium or high dependency) is set to fall.

However for women, it is not so good, with the number of years without needing some kind of care rising by less than a year from 10.7 years to 11.6.

Women will spend almost half of their remaining life with low dependency needs such as help with activities like washing and shopping, alongside a small increase in years requiring intensive 24-hour care (from two years in 2015 to 2.7 years in 2035).

Professor Jagger added: “Trends for men and women are likely to be very different, with women experiencing more low level dependency than men, highlighting the importance of focusing on disabling long-term conditions such as arthritis that are more common in women than men.”

The rise in the number of people with dementia and two or more conditions, led Professor Jagger to warn that this “expanding group will have more complex care needs that are unlikely to be met adequately without improved co-ordination between different specialties and better understanding of the way in which dementia affects the management of other condition”.

Care provision for future needs careful thought and planning

Professor Eric Brunner and Sara Ahmadi-Abhari from University College Medical School, London, commented on the findings, saying: “Care provision at this intense level for more than 1 million people in 2035 will require careful thought and planning at both local and national level.”

Jeremy Hughes, chief executive at Alzheimer’s Society, said the new findings “paint a challenging future.” He added: “After decades of starved funding, the social care system is buckling under the strain. It is simply not fit for purpose for the 850,000 people living with dementia and their carers across the UK, with this study serving as a wake-up call of what’s to come. Through our helpline we hear of people with dementia being forced to choose between a wash or a hot meal due to the limited time of a home care visit, and ending up in hospital with an infection because they didn’t have the support to shower each day.

“The government cannot shy away from this crisis any longer. We need them to face the issues head on in the upcoming Green Paper and NHS plans.”

This study was funded by UK Economic Research Council and the National Institute for Health Research.