AROUND 40 per cent of older patients on hospital wards are likely to be in their last year of life, according to an international expert who believes most should be at home.

According to Professor Ian Philp, professor of Healthcare for Older People at the University of Warwick, Scotland should instead be spending on community-based services to relieve pain and offer financial and benefit advice. 

Providing this, instead of hospitalising the elderly in a crisis, would cost the same as care on the NHS, but leave people more resilient, less likely to return to hospital, and more comfortable at the end of life, Mr Philp claims.

READ MORE: Scotland’s elderly face ‘years of neglect’ unless taxes are raised

The internationally regarded expert will visit Stirling in June to give a masterclass to health and social care professionals on a four-step programme of change. It will focus on older people’s own strengths, address the challenges of frailty, of how to train families and care workers better and design environments better for those affected by dementia.

His “easycare” approach has been tested in 46 countries over
28 years, but it has been a struggle getting it taken on board in the UK. 

“I am increasingly frustrated at the crisis of poor management in health systems for older people, when there are some clear answers,” he said.

“This is not all about money. It starts with talking to older people to find out what’s bothering them the most and then addressing those concerns.”

When asked what they need, 12 per cent of frail older people say they suffer from loneliness, and 12 per cent report being in constant pain, he said.

Meanwhile, 10 per cent ask for help with the activities of daily living such as bathing, toileting and getting dressed. And 10 per cent say they need advice on money or benefits as they are struggling financially.

For most, the last place they need to be is in hospital, Mr Philp said, and they wouldn’t have to go there if there was a significant investment in support at home. 

The Herald:

Professor Philip

“For people of advanced frailty, their life expectancy is very short and every moment counts for that person,” he said. “Around 40 per cent of our  hospital beds are occupied by people who are in the last year of their lives. 

“They spend the majority of the last year of their life in and out of hospital bed, when providing the same care at home would be better and more humane and take pressure off the hospital system. We should only really be taking people into hospital for a test such as a brain scan.”

Preventative services in the community would be cost-neutral but the savings from their preventative effect, at £3.3 billion over 15 years would “pay for the Chancellor’s national insurance U-turn and leave change,” Mr Philp said.

Wraparound services would include the provision of everything from antibiotics to financial advice at home, as well as provision for short-notice emergency community care, which could provide up to two days of intensive care in a person’s own home, he says.