What’s the answer to ‘bed blocking’?

[Cuppasoupmonster]

Another day, another article about ‘bed blockers’ (put in speech marks because I know it’s a bit of a goady term).

I was shocked to find out a third of beds are taken up by ‘social patients’ in some trusts, who are medically fine to be discharged but can’t be because the care they need afterwards isn’t in place. I feel irate that the whole point of lockdowns to ‘stop the NHS from being overwhelmed’ needn’t have happened if it wasn’t overwhelmed in this way to start with.

Whats the answer? Early intervention so they don’t end up in hospital in the first place? A rise in taxes to pay for more services? I’m not sure the working population can afford to pay more tax.

The ‘ageing population’ issue means this can surely only get worse?

Your parents’ wages at the time they had a mortgage for a £3000 property would have been tiny. They wouldn’t have been earning thousands of pounds per year.

@Capri3 Your parents’ wages at the time they had a mortgage for a £3000 property would have been tiny. They wouldn’t have been earning thousands of pounds per year.

Actually, they might have been. In 1972 an average house cost 2.7 times the average annual full time salary. Now its 7.7 times. That's a huge difference.

(per Hansard and the Office for National Statistics, in 1972 the average house price was £5158, and the average full time salary was £1903. Now the average home price is £292,000 -and far more than that in many places- and average full time salary £38,131).

Many elderly people do have to pay for their own carers or at least contribute. Its only the poorest who dont. The problem is finding carers.
It was hard enough 7 years ago finding 2 x carers to do 4 x 30 minutes per day for an elderly relative and that was paying £12.50 per hour net. She was bedbound so just needed changing, washing and her food heated up

Many religious people think it is a mortal sin to commit suicide.

I had them when I was going through chemo when I couldn't keep solid food down

I would be very unhappy to be put in a care home I have to pay for if I only need carers coming into my home a few times a day.
The vast majority of people need some limited help at home, they do not need to be in a care home.

The only people I know who have had these drinks are people with cancer.

Not true loads of people with progressive incurable conditions are given them including dementia/neuro conditions even right towards the end. I work in this field so I know.

@worr Not denying that, just not my personal experience

@Sugarplumfairy65 @antelopevalley but the cost of your house isn't included in the calculation for care. In many other countries, you'd be expected to take out a reverse annuity or similar, so you could stay in your home for the rest of your life (or until you needed residential care), but also release funds for care.

This way people can stay at home (as @antelopevalley says) but also

Pay for care. Otherwise you can have people who've collected a pension for decades, sitting in a £600k house, but low income so get funding.

Tax the wealthy aged more to help their peers

@OverTheRubicon what happens if you need to move? Lots of people come out of hospital after a sudden event e.g. accidental fall, stroke, etc and suddenly need carers at home. But they know that really they need to move to a more suitable house. But this takes time, especially when someone is already ill or badly injured. Or do you end up with people stuck in unsuitable homes unable to move?

And what happens when your house value is used up? Do you have to move out and rent somewhere? Or do you get free care at that point?

Note that almost everyone pays at least something for their home care and a lot of people pay the full cost.

When they bought the house initially yes but wages inflated massively over the time they owned the house so by mid- mortgage the monthly payments were low in relation to their wages. The high inflation in the 1970s reduced the real value of debt considerably as well as pumping up the value of the asset.

Soooo many people across ages and conditions have them. I’m giving more to lower ages than elderly

Bring back convalescent homes.

Well a modern version of them.

I actually am old enough to have been to one, just for a break and funded by union membership.

I had an ensuite room, three hot meals a day and tea and coffee in between, not expected to do anything but I could if I wanted.

If you were not in for lunch they would send you off with a packed lunch.

‘Extra Care’ housing is a great example of how to significantly delay the need for residential care, and is suitable for most discharges of older people from hospital, so reduces bed blocking. I visited a new complex, built by the council, with over 100 independent one and two bedroomed flats, and a few peripheral bungalows earlier this week.

I’m of the age group to qualify for this type of housing, over 60s. Security, caretakers and carers on site, care packages if and when needed. Reduced isolation, fewer falls, wheelchair accessible, mobility friendly. There’s a laundry, landscaped gardens and a cafe. In the private sector, these would cost a fortune, but the rents, which include heating, security, maintenance etc., are reasonable. I hope the tenants who move in appreciate the thought and planning that has gone into them.

More developments of this nature would free up houses across sectors, reduce the demand on the NHS, reduce the worries for families of older people, especially those who don’t live locally.

We had the answer years ago and it was slowly removed. When I was working in the 1980's we had convalescent beds, convalescent wards.

If you had surgery, or were recovering from acute illness requiring a longer stay you'd be transferred.

From here they had gentle rehab and sometimes months of convalescence. It's wasn't technically medically needed, but they needed time to recover and get back on their feet with physio, OT, basic nursing (nursing assistant) care to have a bath or get to the toilet.

As far as I know all these places have gone now. I think Care in the Community in the 1990's replaced them. Soon after that big budget started to be depleted year on year and that started to fail.

The system we have now is one with big gaps where these services once were.

How can this current system carry on? It can't, not without some form of convalescent provision.

Yes I'm not arguing that, im saying if you have an incurable degenerative condition they use them and the side effect is it could extend your life. I personally don't want that for myself so I would do an advanced directive. If other people do that's fine but I've watched too many slow drawn out deaths. I want pain relief and sedation. It's about choice.

The increase in NI was supposed to solve the problem "once and for all" (it wouldnt have). Then Liz Truss spent 6 weeks boasting about having cancelled it.
A change of government will be a step in the right direction.

Families need to get their heads out of the sand and take some responsibility.

Many hospital admissions are after months if not years of decline. They are frail, they are struggling to manage. Their families know it but seem powerless to intervene then the person has the fall, or the serious uti whatever is the final straw that gets them admitted and lo and behold the nursing staff see what the relatives have seen but not acted on, the person cannot manage at home and a long wait for social care begins from an acute hospital bed.

So if you have a relative over 80 or even younger, who is struggling have that awkward conversation with them and tell them they need to organise social care back up at home now or risk a lengthy hospital admission followed inevitably by a care home afterwards.

How may times do we see it on here, 'my frail 84 yr old lives 200miles away and I can't get hold of him i dont know ayone local to check on him'. Absolutely no plan in place for when these very predictable things happen.

Care home places cannot be organised overnight, it usually takes weeks.

It's really common for people with alzheimer's to not realise anything is wrong even when it's blindingly obvious to everyone else. My mum is a typical example. She fiddles with the central heating controls so the clock is hours out or it's on the wrong settings and then wonders why the boiler doesn't come on. Or she switches on the electric heater in the room with the thermostat so the heating doesn't come on as it's already a sub-tropical temperature. She will do this a couple of times a month but because she has forgotten the previous occasions as far as she is concerned it's just this once. We've had difficult conversations about putting a box over the controls. British Gas engineers have had the same conversations. But as far as she is concerned it's totally unnecessary because clearly someone else must have fiddled with the controls (carers or family get the blame) and it's just the once. If we put a box on anyway she would smash it off to get to the controls and a couple of hours later wonder how it got broken.

Do you think families do not have that conversation, often many times!!
It is met with - oh no things are fine, them trying to hide how bad things are, lies about situations, etc. We KNEW my father-in-law was going to hit a crisis, but he refused to see any issue until that crisis happened.

My only family member is my brother, who lives 140 miles away and doesn't drive. He's also a recluse with severe MH issues. There's no way he'd be in a position to help me.

When I couldn't go home to an empty house following knee surgery, I stayed with my SIL for a couple of weeks, but it would be unreasonable to expect her to care for me long term. If I need care in my dotage, I'll be at the mercy of the state, and they'll sell my house to pay for it.