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?

I think far too much money and thus far too many beds are being used to prop up very elderly patients who should probably have died several years ago.
It does sadden me to think people (often young people) are waiting several hours for ambulances for this reason.
I totally get you don't want mum or dad to pass away, I do, but at some point you do have to accept they're far too old and far too uncomfortable now. Many of them end up with dementia and don't know who you are anymore anyway.

It sounds harsh, but it's a harsh truth.

So what do you suggest happens to them @Disneyblueeyes? Should my DM have just been left to die at home in case someone more deserving needed the bed? Maybe the ambulance should have left my aunt when she had stroke last week, she’s in her 90s after all

So if an elderly person falls over and breaks a hip, should it not be treated? Or develops a curable infection?
People on this thread have spoken about all the medications the elderly are on. IME of working in care homes, the very elderly are on fewer medications than younger generations. This is obviously anecdotal but I found people 50 - 75yo tended to be on the more medications due to having more long-term conditions.

Well ideally the NHS should have enough resources to be able to cope with all of it, old and young, quite frankly.
An ageing population is a problem though, especially when everything is curable nowadays.
It basically means we need far, far more nurses and doctors to cater to it all.
That's the answer really.
Is that ever going to happen?

We do need more drs and nurses, generally. However, once a person is medically fit, they need not require a Dr or nurse. They need physio/OT/care support. As noted above, a return to convalescent homes or extending rehab placements in care homes (with adequate OT/physio support) is a partial solution.

In my mother's area it would involve competent social services. I asked for an OT assessment and the moron they sent failed despite me repeatedly asking for it and then a progress report. Eventually, my mother fell over and broke her hip, this was totally due to negligence and incompetence. The social services failed to investigate properly and the social worker and his senior rang up and laughed down the phone at me. My DB and DSIL asked me not to continue the complaint which meant that they got away with what could have been murder! That is why so many people are waiting for care, useless and incompetent idiots failing the vulnerable people in need. I'm going to get reamed by people but let me point out that your experiences are not mine so there is no point in telling me about them, they are nothing to do with me. What I am saying is that there are too many vulnerable people of differing ages who are consistently let down by the people who have chosen that career.

I don’t think it will even if we magicked up the money somehow. The population needs more support than ever before - physical health, mental health, childcare etc etc - half the public would have to be some form of health or support worker and it’s just never going to be sustainable.

I used to work for the NHS many years ago. We also used to get patients who refused to go home! They were either too scared to be alone or had come to quite like being looked after and fed. They wouldn’t leave and we couldn’t force them for days in some instances.

They want families (women) to go back to looking after their elderly family members.

“Bed blockers” do not require medical care, they need help with eating, drinking, washing etc. Families (women) used to do this. The current system is failing because there is not enough social carers or money to replicate this.

In the Spring of 2021 I spent 3 hideous weeks in hospital and had a good insight into the ‘bed blocking ‘ situation. I was on a bay of 6 women and by week 2, I was the only one unfit to go home-the other 5 were all fit for discharge but had no ‘ care package’ in place. Of the 5, 4 were elderly and needed help at home, but the last (young) woman just simply refused to go home. They wanted her to sleep downstairs for a while as she was unsteady on her feet but she wouldn’t agree to this! She had a partner at home and he came in several times trying to persuade her.I was desperate to get out and couldn’t understand it!

Bed blocking has unfortunately been a "thing" for decades. It is a consequence of insufficient funding of every aspect of social care and every cut that the government makes to social care makes bedblocking worse.
You can't have decades of social care cuts "savings" and expect that bedblocking won't happen. (The general "you")

Then on top of that, privatisation of social care has also meant that any efficiencies (cost or operational) now simply generate profit for private sector businesses instead of going back into the system.

Yes but successive governments forced encouraged women into the workplace once children were in school and most families now rely on double incomes to exist. Also put up the retirement age so women are working til at least 67. The world is a very different place. More women may wish to care for elderly relatives but are financially unable to give up work. If the government actually paid a decent carer's allowance it may help ease the burden on the state.

Adult social services, and care in the community. Decent rate of pay for carers is a must because the care sector is haemorrhaging carers, who can help people in their own homes to speed up hospital discharges quicker.

But what would that allowance be? And could the government afford to pay it for, let’s say, a quarter of working age women so some 5 million people?

Redistribute funds and prioritise social care, health and education.

From where?

It’s a bit depressing. Not sure the law re assisted dying will change. I see your point though

Wtf is a social patient? You mean people who need carers and there aren’t enough carers? Because that is the problem. It doesn’t matter if you can afford to pay for care it isn’t any more available than if you can’t. I find the term social patient really vile.

It's a disgrace that I can't choose to have a good death and pass peacefully at a time of my choosing. We need to challenge the religious stranglehold on the state that prevents this and neddlesnessly prolongues life in very old age. We also need to find social care property and tax wealth to achieve it. The gap between the top 5% wealthiest and everyone else is crackers, they are not wealth creators they are asset borders and the structure of our economy needs to change.

@hettie Lots of elderly people are religious and think it is wrong to commit suicide.

Twenty years ago maybe, not any more.

It was pointed out at the time that making sure women were in the workplace until at least 67 would have social repercussions.
Families can not care if they are all working.

You are wrong. Anyone I know in their eighties and older are horrified at this idea.

You don’t know everyone over 80 @antelopevalley.

I don't think the majority are solely social admissions.

People have been admitted with an illness/problem then because of all the paper work nowadays patients are not deemed fit for discharge. I have no idea what the solution is tbh.