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?

What happened to your mum after the equity release? That seems fairly risky? In terms of losing a lot of cash for the purpose of staying put an extra few years.

It wasn't. The type of equity release didn't involve interest as such, it was a straight 50/50 split so when the house was sold the company got 50% and Mum would have got 50%. It was well worth it for her as it meant she could stay in the house until she died 18 years later. It was a 2 bedroom semi and she absolutely didn't want to downsize - she'd lived there since she got married and if she'd gone into assisted living she would have had to have given up her pets, wouldn't have had a garden etc.

Glad it worked out. That said, everyone is expected to give up their house if they can no longer pay for it, not just the elderly, but society acts like their homes are sacred and special and nothing should make them leave. If I didn’t pay my mortgage I would be repossessed - they wouldn’t listen to my objections about this being my children’s home etc, they would turf us out. It’s just interesting, the contrast there, and probably part of this as a wider issue.

Glad it worked out. That said, everyone is expected to give up their house if they can no longer pay for it, not just the elderly, but society acts like their homes are sacred and special and nothing should make them leave.

My parents had paid for their home so why should she have given it up if there was another option, which there obviously was (although not suitable for everyone)? She wasn't asking for handouts, she wanted to carry in living in the family home with her pets and could afford to once she had released the equity. She was only 67 when she was widowed so wasn't ready to give them up and live in sheltered accommodation.

FYI the poster Topgub has posted in the past that she sees no reason why women shouldnt be in the workplace but then also posts that she expects an army of family carers to become available at short notice.

The problem with this statistic is that it refers to people over 65. Let's face it 65 is not elderly in this day and age. How many over 80 own their own home? I imagine that is a lot less than 74% and I imagine the number living in poverty will be a lot higher. That is the demographic we are talking about here.

Why? Do you have anything to back that up, factually?

And how would you police that? What about obesity? What about people who just simply don't exercise? Yes I agree people absolutely need to take more responsibility for their own health, 100% but charging people for accessing emergency care would not change that one little bit. Alcohol and drug use are complex problems, not simple but really that's for another thread.

Because if she needed to pay for care, it’s an asset like any other that should be sold to pay for it?

I think it would change things, not completely of course but it would nudge people who need that extra motivation in the right direction.

In theory, an advance directive should prevent this

in practice, anyone present at such a situation does have to call 999 to cover themselves.

my mum has a DNR but I dread the possibility of having to call an ambulance and then say "by the way, she's DNR".

It’s a hard one to fix no doubt, but the U.K. does have this problem especially and it’s not really addressed at any point.

There isn’t a single answer, but using AI to predict when people will be distracted so social care providers will have time to prepare is great

www.thetimes.co.uk/article/92b884f8-8482-11ed-bb21-8f4d97ec7b02?shareToken=1e8cbf153eb7f648127eb90307573299

Oh god, this is ridiculous

whatever happened to actually looking at the patient!

the health service we had 15 years ago wasn't perfect but I do miss it. The rush to discharge wasn't nearly so bad.

@Cuppasoupmonster you seem to think that owning your own home means you don't live in poverty. Lots of home owners are asset rich, cash poor and yes selling up is a solution to pay for care but when you factor in things such as mental health problems, isolation etc elderly people with no financial power of attorney, it's not that simple. Age UK have a good document on poverty in later life. 2.1 million pensioners living in poverty last year. As with all poverty statistics that number is rapidly rising.

But I can see from a few of your comments that you are a person with quite and black and white view of the world. When it comes to people, health and social care and well many things, the world is pretty grey and not at all as straightforward as you would like to think.

Because if she needed to pay for care, it’s an asset like any other that should be sold to pay for it?

Well half was sold so she could carry on living in her home! What should she have done, sold it and moved into some old peoples complex on the off chance she needed care later on? Anyway, you'll pleased to know she died before needing care so unless you begrudge her the few home visits from her GP, hospital appointments for her glaucoma and 5 days in hospital, which wouldn't surprise me, she didn't cost the sainted NHS much at all.

Just to say, a more efficient computer system would be great. I presume the continual failure here is so parties can keep giving new IT contracts to their mates.

No, but had she needed a residential care home then yes it should’ve been sold. Unless you disagree with that? And no I wouldn’t begrudge that at all

She’s under the illusion that a house is a liquid asset @Orangebadger. She also has an almost pathological hatred of anyone born before about the mid 1950s. Best ignored.

Well it becomes liquid if it’s sold. And I could say you have a pathological hatred of younger people, Blossom, but I won’t because I actually understand people have different opinions 🤷🏼‍♀️

And I could say you have a pathological hatred of younger people, Blossom

You could but it would be a lie with no evidence. Whereas your ageist posts are numerous and easily available to anyone who cares to look.

Bit like your claim that I ‘hate anyone born before the 1950s’. Believe it or not some people have opinions other than just ‘tHe GoVerNmEnT ShoUlD Do MoRE’. Do you think the threads about ‘men in general’ are sexist per chance?

Interesting article on AI. There have been several articles in the Times about various new systems being trialled on a large scale before a full roll out. The other is Palantir, which is an electronic patient record that holds a full medical history, including all scans, tests and procedures. Apparently, it's very similar to something created in a London hospital 15 years ago that (for reasons unknown) didn't get taken up across the NHS. And very similar to the systems and software that were in use in American back in the early 2000s... I visited the company in North Carolina to be shown its capabilities as I was working on the UK parent company's annual report.

Technology has to be at least part of any solution to getting better health outcomes.

No, but had she needed a residential care home then yes it should’ve been sold. Unless you disagree with that?

Which it would have been. The 50% that was my Mum's would have been spent on care home fees, why wouldn't it?

Also read this week, probably in the Times, that Italians carry a micro-chip health insurance card that links into medical computer systems to bring up their digital health record. Since 2007!

Lets look at a scenario comparing some older people who need care. All similar age, with similar needs.

A. Has been a high rate tax payer, even in retirement, and owns a property worth around £1m. Has substantial savings.

B. Has always been a low to middle earner. Always lived in social housing, never bought. Has minimal savings, and receives Pension Credit. B will not have to sell any assets, or use savings. B always had a nice car, good holidays, and an active social life when working. B gets rent and council tax benefits.

C. Earned the same (or even less) as B, but had different priorities. C saved up, and bought a house. C’s family holidays were visiting relatives, or renting a caravan. C never had a new car, but did save a bit into a works pension, putting them just above the limit for Pension Credit, and other means tested benefits. In reality they aren’t much better off in retirement than B, especially as they have to pay for repairs and maintenance they are no longer able to carry out themselves. C wants the grandchildren to have some inheritance, mainly from the family home which is worth around £175k.

No one would argue that A shouldn’t pay. But why is C penalised for being thrifty and wanting to help the family?