Changes over time in the health and functioning of older people moving into care homes: analysis of data from the English Longitudinal Study of Ageing

Background: the number of people requiring care home support is projected to rise in future years, but little information is available on the needs of new care home residents. Objective: to measure the health and functioning of people moving into care homes and how they have changed between 2002 and 2015. Setting: English Longitudinal Study of Ageing. Participants: two hundred fifty-four of the 313 (1.99%) individuals who moved from the community into a care home, and were interviewed in the survey wave prior to entry. Main outcome measures: changes over time for number of health conditions and functional deficits (deficits in activities of daily living (ADL), and instrumental ADLs (IADLs)), assessed in the survey wave prior to admission. Results: over time there were significant increases in the total number of health conditions and functional deficits amongst soon to be care home entrants (P = 0.0011), the proportion with high blood pressure (OR 1.37, 95% CI: 1.17-1.62, P < 0.0001), memory problems (OR 1.33, 95% CI: 1.11-1.61, P = 0.0021) or total number of IADL deficits (P = 0.008). Non-significant increases were observed in the proportion of care home entrants with cancer (OR 1.23, 95% CI: 0.93-1.65, P = 0.15), lung disease (OR 1.21, 95% CI: 0.85-1.75), heart disease (OR 1.12, 95% CI: 0.95-1.30) and arthritis (OR 1.11, 95% CI: 0.95-1.30). Stroke and ADL deficits did not increase. No differential ageing effect was observed. Conclusions: the support needs of care home entrants in England appear to be increasing over time. This has important implications for the provision and funding of care home places and community services.