Urban dwellers more likely to be admitted to care
A new study has shown that older people living in towns and cities in Northern Ireland are a quarter more likely to be admitted to care homes than people living in rural areas.
Researchers from the University of Glasgow found that rural dwellers had greater access to informal networks of care, such as family, friends and neighbours, which decreased their reliance on the care system.
The study also showed that it was less common for older people in rural areas to live alone with 25% living with other family members, compared to 18% in urban areas.
Lead researcher, Dr Mark Mccann, from the Medical Research Council Chief Scientist Office Social and Public Health Sciences Unit (MRC-CSO SPHSU) at the University of Glasgow, said: "A lot of work has been done before now on individual and social characteristics, rather than geographical factors. This study shows a definitive link between where you live and the likelihood of you needing to enter a care home in later life.
"Even though older people living in rural areas were more likely to live with members of their family, we found that this did not explain why there was less chance of them needing to go into care homes. Our work suggests that informal networks of relatives, friends and neighbours are more prevalent in rural areas and provide a beneficial service keeps a certain percentage of care recipients out of homes.
"These informal care networks are a vital and undervalued part of our health and social care services and we need to be able to ensure the continuing provision of practical and financial support, such as respite options, for informal carers."
The study was published in the Journal of Health and Place looked at 51,619 people over the age of 65 in Northern Ireland using data taken form the Northern Ireland Longitudinal Study. The findings showed that, even after adjusting for age, sex, health and living arrangements, the rate of care home admission in rural areas was still only 75% of that in urban areas.
Nursing and residential care is a costly means of meeting the needs of older people, it has been estimated that care home placements count for 57% of local authority spending on social care for older people, and the cost of the average length of stay in a care home is over £65,000.
In addition to the financial cost, there is an emotional impact on those admitted to care, for whom the preferred option is usually to stay in their home when possible.
More information: Mark McCann, Emily Grundy, Dermot O'Reilly, "Urban and rural differences in risk of admission to a care home: A census-based follow-up study," Health & Place, Volume 30, November 2014, Pages 171-176, ISSN 1353-8292, DOI: 10.1016/j.healthplace.2014.09.009.