Community health

Integrated Homes, care and support: A proven model to achieve better lives for older people

By - Integrated Care Journal
Integrated Homes, care and support: A proven model to achieve better lives for older people

ExtraCare Charitable Trust commissioned Aston University, and subsequently Lancaster University, led by Professor Carol Holland, to evaluate whether its approach increased positive outcomes for healthy ageing. In this longitudinal study, measures of health, well-being, cognitive ability and mobility in residents across fourteen ExtraCare villages and schemes, were compared with measures from control participants. Mick Laverty, Chief Executive of ExtraCare, writes for ACJ on what the report means for resident health outcomes.

The latest report, published in March 2019, extends the findings of the 2015 report to focus on the benefits for residents, including; sustained improvements in markers of health and well-being for residents and subsequent cost implications for the NHS.

Our initial report in 2015 showed that significant continuous improvements occurred over the three years prior in depression, perceived health, memory, and autobiographical memory, all of which are unique to ExtraCare participants (i.e. improvements absent from control participants).

The findings on reduction in health and social care costs are particularly important for us and our residents. Our initial research shows we can support our residents to become more resilient (or less frail) which we know helps stave off the need for care and other health-related issues. We also know that this helps to reduce the burden on the NHS and local authorities, saving money and providing better services for our residents.

We have spent the last few years implementing the key findings and recommendations from the first report, including; putting the new resilience tool (measuring how resilient residents are in terms of physical and cognitive health) into our well-being assessment and using this for all new residents before they move in. This helps us assess their needs and ensure we are providing the right environment for them. It also helps us set more personal goals with residents to improve their physical and cognitive health.

The first report also stated that some residents felt isolated after they moved in and found it difficult to integrate into the new environment. In response, we have launched a ‘buddy’ system to get resident volunteers to support new residents as they settle-in to ensure they feel welcomed and part of our family.

Key Findings 

The report shows a 23 per cent decrease in anxiety symptoms, improvements in memory and cognitive skills, including; a 24 per cent increase in autobiographical memory and 17 per cent increase in memory recall tests. We can see from this that a reduction in anxiety levels is more apparent over the longer period than in the first 18 months. This indicates that we need to provide continuous, long-term support for residents suffering from anxiety.

Mobility is also a key factor in breaking the link between older adults and depression. If access to social interaction and ability to fulfil activities of daily living is less restricted, mobility issues can have less impact on depression. Furthermore, mobility in terms of walking speed is also shown to improve over time for residents, having a positive effect on reducing depressive symptoms.

In terms of social well-being, the report shows that 86.5 per cent of residents are ‘never or hardly ever’ lonely. Levels of loneliness are shown to be lower for residents in ExtraCare than the national average. That’s good news for our residents. Very few are lonely because the social environment means there is often lots going on and lots of opportunities to join in groups and activities. Those activities that encourage our residents to immerse themselves in the wider community and mix with people of all ages have the most impact.

Further Findings:

1. 23 per cent decrease in anxiety symptoms;

2. Significant improvements in the level of exercise done by residents (75 per cent);

3. Increase in walking speed and a reduction of falls over the first two years;

4. The increase of frailty is delayed or reversed in residents;

5. 24 per cent increase in autobiographical and 17 per cent increase in memory recall tests;

6. 86.5 per cent of residents were ‘never or hardly ever’ lonely;

The 2012-15 study with Aston University which showed:

7. NHS costs reduce by 38 per cent;

8. Unplanned hospital stays reduced from 8-14 to 1-2 days;

9. 46 per cent reduction in routine and regular GP visits; and

10. 14.8 per cent reduction in depressive symptoms in 18 months.

Our Longbridge Village in Birmingham, for example, has successfully run a well-attended stay and play group for local parents and residents. Each week the group meets for fun activities including arts and crafts, singing and gardening. Sharing skills between residents, younger parents and their children has helped residents to feel connected to a strong and vibrant community.

However, some residents are still lonely and we need to help identify those who are and look at how we can support them. The report shows us that working on autobiographical memory with residents could help to improve social connectedness and loneliness even further, helping prevent depression and its impacts and building a resilient social network for people with mobility issues is also critical in reducing their level of loneliness over time.

Find out more about ExtraCare here.

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