Given that a third of all people aged over 65 fall each year (equivalent to over 3 million)¹ and falls account for 10 – 25% of ambulance call-outs for people aged 65+ (at a cost of £115 per call-out), anything that can help lessen the incidence will mean a real cost saving in both human and financial terms.² Falls represent over half of hospital admissions for accidental injury.³ and half of those with hip fracture never regain their former level of function. One in five dies within three months.⁴
A live-in carer minimises the likelihood of falls but cannot eliminate the risk entirely.

Finally, hip fractures are the most expensive osteoporosis fracture with estimated costs per patient ranging from £12,000 (1998 figure)⁵ to £25,424 (2000 figure).⁶ The latter figure is now routinely updated to £28,000 by some falls teams to reflect increased costs over the past 10 years.

• Epidemiology of falls. Masud T, Morris RO., Age and Ageing, 30-S4:3-7, 2001
• Fall prevention: New approaches to integrated falls prevention services. NHS Confederation, Briefing, April 2012 Issue 234
• London Health Observatory. Accessed 05/10/10, at http://www.apho.org.uk/  
• 148 Reducing falls and resulting hip fractures among older women. Stevens JA, Olson S., MMWR Recomm Rep. 2000 Mar 31;49(RR-2):3-12, 2000. http://www.ncbi.nlm.nih.gov/pubmed/15580729
• The cost of treating osteoporotic fractures in the United Kingdom female population. Dolan, P and Torgerson, DJ, Osteoporosis International, Volume 8, Number 6; 1998
• The economic cost of hip fracture in the UK. Parrott, Steve (2000). Commissioned by Health Promotion England on behalf of the Department of Trade and Industry from the Centre for Health Economics, University of York. This estimated the costs of a single hip fracture patient assumed to survive following a fracture and spending a year in long stay residential care. It excludes possible costs incurred by the family in caring for the patient or associated travel costs of the patient travelling to a health care provider

UTIS are the most common non-respiratory infection in care homes with an incidence rate of up to 50% as environments provide the opportunity for transmission of infection. These infections drive falls, behavioural challenges and deterioration in health, resulting in increased hospital admissions and pressure on primary care. Admissions for UTIs ‘increased by 45 per cent between 2007/8 and 2012/13’, according to a CQC report that said they ‘could have been avoided had they not been neglected by GPs, care homes & social services’.

With one-to-one live in care at home on the other hand, especially where help is given with personal hygiene, the risk of UTIs decreases significantly. Staff are trained to identify the symptoms early so that, where they do occur, the correct medical treatment can be sought and crisis avoided. In contrast to the figures above, while not all our care providers keep statistics, one recently reported that 65 per cent of its clients were UTI free and only 10 per cent of clients had had two or more UTIs in the previous three months.

Peter F, aged 88 had been admitted to hospital following a fall in which he’d gashed his leg – and presented with comorbities. He was improving, but very frail and wouldn’t have been able to get himself dressed, cook or get out of the house if he went home alone. He needed full time care. Norovirus was present on the ward at the time and, fearing infection, his family were desperate to move him out.

They lived some distance away and were juggling the demands of full time jobs and children still living at home, so looking after Peter themselves was not a realistic option. It looked as if there was nowhere for him to go.

His daughter Jane explained: “We’d been told that no care home would take him with the risk of norovirus. And we were terrified that even if we did find a home, he’d just sit in a chair and no-one would push him to do much. He’s such an active man with so many interests, we’d worry that he may go downhill rapidly and then not be in a position to come out.”

Jane concludes: “We just didn’t know what to do for the best.”

Then, one of her friends recommended a company that provides full time care at home. Live-in care was arranged at short notice. The carer was very calm, kind and organised and Peter improved day by day with her attention and encouragement. Within eight weeks he was able to do all the normal things again; his confidence had increased significantly.

Indeed so sprightly and alert was he that soon after he was going out to concerts, back to painting again (a favourite pastime), even returning to giving Spanish lessons! He now has just a little assistance each morning and is otherwise independent.