professor of practice in ageing & vitality @adl pg #lifecurve · professor of practice in...

Doing care differentlyImproving independence and reducing care costs at scale

Prof Peter Gore CEng FIMechE FRSA

Professor of Practice in Ageing & Vitality

@adl_pg #LifeCurve

National Innovation Centre for Ageing


© 2020 Prof Gore CEng FIMechE FRSA

AgeingWhy do people need care?



Co-morbidity Frailty DisabilityAge-related decline

(Primary & secondary)

What happens when we age?



A simple multi-stakeholder concept developed at Newcastle University, operationalised by ADL Smartcare built on:

”New horizons in the compression of functional decline” in Age and Ageing 2018

1. Trajectories based on a hierarchy of ADL/IADL difficulties experienced with ageing

2. Order of intervention approaches to achieve best Compression of Functional Decline

3. A commonly understood language

CFD or the ADL LifeCurve™



The hierarchy of “age-related decline”

…ess

entia

l to

inde

pend

ence



Age-related functional decline

most care



AgeingWhat does it cost?



Health and Social Care costs across the ADL LifeCurve™



Approx. increase £640/person/stage/year

Hea

lth

sp

end

by

stag

e



AgeingCould it be different?



42 79 100

Chronological ageing is a poor metric for age-related decline

At what age does functional decline occur?



© 2018 Prof Peter Gore CEng FIMechE FRSA

”New horizons in the compression of functional decline”

Malleable trajectories



Order of interventions

Build reserve Reactivate Compensate Care

Positive messages about ageing well

Building good connections

Managed full recovery from transient decline

”New horizons in the compression of functional decline”

Good compression is achieved by intervening – not just at our 15 markers – but ideally at each

functional decline-related challenge



WHO 2005£2bn savings (England)

55% of GP appointments68% of outpatient and A&E appointments77% inpatient bed-days

House of Commons Health Committee “Managing the care of people with long-term conditions” 2nd report of session 2014-2015 Volume 1: 222 pages

Estimated 70% of total expenditure on health & care in England is spent on 30% of pop with LTC.

They CAN be prevented by better ageing



0

5

10

15

20

25

30

35

40

45

50

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

UK median residential care stay

Decision to prioritise ageing in place

Big early wins

Decision to build capacity through self-help/clinics

Challenge to sustain

Analysis shows this to be a statistically significant trend

Increasing numbers of older people

n=6100

Median stay in residential care (months):case study of a UK Local Authority

Imp

act

of

em

po

wer

men

t/re

able

men

t



How do we impact more older people?healthy ageing advice/support

how do we take these highly effective

messages/interventions to more older people?

Traditional services(2.58m in England with unmet need)

Self-help

…and ?✓



Through these resources?

Professionals?Support workers?

…probably neither



…for an audience interested in care?

Opportunity



…aren’t carers

already with many older

people?

…yes - but I’m too busy

already!



Supporting independence

…using supported caregivers



…and this is what happened when we equipped a professional caregiver with the specific knowledge to help ‘JH’



JH was immobile and had lost independence

Professional carer-givers introduced exercises (available in App)



In a small trial sponsored by ADL Smartcare and Eclipse Homecare: 15% average reduction in required care hours after 6 weeks

(7 case studies)

…so

we

can

fre

e u

p

reso

urc

es

the

n?



JH regained mobility and independence

…an

d r

ed

uce

h

eal

thca

re s

pe

nd

?



The management team spent time with and spoke to people and their families to help them focus on people's happiness, health and wellbeing and made sure these were at the forefront of the support given.(courtesy CQC/Eclipse Homecare)

“

”



For example, for a number of people, the care and support, together with specific exercises had ensured they had regained their independence. One person told us how the care provided had impacted so positively on their well-being, they said, "I feel it really knocked my confidence having a fall. I was totally independent before the fall and they have helped me get this back."(courtesy CQC/Eclipse Homecare)

“

”



…and happy, better rewarded caregivers

…well maybe not quite that happy!



…but a bit more difficult than at first sight



The tipping point is uncertain

but it will tip!



& turn our world upside down



Surp

rise

s

Co

min

g?

Ageing:let us help you think differently!

Thank you


professor of practice in ageing & vitality @adl pg #lifecurve · professor of practice in...

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