professor of practice in ageing & vitality @adl pg #lifecurve · professor of practice in...
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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
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
AgeingWhy do people need care?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Co-morbidity Frailty DisabilityAge-related decline
(Primary & secondary)
What happens when we age?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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™
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
The hierarchy of “age-related decline”
…ess
entia
l to
inde
pend
ence
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Age-related functional decline
most care
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
AgeingWhat does it cost?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Health and Social Care costs across the ADL LifeCurve™
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Approx. increase £640/person/stage/year
Hea
lth
sp
end
by
stag
e
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
AgeingCould it be different?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
42 79 100
Chronological ageing is a poor metric for age-related decline
At what age does functional decline occur?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
© 2018 Prof Peter Gore CEng FIMechE FRSA
”New horizons in the compression of functional decline”
Malleable trajectories
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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 ?✓
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Through these resources?
Professionals?Support workers?
…probably neither
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
…for an audience interested in care?
Opportunity
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
…aren’t carers
already with many older
people?
…yes - but I’m too busy
already!
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Supporting independence
…using supported caregivers
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
…and this is what happened when we equipped a professional caregiver with the specific knowledge to help ‘JH’
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
JH was immobile and had lost independence
Professional carer-givers introduced exercises (available in App)
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
JH regained mobility and independence
…an
d r
ed
uce
h
eal
thca
re s
pe
nd
?
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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)
“
”
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
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)
“
”
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
…and happy, better rewarded caregivers
…well maybe not quite that happy!
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
…but a bit more difficult than at first sight
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
The tipping point is uncertain
but it will tip!
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
& turn our world upside down
National Innovation Centre for Ageing
© 2020 Prof Gore CEng FIMechE FRSA
Surp
rise
s
Co
min
g?
Ageing:let us help you think differently!
Thank you
National Innovation Centre for Ageing