Home care pressures leave 89-year-old in bed for up to 19 hours

An 89-year-old woman says she is routinely being helped to bed in the early afternoon because staffing pressures mean her full home care package is not being delivered.

Alison said carers now give her an evening meal and sleeping medication during a "tea time call" at about 15:00 BST and help her to bed for the night.

As she lives alone and has a history of epilepsy and repeated falls, she says she can often spend up to 19 hours in bed until the carers return the following morning.

The Northern Health and Social Care Trust has apologised for the ongoing challenges with Alison's care package and will liaise with her GP to carry out a review of her medication arrangements.

Alison stressed she is not forced into bed, but feels she has little choice, fearing she could fall and injure herself if she remains up alone.

She relies entirely on trust-arranged domiciliary care following the death of her husband 14 years ago.

"I miss my freedom," she said. "I'll be 90 in September, so I need help.

"I don't like to, but I do need help, and I don't get the help that I need."

Alison said her care package provides three daily visits for breakfast, lunch and an evening meal.

However, she said the final visit now often takes place at about 15:00.

During that visit, carers help her into bed, provide her evening meal and administer night-time medication, including sleeping tablets.

She believes taking the medication several hours earlier than intended may have contributed to falls.

She estimates she has suffered three major falls, along with numerous smaller slips, since the changes to her care routine.

Alison said she had previously spent around two hours on the floor after one fall before receiving help.

Despite her concerns, she praised the carers themselves.

"The girls are all very, very nice," she said.

"But it's their timing that's a bit of a mix-up. It's not their fault."

She said delays often leave her unable to plan her day because carers cannot always guarantee what time they will arrive.

The Northern Health and Social Care Trust apologised to Alison for the challenges with her care package, but said it was "regrettably" unable to facilitate a bedtime visit because of staffing pressures and increasing demand.

The trust said Alison's third and final call of the day is a tea time call to help with her evening meal and medication, and added that her social worker had discussed her daily medication requirements with her and "continues to provide support".

The trust said it has offered to look at alternative care providers and other care options, which Alison has declined as she is "content with her current care providers".

A spokesperson said this was "reassuring" but added: "The current arrangement means we are unable to deliver [Alison's] full daily care package at present.

"We acknowledge that this is not the level of service we want to deliver, and we are continuing to explore alternative solutions to ensure [Alison's] full package of care can be restored as quickly as possible."

The spokesperson added that the trust, like many others, was "currently facing significant pressures on home care services due to a combination of workforce availability and increasing demand".

Demand for home care services has increased by more than 12% since 2022.

The Commissioner for Older People for Northern Ireland described Alison's experience as "deeply concerning and totally unacceptable".

"No older person should find themselves effectively having to end their day in the middle of the afternoon because the care package they require cannot be fully delivered," Siobhan Casey said.

She said her office had seen a significant increase in calls from older people and families struggling to access domiciliary care, including delays to hospital discharge, reduced care provision and long waits for support.

She said concerns included delays in hospital discharge because care packages were unavailable, long waits for support at home, reduced care provision and difficulties accessing services in rural areas.

"Older people need more than apologies. They need action," she said.

She called on the Department of Health, the Executive and Health and Social Care Trusts to work urgently together to address staffing shortages and ensure older people receive the care they need to live safely and independently in their own homes.

In a statement, the Department of Health said: "Through the work of the Social Care Collaborative Reform Board, we have a specific focus on homecare within Northern Ireland.

"This work includes reviewing demand, capacity, commissioning and the model of homecare required to make homecare fit for now and into the future."

Alison said she worries not only about her own situation but also about others receiving home care.

"I'm not the only one," she said. "There must be lots of people in the same boat."

Although she described herself as fortunate to have supportive neighbours and friends, she believes others may have fewer people to rely on.

"I'm one of the lucky ones because my house is small and cosy and I've lovely people around me," she said.

"I don't want to live like a queen. I just want to live without worrying."