Harold is 91 years old, he has dementia which was diagnosed 3-5 years ago. It is now at the moderate stage. He lives with his wife, Kathy. They are devoted to each other, but are both frail and need help to stay in their home. Their main carer is Kathy’s sister, Maureen, aged 72.
Harold has an income below £15,000pa.
He takes 4 medications daily.
During the 6 months before going into hospital, Harold went to one Out Patient appointment to see an eye specialist.
Carers visit Harold and Kathy 24 times per week and Maureen spends on average 5 hours a week caring for them. Harold and Kathy have regular respite placements at a local care home, for 6 weeks per year. They have spent 28 days in respite during the past 6 months.
Costs of care for 6 months before hospitalisation:
|Medications @ £13 per month||£78.00|
|1 OPD appointment – eye specialist||£100.00|
|Personal care; 24 contacts per week for 7 weeks 2 days @ £25/visit||£4,372.00|
|Respite, 28 days @ £546 per week||£2,184.00|
Harold was admitted to hospital with a chest infection. While he was away, his wife went into a care home. He was treated for 7 days for a chest infection, but was not able to return home for a further 35 days because his mobility got worse and it was not clear if he would manage at home after discharge.
Cost of hospital admission:
|7 days @ £346||£2,422.00|
|35 days @ £255||£8,925.00|
As Harold got better, his mobility improved and he was discharged home. Kathy also came home again. All Harold’s assessments had stayed the same, but he had become incontinent while in hospital so needed continence pads when he got home. Personal and social care increased, as shown in the table. He saw his GP once, a mental health nurse once and an ophthalmologist once to check on his glaucoma. A social worker visited 3 times to make sure that Harold and Kathy were coping at home.
He was seen in Out Patient clinic and admitted to hospital again for one night because of suspected dehydration.
Harold and Kathy were both treated at home by their podiatrist once, which they paid for.
Costs of Care 0-6 months after leaving hospital:
|Continence pads, 14 @ 30p/pad for 26 weeks||£109.20|
|Medications@ £111 for 6 months||£666.00|
|GP visit x 1 @ £120||£120.00|
|Mental Health Nurse visit x 1 @ £56||£56.00|
|Hospital admissions, I night @ £346||£194.00|
|Out patient appointment||£100.00|
|Social worker x 3 visits @ £213||£639.00|
|Personal care, 30 contacts/week @ £25||£19,500.00|
|Podiatry x 1 @ £35||£35.00|
Harold was prescribed medication for dementia while in hospital. From 6 to 12 months after leaving hospital, Harold remained well. Assessments of his health, activity and dementia showed no change. He had no further contact with hospital, but his GP visited once as did the District Nurse.
Costs of Care 6-12 months after leaving hospital:
|Continence pads, 7 @ 30p/pad for 26 weeks||£46.20|
|Medications@ £111 per month||£666.00|
|GP visit x 1 @ £120||£120.00|
|District Nurse visit x 2 @ £27||£54.00|
|Personal care, 30 contacts/week @25 per visit||£19,500.00|
|Podiatry x 2 @ £35||£70.00|
Costs of care are taken from the Personal Social Services Research Unit Report, 2011, written by the University of Manchester, The University of Kent and the London School of Economics.