There the 20th century, England and Wales had



are approximately 410,000 elderly people in residential and nursing homes
across the UK according to the Department of Health. Nursing homes were developed
during the late 19th century while Thatcher was in power and the
conservative government acknowledged that they had to provide care for those
who needed it; especially those who were poor. Over the years, the number and
condition of these homes improved drastically. Towards the end of the 20th
century, England and Wales had a number of 3335 residential homes accommodating
110 767 people with 86% of these being elderly according to Townsend. With life
expectancy improving constantly, this number will continue to rise. Care homes
have been a good invention over the years but they do; however, come with a
number of both benefits and drawbacks leading to the ultimate question of ‘are
they the best choice of care for the elderly’?


 When a person moves into a care home, they may
feel like they have lost their friends, family and those they are used to
seeing on a daily basis. Many older people are admitted to a care home for end
of life care. Many care homes wish for their residents to be happy in the last
chapter of their life and help to do this by keeping their social life active. Health
and Social care provider-Evolving Care, make it their priority to provide
companionship. They accompany the residents on trips, holidays and daily
outings as well as encouraging them to participate in hobbies and crafts with
other residents. Christchurch care home in Bournemouth recently opened a café
situated in the home for both residents, their friend’s and family and local
people. With the use of designs and pictures from the village, the residents
were able to stay connected to the local community and interact with people
they knew and recognised.


 In addition; in 2014, the care quality commission
(CQC) began to inspect how well care homes were creating an environment to make
the resident feel at home. Resident’s with dementia, which many of them have,
definitely struggle in an environment that is not familiar to them. Care
company Anchor, encourage residents to bring their personal items with them to
make them feel more settled. According to the dementia centre at Stirling
University, some care homes have even allowed the residents to paint their own
bedroom doors so they feel the place is their property. With CQC reports each
year, care home staff are making sure that their institutions are a relaxing
and comfortable environment for the residents.  


   Care homes also need to make sure that the
residents’ nutritional needs are being met. 
The British Association for Parenteral and Eternal Nutrition (Bapen), stated
that 30% of the elderly who are admitted are either at risk of malnutrition or
are obese. By following the Food Standards Agency guide on ‘Food Served to
Older People in Residential Care’ which contains menu examples and advice on
special requirements, it is possible for care homes to keep these health risks
under control. A care home in Wimbledon has been named the ‘academy of
nutrition’ as a result of responding to what the residents are wanting while maintaining
a good quality.  96% of the residents and
their families see their catering service as highly favourable. Due to their
standard of food, the residents’ GP has rarely had to prescribe food
supplements. If all care homes can get to this high standard care homes will
most likely be the best option of care.


the other hand, although care homes do provide more benefits such as safety,
supervision and erasing the need for the resident to upkeep household bills,
there have been a few cases when care homes standards have declined and
residents have suffered. In the past couple of years, the CQC found 11 care
homes in England to be inadequate and 9 to have low or worrying staffing
levels. According to Merrifield, due to shortage of money, no agency staff
could be hired at a home in Dudley, which ultimately led to the same staff
working long hours several days in a row. This is dangerous for the residents
as the staff are more likely to make a mistake when tired. Low staff numbers
have also led to medication being prescribed and administered incorrectly,
therefore becoming ineffective. At Harmony House in Nuneaton, staff did not
have time to check if medicines were in stock resulting in one resident missing
8 doses of their medicine as the care home did not have it. This shows that
care home staff could actually contribute to the decline of a resident’s


  Moreover, moving an older person into a
care home can have a huge psychological impact on the elderly. With the
confusion, loss of independence and the realisation that this step is the end
of their road in life; it is a very distressing time for them. Sollito tells us
that 40% of residents in care homes are likely to suffer from depression due to
a huge life change and lack of socialising and stimulation. Some care homes
prepare therapy for the resident but a lot of them won’t go without their
family which isn’t always possible according to Dr. Sakauye told Aging Care.
Home care, an alternative care option, allows the elderly to stay in their home
and in an environment they are used to which could have less of negative impact
on their mental health. Caregivers are also able to spend as much time with the
resident as they need; whereas low staffing levels in care homes, result in a
lot of the residents being left alone for large amount of time. Family can also
feel guilty about shipping their relatives off to a care home; care homes have
specific visiting hours which family members may find difficult to fit in with their
lives. Fortunately, home care allows them to see their relative at any time. It
is clear here that other methods of care can be more beneficial.