Older age is associated with many physical and psychological comorbidities. Assessment and management of comorbidity is a major challenge for home care providers. Residents’ needs are complex and multidisciplinary, so care must be taken to address a variety of issues, not just specific, specific health needs. Although it is housing for the elderly, it seems to have the same tendency as nursing homes in other countries. To understand the need for
care, a national survey of nursing home residents in the United Kingdom (n = 16043 residents of 244 nursing homes) found that more than 90% of cases were hospitalized for medical illness with associated disabilities. I showed that it was the reason. Over 50% of residents suffered from dementia, stroke, or other neurodegenerative diseases. About 76% of the inhabitants needed mobility assistance and 71% were incontinent. Twenty-seven per cent had multiple issues of immobility, confusion, or incontinence. Only 40% of those in residential care were ambulant without assistance. It was concluded that care needs in long-term residential care homes were determined by progressive and chronic illnesses. Similarly, up to two-thirds of residents in care homes in the USA have a cognitive impairment, with many diagnosed with dementia.
The care need issues imply residential care facilities for older adults need specific adaptations for toilet facilities to ensure hygiene, nutrition planning taking into account specific nutritional needs of the elderly as well as individual comorbidities requiring customized diets, physiotherapies and exercise to maintain a range of motion, balance, endurance, strength, and flexibility environmental adaptations for easy mobility and prevent falls, specific measures to prevent pressure ulcers in nonambulatory residents,28 periodic medical consultations as well as immunization.
In addition, the elderly in old age homes have high rates of psychiatric morbidity. Indian studies have reported high rates of depression, anxiety, and psychotic disorder in residents of old age homes in addition to dementia.
Apart from pharmacotherapy, addressing the mental health care needs of the elderly residents may range from providing cognitive stimulation, prosocial environments, and ensuring sleep hygiene to managing agitation and frank aggression. Effective non-pharmacological management can reduce the need for medication with medication 32. This requires specialized training. Few centers run courses for elderly care, such as the National Institute for Defense Studies under the Social Justice and Empowerment Department. However, the number of people trained in such an environment is negligible compared to the demand for home care facilities. In addition, the need for trained personnel in several areas can increase service costs. At the same time, there is no framework for regular evaluation, inspection, certification, and recertification of such service providers.