An 89-year-old woman is routinely being put to bed by 3pm, receiving her evening meal and night-time medication hours earlier than intended, due to ongoing staffing pressures within her home care package. Alison, who lives alone and has a history of epilepsy and falls, states she can spend up to 19 hours in bed until carers return the following morning, significantly impacting her quality of life and sense of independence.
Alison, who will turn 90 in September, relies entirely on domiciliary care arranged by the Northern Health and Social Care Trust since the death of her husband 14 years ago. While her care package is designed to provide three daily visits, she reports that the final visit now often occurs around 3pm BST. During this visit, carers administer her evening meal and night-time medication, including sleeping tablets, before helping her into bed for the night. She expresses concern that taking medication, particularly sleeping tablets, several hours earlier than intended may have contributed to recent falls, estimating three major falls and numerous smaller slips since the changes to her routine. On one occasion, she lay on the floor for approximately two hours after a fall before receiving help.
Despite her distressing experience, Alison praises the carers themselves, acknowledging that the timing issues are not their fault. However, the unpredictable nature of visit times often leaves her unable to plan her day. The Northern Health and Social Care Trust has apologised for the challenges but stated it is 'regrettably' unable to facilitate a later bedtime visit due to severe staffing pressures and increasing demand for home care services. The trust confirmed that Alison's third call is a 'tea time call' for her evening meal and medication, and that her social worker continues to provide support and has discussed her medication requirements.
The trust has offered alternative care providers and options, which Alison has declined, expressing contentment with her current care providers. While acknowledging this, a spokesperson for the trust stated, 'The current arrangement means we are unable to deliver [Alison's] full daily care package at present.' They added that the trust, like many others across the UK, is 'currently facing significant pressures on home care services due to a combination of workforce availability and increasing demand.' Official figures indicate that demand for home care services has surged by more than 12% since 2022, placing immense strain on an already stretched system.
Siobhan Casey, the Commissioner for Older People for Northern Ireland, described Alison's situation as 'deeply concerning and totally unacceptable.' She highlighted a significant increase in calls to her office from older people and their families struggling to access domiciliary care, citing issues such as delays in hospital discharge, reduced care provision, and extended waits for essential support. The challenges faced by Alison are reflective of broader systemic issues within the UK's social care sector, which is struggling to meet the complex needs of an ageing population amidst workforce shortages and funding constraints.