When my grandmother died this summer, I got a glimpse of how poor end-of-life care is in this country. A fall triggered a week-long stay in hospital and two months of exponential decline. Like thousands of others, her hospital stay was prolonged not because of medical necessity, but because a safe care plan needed to be put in place before she was allowed to return home. Around 250,000 people in England were waiting for a care assessment in August 2023, the Association of Directors of Adult Social Services estimated. In September between 11,783 and 14,324 patients remained in hospital each day who did not meet the criteria to stay, according to NHS England data. The higher figure represents one in eight general and acute beds in England.
My mother began calling agencies to secure 24-hour, live-in care so my grandmother could return to the home she had lived in for more than 60 years. In the interim, she was moved from ward to ward. Seven weeks later, she died. As peacefully as possible, at home. While it was clear in those last weeks that she had had enough and was in pain, she retained her dignity and was deeply cared for. But this kind of death is uncommon and beyond the means of most. In-home end-of-life care comes at an enormous cost – £10,000 a month in my grandmother’s case. Is it any wonder people are left in hospital to deteriorate?