Page 136 - PROOF_ENG

134
It appears that residents in West Wales have increasingly complex needs associated with dementia and associated lack of capacity; Hywel Dda University Health Board made the greatest number of applications for Deprivation of Liberty Safeguards in 2013- 14, with Carmarthenshire LA having the highest number of applications in Wales (Care and Social Services Inspectorate Wales, 2015). Whilst this may reflect improved processes and systems, it may also suggest a heightened level of need particular to this area, with dementia not being diagnosed but still recognised in a residential setting.
Falls are a common and serious problem for older adults and it has been reported that more than 50% of people over the age of 85 fall at least once a year (Age UK, 2013) Daffodil Cymru data suggests that the number of hospital admissions because of a fall predicted to increase in the area by almost 70% by 2035.
A significant percentage of older people in West Wales provide unpaid care to support family or friends with the greatest predicted increase in those over 85 providing more than 50 hours of unpaid care of 122% by 2035. (Daffodil Cymru, 2014b).
3) A range of ‘accelerating factors’ are likely to exacerbate the needs of some older adults
The West Wales region is the second most sparsely populated in Wales. Research into ageing in rural communities has described a set of compounding factors which result in ‘multiple disadvantage’ (Hartwell et al, 2007) as rurality impacts on many factors including housing, deprivation, access to services and, vitally, levels of physical and social isolation. Evidence indicates that rural areas are also ageing faster, the projected increase of the 65+ age group by 2021 in rural areas is 29% compared to 20% in urban ones (International Longevity Centre, 2013)
In nearly all instances, people living in the more deprived areas experience worse health than those in more affluent ones. Deprivation has an impact on older adults especially in relation to healthy and disability free life expectancy. There are a number of areas of high deprivation in the region, with the largest concentration around Llanelli in the east of Carmarthenshire. Data shows that people living in the least deprived areas of Carmarthenshire can expect to live healthily for nearly 14 years longer than those in the most deprived ones (Public Health Wales, 2011).
The West Wales region reports the second largest instance of excess winter deaths in the over 65s in Wales (Hywel Dda University Health Board, 2016a). There is a strong relationship between poor insulation and heating of houses, low indoor temperature and excess winter deaths of older people (Marmot Review Team, 2013). With respiratory disease being the major cause of seasonal mortality (Office of National Statistics, 2015) and the proved causality between damp housing and asthma (Basham, 2002), levels of
West Wales Population Assessment March 2017 Older people