A Census-based longitudinal study of variations in survival amongst residents of nursing and residential homes in Northern Ireland

Background: despite the intensive services provided to residents of care homes, information on death rates is not routinely available for this population in the UK. Objective: to quantify mortality rates across the care home population of Northern Ireland, and assess variation by type of care home and resident characteristics. Design: a prospective, Census-based cohort study, with 5-year follow-up. Participants: all 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a special emphasis on the 2,112 residents admitted during the year preceding census day. Measurements: age, sex, self-reported health, marital status, residence (not in care home, residential home, dual registered home, nursing home), elderly mentally infirm care provision. Results: the median survival among nursing home residents was 2.33 years (95% CI 2.25–2.59), for dual registered homes 2.75 (95% CI 2.42–3.17) and for residential homes 4.51 (95% CI 3.92–4.92) years. Age, sex and self-reported health showed weaker associations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised. Conclusions: the high mortality in care homes indicates that places in care homes are reserved for the most severely ill and dependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunct for clinical staff and the planning of care home provision.

New Circus: the benefits of Circus Training for young people in a residential setting,

Circus 1 to 3 is a circus school, based on the concept of New Circus, for boys resident in St. Patrick's Training School, Northern Ireland. The project is designed, not only to teach Circus skills, but also to foster social and personal skills. This report details an evaluation undertaken to assess die extent to which this programme meets these aims. A study of participants Circus records indicated that significant gains in co-operative behaviour, team-work, attitude and participation, as rated by Circus tutors, were evident over the course of boys involvement. A qualitative study was also conducted. These interviews with Circus 1 to 3 participants indicated that this project enhanced the quality of life for boys resident in St. Patrick's Training School. In addition the project, through the use of positive feedback, provides opportunities for boys to develop their social and personal skills. This evaluation concludes that Circus 1 to 3 is a worthwhile and successful endeavour.