The decline in geriatric long stay beds: who remains?

A day census of all long-term hospital patients in the Canterbury geriatric service area was carried out in 1984 (when there were 127 beds) and repeated in 1989 (when there were 66 beds). The patients in the 1989 census were more confused and physically more dependent than those in 1984. Comparison with residents in local residential and nursing homes in 1987 shows that a higher proportion of long-term hospital patients had severe mental and physical disability. There is a hard core of patients who are difficult to place outside hospital. This has predictable resource implications and in Canterbury such patients will continue to occupy National Health Service beds as there are no practicable alternatives.