The closure of residential homes: what happens to residents

A controlled, prospective study is described which demonstrates changes in behaviour and mortality in the residents of two residential homes which were closed. The 59 residents were dispersed to 19 different establishments. Thirteen general practitioners (GPs) received sick elderly people on their lists after relocation. There were delays and other difficulties in communication between GPs. Restlessness, as measured by the Crichton Geriatric Behavioural Rating Scale, was increased soon after moving but no differences in behaviour or dependency between patients and control subjects were demonstrable after 1 year. Although moving in itself did not increase mortality, residents with poor mobility and dressing skills had a high death rate. This pattern of closure with widespread dispersal of residents is likely to become more common after the introduction of the NHS and Community Care Acts. It is associated with psychiatric morbidity which may be preventable by better organization. Medical involvement in the move was minimal, and the special responsibility of medical care of patients living in residential homes should be recognized.