What’s the Answer for Long-Term Elderly Care?

OLYMPUS DIGITAL CAMERAThe Dilnot social care white paper on funding elderly care was submitted a year ago, but action on its recommendations was recently put off until the next Government spending review. As controversy surrounds the delay, with some calling for an immediate change in policy and some condemning its recommended ‘death tax’, Tim sees an aspect of the discussion that’s been overlooked…

The controversial delay on the Dilnot social care white paper, and Andrew Lansley’s ‘loan’ proposal for elder care funding, has prompted some thoughts on this country’s confused priorities on elderly care.

While dealing with older people’s happiness and community inclusion, WaveLength sees a continual shift away from care by families. As people move to other cities, or abroad, their older or disabled relatives depend on paid-for care. Current funding shortfalls mean that some of these people are going without – see the 15 minutes of care per client allotted by many agencies. Those who do have family or friends around are often forced to rely too heavily on them, putting these unpaid carers at risk of depression, debilitating stress and isolation themselves.

The short-term answer to this problem may be the one proposed by Dilnot, stripping older and disabled people’s assets to cover costs. Personally, I’ve witnessed one London council put a disabled man’s care on hold when he received a £20,000 injury settlement, only granting financial help again when this asset was stripped and he was left with nothing. But this kind of situation begs the question: why are we paying into a social care system if it’s not going to support us to the ends we need it to? What’s needed here is foresight and long-term thinking; and it seems that the Government is shying away from the dramatic solutions needed to deliver real fairness in funding.

I also feel very strongly that a trick is being missed here, as little focus is put on the question of avoiding costly residential care costs for as long as possible. If decision-makers think long-term, it should be clear that activities such as visits, entertainment and day centres are both more effective and more cost-effective than letting isolated older people decline towards a state of needing far more costly residential care. The strong desire of many people to stay in their own homes may well mean that those homes should be protected from sale when their owners are institutionalised; it should also lead councils to focus on improving the quality of non-residential care.

This week in Oxford, the international ‘What Do We Know About Loneliness?’ conference saw evidence proving without a doubt that isolation and loneliness are bigger killers for elderly people than smoking or alcohol. More and more research like this is coming out, and we need to readdress the assumption that sustaining life in elderly people should always take priority over quality of life. As the conference concluded, we need smarter, more realistic answers on care. Three years ago the international Conference of Television in Spain showed how television, interaction and group contact can Alzheimer’s sufferers in their homes, without (expensive) intervention care, for much longer. Technology such as home environment systems should also be encouraged – whether they’re provided by councils to less well-off older people, or seen as sensible personal investments to prevent oneself or one’s parents from moving out of or selling their homes.

If there’s one thing that the BBC’s ‘When I Get Older’ series shows, it’s the difference between the old age enjoyed by celebrity participants with active careers, large social circles and high mobility, and the old age experienced by people isolated by disability or lack of funds. When one full-time unpaid carer in her seventies was given a night off for a bingo visit, years dropped off her! It would be a shame to overhaul the end-of-life care system without also looking at the way in which care provided in later life can remove the need for intensive residential care.

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