Balance needed

Stephanie Rose redresses the balance in the debate concerning care of the elderly and vulnerable

Over the past couple of weeks, here in our blog, we have published a series of articles and reports concerning problems in relation to the care of the elderly and vulnerable. Mostly they give depressing reading concerning an industry in turmoil and sometimes crisis; and the inability of government to resource the issue of an increasing number of people in society living into 'new' - old age. Yes, 10% of people in OECD countries will be more than 80 years old by 2050, up from 4% last year, and up from 1% in 1950. Clearly the systems of care, and paying for that care need to change. What barely works now will certainly not work in 40 years time.


Having said that, it is noticeable how well we can rise to the challenge. Day by day, new care services are being developed. A quick search on the web reveals many great new projects and businesses across the country that are designed to meet the needs of an ageing population. And perhaps that is where the answer lies.


What is manifestly evident is that central and local government are retreating from the responsibility of 'providing' care for the elderly. Even where financial assistance is provided, the emphasis seems to have entirely shifted from 'providing care' - to 'funding care in the private sector'. Approve or not, it seems that it is now up to the private sector care services to fill the gap in provision, albeit with decreasingly resourced services.


Within Stephanie's Bespoke Care Services, we estimate that home care can be provided at about 50% of the cost of residential care for those of the elderly who are not confined to bed or in need of round-the-clock care. Clearly, for those needing intensive levels of care and continuous presence of carers, the best and possibly most economic place to live may be a care home or nursing home. This group regrettably includes many who have advanced levels of Alzheimers and other forms of dementia. For the rest - the vast majority of the elderly who need care - the answer lies in the provision of bespoke packages: ones that have been carefully thought through by those receiving care, their families, the extended health care team and the designated social worker, if one has been allocated. And the care packages, by their very definition, need to be kept under active review. It is not enough to assess and prepare a care plan, then to proceed as if the job is done. Here within our service, we encounter individual cases that change day by day and where a failure to keep the care package under review would be unacceptable. Additionally, the bespoke care packages need to be supervised. Wherever possible, we prefer to work with our clients' extended families who are sometimes the best qualified to know what their elderly relative needs, or simply wants for peace of mind. How often have an agreed care package been put in place only to discover that the client asks for less intrusion, or a little more help within their home. In particular, with the low-cost availability of new services from existing carers, such as hand and foot massage, hair care, manicure and supported trips, clients are seeking small indulgences in what otherwise may be a very hum-drum existence.


Whilst all care comes at a price, it is becoming clear that many of the 'new' elderly are asking to remain in their own homes and keep a higher level of control over their lives, rather than commit themselves to private community care. And why not? After all, it makes practical and financial sense.

The ideas here are the personal ideas of the author and may not be reproduced without permission and attribution to Stephanie's Bespoke Care Services.




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