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Welfare Reform on the Web (February 2009): Care of the elderly - UK

Care contradictions: putting people first

C. Bernard and A. Passingham

Working with Older People, vol. 12, Dec. 2008, p. 27-30

There is growing evidence that local authorities are providing care only to those people who are most critically in need, and that many are being forced to rely on informal care at home, or no care at all, because they cannot afford service charges levied by social services departments.

Cost of free travel for elderly may hit student bus services

M. Beckford

Daily Telegraph, Jan. 9th 2009, p. 9

Councils have said that they may be forced to end subsidised travel for students and school children, or cut support for loss-making routes, because so many pensioners are using their free bus passes. They claim that the government underestimated the popularity of the scheme, launched in 2008, and failed to provide councils with enough funding to cover its costs.

The cost of unpaid caring

A. Fox

Working with Older People, vol.12, Dec. 2008, p. 22-26

The costs to informal carers of their undervalued and unrecognised role are considerable. More than half have given up paid work to care and on average they retire eight years earlier than other people. Eighty per cent suffer from ill health. More needs to be done to recognise the skills and knowledge of informal carers and better support needs to be provided to prevent their ill health, thereby helping to reduce rising formal care costs to local social services.

Delayed transfer from hospital to community settings: the older person's perspective

A. Swinkels and T. Mitchell

Health and Social Care in the Community, vol. 17, 2008, p. 45-53

Delayed discharge of older people from hospital is a long-standing concern to health and social services professionals. The strength of concern is evidenced by a raft of policies recently implemented in the UK to address the issue. This study uses conversational interviews and a phenomenological approach to explore and interpret patients' perceptions of delayed discharge from hospital. Results show that patients actively or passively relinquished their involvement in discharge planning because of the perceived expertise of others and feelings of disempowerment arising from poor health, low mood, dependency, lack of information, and the complexity of the discharge planning process for complex community care needs. Patients expressed a longing for continuity, emphasised the importance of social contact, and sometimes appeared unrealistic about their future care needs.

Dementia: putting people at the centre

T. Williamson

Working with Older People, vol. 12, Dec. 2008, p. 38-41

The government has made dementia a policy priority and 2008 has seen the publication of the first national dementia strategy for England. This article describes the challenges posed by the rise in the incidence of dementia, and Mental Health Foundation projects aimed at improving the lives of victims.

Dementia and dying: the need for a systematic policy approach

A. Kellehear

Critical Social Policy, vol. 29, 2009, p. 146-155

Guidelines jointly developed by the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) to improve the care of people with dementia do not recognise that dementia is a terminal illness and do not deal adequately with provision of palliative care. The document also reflects a medicalised approach to care (emphasising pharmacological management and health services) and one characterised by professional dominance (emphasising professional authority and control). The author sets out an alternative strategy for the care of the dying that includes components of a public health approach. These public health components are: an explicit health promotion agenda, a community development agenda, and an ecological approach to environmental management.

Drop in help for elderly at home

M. Beckford

Daily Telegraph, Jan. 8th 2008, p. 2

Figures released by the charity Hep the Aged show that 414,700 pensioners and disabled people in England were given support in their own homes in 2000. By 2007 this figure had fallen to 346,700, a drop of 70,000. The fall has been attributed to the introduction of guidance by the Department of Health in 2003 which gave local authorities the right to impose eligibility criteria on pensioners who apply for home help. An estimated three-quarters of local authorities now restrict home care to those with the most severe health problems.

Explaining about health and social care commissioning

D. Klee

Working with Older People, vol. 12, Dec. 2008, p. 10-13

Explains how national policy is changing the way services are planned and commissioned, and what this means for older people and providers. Covers the implications of patient-led commissioning of NHS services and of personal budgets

Self-assessment and self-managed care

O. Mills

Working with Older People, vol. 12, Dec. 2008, p. 31-34

Government policy requires that every locality should have a single community-based support system focused on the health and well-being of the local population. Local government elected members and directors of adult services are charged with putting this system in place by 2011. The author describes the complex challenges and barriers faced by councils as they seek to personalise care and support for vulnerable adults. They need to put in place universal information, advice and advocacy services, simplified needs assessment and access to support, and resource allocation systems for personal budgets and to stimulate a market for flexible, affordable and accessible support services.

Social work with older people. 2nd ed.

K. Crawford and J. Walker

Exeter: Learning Matters, 2008

This new edition looks in detail at the role of the social worker who engages with older people. It enables the reader to develop the key skills required to understand the mental and physical needs of older people in society while encouraging plenty of discussion and critical, independent thought. Furthermore, this book is a source of contemporary research and offers the reader insights into government legislation and policy.

Some social consequences of remodelling English sheltered housing and care homes to 'extra care'

F. Wright and others

Ageing and Society, vol. 29, 2009, p. 135-153

Housing with care schemes are being developed in England as an alternative to residential homes for very frail older people. Although many extra-care schemes are new build, a considerable proportion have been remodelled from sheltered housing complexes and residential homes. Remodelling sheltered housing or a residential care home to an extra-care scheme raises architectural, economic and social care issues. This paper critically examines the criteria used for allocation of extra-care places and explores some important social issues arising from remodelling. There is huge variation in what is described as an extra-care scheme and in the criteria for admission. A number of tenants remained in situ during the remodelling process in six of the schemes examined. This led to building delays and significantly increased remodelling costs. Old tenants also resented their scheme changing to extra-care and were hostile to new tenants with obvious disabilities.

Still playing for time

V. Russell

Public Finance, Dec. 12th-18th 2008, p. 18-21

The system of long term care in England is plagued by two chronic problems: historic under-funding and a lack of national eligibility standards. Needs that might qualify for state-assisted care in one local authority would not necessarily do so in a neighbouring council. The system is in urgent need of reform, but plans may be derailed by the current recession and the imminence of a general election due in 2010.

Thousands of care homes face 50,000 fine over failure to reach basic standard

R. Bennett

The Times, Jan. 28th 2009, p. 18

A report by the Commission for Social Care Inspection (CSCI) has found that - as well as one in five care homes failing to reach the national minimum standards introduced in 2002 - one third were judged to be only adequate or poor by inspectors in the last year. A survey by Times Online also found 59 per cent of people with a relative in a care home said they had cause to complain about care, and a third were dissatisfied with the standard of service received.

'We don't blame anyone, but if we don't know about amenities, we cannot seek them out': black and minority older people's views on the quality of local health and personal social services in England

J. Manthorpe and others

Ageing and Society, vol. 29, 2009, p. 93-113

Improving access to culturally-appropriate services and enhancing responses to the needs of older people from black and minority ethnic communities were among the aims of the National Service Framework for Older People introduced in England in 2001. Progress on meeting the Frameworks aims was evaluated by a mid-term independent review led by the Healthcare Commission. This paper reports some of the results of the consultation that underpinned the evaluation. The levels of satisfaction with health and personal social services amongst black and minority ethnic older people were higher than anticipated. Their concerns centred more on the incomplete recognition of the culturally-specific needs of older people from minority groups by mainstream services than on the need to develop separate services for them.

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