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Welfare Reform on the Web (December 2010): Care of the elderly - UK

An Age old problem: a review of the care received by elderly patients undergoing surgery

K. Wilkinson and others

The National Confidential Enquiry into Patient Outcome and Death, 2010

This NCEPOD report highlights the process of care of elderly patients who died within 30 days of emergency or elective surgery. The report takes a critical look at areas where the care of patients might have been improved, ranging from lack of input from Medicine for the Care of Older People to the level of pain relief provided. Remediable factors have also been identified in the clinical and the organisational care of these patients.


Anticipating the new Health Act: messages from the Innovation Forum

G. Wistow and C. Henderson

Journal of Integrated Care, vol.18, Oct. 2010, p. 4-14

During 2003/04, a group of high-performing English local authorities voluntarily embarked on a project to reduce the exposure of older people to clinically unnecessary stays in hospital. They wished to demonstrate the value of the local authority community leadership role. Their success in meeting the target of a 20% reduction in bed days for people aged over 75 over three years to 2006/07 supports the new NHS White Paper's proposals for transferring functions and responsibilities from primary care trusts to councils. It suggests that councils can successfully adopt the lead responsibility for ensuring strategic co-ordination of place-based commissioning in health and well-being.

The forgotten age: understanding poverty and social exclusion in later life

Older Age Working Group

Centre for Social Justice, 2010

This report argues that the ageing population has led to a surge in the numbers of older people who need help with basic care. An additional 1.7m pensioners are likely to become dependent on others within 20 years. A collapse in the extended family has resulted in fewer relatives able and willing to act as informal carers. Current generations are unwilling to provide care if they live at a distance or simply do not get on with parents. Those who do care for family members are often left without respite and can feel growing resentment and isolation. There is a growing trend of 'Cinderella' carers, where one sibling takes on the whole responsibility of looking after aged parents. The report calls on society as a whole as well as government to address this looming crisis.

The future ageing of the ethnic minority population of England and Wales

N. Lievesley

Runnymede and the Centre for Policy on Ageing, 2010

This research aims to describe the likely changes in the age structure of black and other ethnic groups in England and Wales. It uses data on fertility, mortality and migration to make some projections of the number and profile of older people from ethnic groups. Although it is difficult to make population predictions, projections can be used to stimulate thought about the types and amount of support that may be needed by the growing numbers of black and minority ethnic older people and the contributions that they may make.


Million elderly people to be given control of care budget

R. Ramesh

The Guardian, Nov. 17th 2010, p. 9

Care services minister Paul Burstow has announced measures to put a million people in charge of their own personal care budget, compared to the current 250,000. Personal budgets can range from a few hundred pounds to 50,000 a year and allow the elderly and infirm to buy services such as home help from charities and private companies. Other measures include 400 to support holiday breaks and hobbies for carers.

Private insurance for care of elderly

T. Ross

Daily Telegraph, Nov. 8th 2010, p. 1 + 2

Under radical plans being considered by a government review, the middle classes could be asked to pay for private insurance to cover the cost of their care in old age. Alternative approaches, such as a levy on estates when older people die to cover care costs, are still said to be 'on the table'.

Targeting, care management and preventative services for older people: the cost-effectiveness of a pilot self-assessment approach in one local authority

P. Clarkson and others

British Journal of Social Work, vol. 40, 2010, p. 2255-2273

As local authority social services face funding cuts and as eligibility criteria consequently tighten, the issue of targeting becomes increasingly relevant. This paper presents findings from a pilot project in one local authority that aimed to target access to assessment on older people with low level needs who would normally have fallen under eligibility thresholds. Self-assessment was used as a tool whereby they could identify, with assistance, their preferences for a range of preventative services. Via a randomised design, the study evaluated the costs and benefits, in terms of satisfaction, of this approach compared with the usual care management professional assessment. Although self-assessed cases were offered more advice as to a wider range of preventative services, which generated greater costs, total costs were lower for this group. The cost saving arose from using cheaper staff as self-assessment facilitators, who also spent less time on administrative duties and gathering information. Satisfaction with self-assessment was comparable to a professional assessment, therefore representing a cost-effective approach.

What is the 'extra' in extra care housing?

F. Wright and others

British Journal of Social Work, vol. 40, 2010, p. 2239-2254

This article discusses key findings from a multidisciplinary study of ten remodelled extra care schemes for older people. It argues that the current absence of a clear national definition of 'extra care' makes it difficult for older people, their relatives and social workers to decide if an extra care scheme is appropriate. Schemes were idiosyncratic. Only a minority provided an optional communal cooked lunch, meaning that they would not necessarily combat loneliness and social isolation. A common problem was high care staff turnover and use of temporary agency workers who often had little idea of what an extra care scheme should provide. Although assessment for an extra care place was based on the amount of paid care an older person had at home, this was unsound because it was common for care needs to decline in a scheme's improved physical environment.

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