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Welfare Reform on the Web (May 2004): Care of the Elderly - UK

DIRECT PAYMENTS FOR CARE

K. Willmington

Working with Older People, Vol. 8, Mar. 2004, p.32-35

Direct payments for care is the system whereby local authority social services departments offer older people living at home cash to purchase their own care services. Direct payments can be used to pay for a personal assistant, equipment, minor house adaptations, and care services from an independent agency.

FACILITATING CHOICE AND CONTROL FOR OLDER PEOPLE IN LONG-TERM CARE

G. Boyle

Health and Social Care in the Community, Vol. 12, 2004, p.212-220

The community care reforms have enabled some older people with severe disabilities to remain at home with domiciliary care services as an alternative to institutional admission. The study explored through structured interviews the extent to which the reforms actually enabled people receiving domiciliary care to exercise greater choice and control in their lives than older people living in residential care. Results showed that people living in institutions perceived themselves to have greater decisional autonomy in their everyday lives than did older people receiving domiciliary care. It was clear that living at home did not ensure that people's decisional autonomy would be supported.

FIVE MILLION WIN RIGHT TO FLEXIBLE HOURS

R. Bennett

The Times, April 23rd 2004, p.1

Five million carers who look after sick or elderly relatives are to be given special rights to demand part-time jobs in a radical extension of flexible working. Although details of the policy are yet to be hammered out all men and women who look after an elderly relative should be entitled to demand more flexible from the boss. That would mean that anyone who has to help

An elderly parent to get up in the morning, assist with household chores or take him or her to the doctor regularly would qualify for the new "carer's right to request".

HAPPY MEMORIES: REMINISCENCE WITH ETHNIC MINORITY ELDERS

London: Age Exchange, 2004

The book offers care workers ideas for ways to encourage older people to talk about their past and exchange experiences with young people. It is full of individual stories and accounts intended to provide triggers for reminiscence and debates.

IT PAYS DIVIDENDS: DIRECT PAYMENTS AND OLDER PEOPLE

H. Clark, H. Gough and A. McFarlane

Bristol: Policy Press, 2004

The study found that older people receiving direct payments reported feeling happier and more motivated and having an improved quality of life. Support services were crucial in enabling older people to use direct payments. Ongoing assistance was required to enable older people to meet audit and administrative demands. Most older people employed personal assistants. There was a call for support services to maintain registers of assistants to ease recruitment. Finally care managers are key to enabling older people to access direct payments, but direct payments have not yet become embedded in the culture of care management.

NURSING HOME INTERMEDIATE CARE

S. Foti

Working with Older People, Vol. 8, Mar. 2004, p.17-20

The article describes how the charity Brendoncare Foundation uses beds in one of its nursing homes to provide a rehabilitation service in partnership with local NHS bodies.

OLDER PEOPLE: INDEPENDENCE AND WELL-BEING

Audit Commission

Audit Commission Publications, 2004

The report calls for a move from a remedial approach to the problems of old age to an approach aimed at meeting aspirations and exploiting technology. It identifies the key constituents of independence as: having choice, exercising control, enjoying a comfortable home, being close to friends and amenities, keeping busy, using transport, being able to cover new expenses, knowing how to play the system and having access to health services. It calls for a strategy which addresses older people's priorities, processes for effective involvement, good communication of information, commitment and leadership at all levels, comprehensive care services, work to tackle ageism, and co-ordinated support for carers.

TAKING THE MONEY

J. Leece

Working with Older People, Vol. 8, Mar. 2004, p.36-39

The article describes how barriers to use of direct payments by older people can be overcome. These include lack of information, difficulty in demonstrating consent for people with dementia, concerns about employing "non vetted" staff, desire to employ family members and the need for a good support system for direct payment scheme users.

WHAT TYPES OF HOMES ARE CLOSING? THE CHARACTERISTICS OF HOMES WHICH CLOSED BETWEEN 1996 AND 2001

R.A. Darton

Health and Social Care in the Community, Vol. 12, 2004, p.254-264

The paper compares private residential homes and nursing homes for older people which closed between 1996 and 2001 with those that remained open. Homes which closed tended to:

  • be smaller
  • have lower occupancy levels in 1996
  • be the only home run by the organisation
  • have more shared bedrooms
  • have en-suite facilities in none or only some of the bedrooms.

A separate analysis of date on social climate found that the homes with a more positive social environment were those most likely to have closed. The findings support the view that there is likely to be an increase in importance of homes run by corporate providers relative to single, owner-managed homes, reducing choice for potential residents.

WHAT WILL PEOPLE THINK?

V. Seabrooke and A. Milne

Mental Health Today, Apr. 2004, p.27-30

The article outlines a research project undertaken in North West Kent to explore the service-related needs of Asian older people with dementia and their carers. Currently Asian elders and their carers are only willing to use services where their cultural and linguistic needs are met. Unfortunately such services are generic and are neither appropriate nor resourced for managing people with dementia. GPs also have difficulty with diagnosing dementia in Asian elders, and families are reluctant to come forward for treatment due to community stigma.

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