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Welfare Reform on the Web (May 2006): Care of the Elderly - UK

The £30bn question

J. Glasby

Community Care, Apr.13th-19th 2006, p.36-37

The Wanless report on social care for older people calls for a massive injection of state funding, which seems unlikely given that future public spending is predicted to be tight. It also calls for more preventative services, but there is no research evidence as to whether or not such services are effective. Finally, it proposes sharing the costs of care between the state and the individual, but there is no guarantee that the state will not renege on its part of the bargain if costs run out of control.

Achieving a fair price for care

A. Mackay

Working with Older People, vol.10, March 2006, p.13-15

There is evidence that care home owners are not being paid a fair price for places. This article reports on research which examined the scope for using costing models to determine care costs. It sets out the case for using such models and highlights the key recommendations from the research which should ensure that people pay a fair price for care.

Baby boomers’ care in old age set at £30bn

J. Carvel

Guardian, March 30th, 2006, p.6

“Securing good care for older people”, Sir Wanless’ report for the Kings Fund, has received widespread support. The report argues that state spending on social care for older people will have to treble to about £30bn by 2026 to meet the needs of an ageing population. This article summarises the main proposals and provides case studies.

[See also Times, March 30th 2006, p.26]

Careworn country

K. Brown and E. Matthews

Community Care, Apr. 6th-12th 2006, p.34-35

Government is increasingly relying on informal carers to look after elderly relatives in the community. However the increasing incidence of family breakdown is threatening this resource. Children of divorced parents may not feel obligated to care for the parent who left the family home, and single parents need to work, leaving them with less time to look after elderly relatives. There is therefore likely to be a significant increase in demand for social care services.

Delivering Unique Care: care co-ordination in practice

R. Adam

Journal of Integrated Care, vol.14, Apr.2006, p.37-47

Unique Care is an approach to managing the care of older people with long-tern conditions in primary care and is based on the socio-medical model of case management developed at Castlefields Health Centre, Runcorn. It requires an intensive, coordinated approach to each individual’s unique health and social care needs, and provides a mechanism that promotes such an approach from all services. It is based on five key principles: 1) creation of a Unique Care team between health and social services; 2) creation and maintenance of a practice-based register of patients with complex needs; 3) identification of patients at risk of hospital admission; 4) establishment of hospital in-reach; and 5) creation of a bespoke plan with each patient.

'Dignity nurse' in every hospital

S. Womack

Daily Telegraph, April 20th 2006, p.1

The announcement proposing between one and three nurses per hospital responsible for the dignity of older people who make up two thirds of patients, has met with criticism. The move has been called “an insulting and cheap gimmick”. The plan appears in part 2 of the government’s national service framework for older people.

[See also Daily Telegraph, April 24th 2006, p.4]

Growing older in a black and ethnic minority group

S. Northmore

Working with Older People, vol.10, March 2006, p.30-33

Article presents the results of four studies of the quality of life of black and minority ethnic elders. The studies cover ethnic inequalities in the quality of life at older ages, availability of social support among different ethnic groups, quality of life of older women, and poverty and social exclusion in deprived areas.

Home improvement agencies: an award winning formula

L. Bonnett

Working with Older People, vol.10, March 2006, p.20-25

Article introduces the work of home improvement agencies. These are not-for-profit locally based organisations which assist vulnerable home owners and private tenants to repair, improve, maintain or adapt their homes. They help their clients to find funding for works that need to be done to their home by sourcing grants or loans. The agencies will also help with selection of a contractor.

How the NHS has betrayed the elderly

J. Laurance

Independent, March 27th 2006, p. 2

“Living Well into Later Life”, is a joint study from the Audit Commission Healthcare Commission and Commission for Social Care and Inspection of services for older people delivered by forty NHS trusts and ten local authorities. It identifies major failings in the care of the elderly. This article touches on the deep problems exposed, including “cultural attitudes”, and “explicit discrimination”, providing examples and comments. Mental health services receive particular criticism.

[See also Daily Telegraph, March 27th 2006, p9 and March 28th 2006, p.10; Times, March 28th 2006, p.20]

Neighbourhoods for life: designing dementia-friendly outdoor environments

L. Mitchell and E. Burton

Quality in Ageing, vol.7, March 2006, p.26-27

Paper presents the results of a research project which examined how the outdoor environment could be made dementia-friendly. It investigated the perceptions, experiences and use of the outdoor environment by people with dementia and identified design features which influence their ability to successfully negotiate their local neighbourhoods. Results showed that dementia-friendly outdoor environments are places that are familiar, legible, distinctive, accessible, comfortable and safe.

Securing good social care for older people: taking a long-term-view

D. Wanless

London: King’s Fund, 2006

At present few older people with long term conditions receive free continuing care from the NHS. Social care is means-tested and focused on a minority of older people with very high levels of need. The means-testing is deeply resented as it penalises people who have saved for their old age. The report recommends a new partnership approach under which everybody would be entitled to an agreed free “basic” level of personal care, after which individuals’ private contributions to the purchase of extra services would be matched by the state up to an agreed maximum. This model would open up social care services to significantly more older people with low to moderate levels of need, but would require a big increase in funding.

(For summary and comment see Public Finance, Apr 7th-13th 2006, p.18-21 and Community Care, Apr. 6th-12th 2006, p.16-17)

State must provide care for the elderly, urges Age Concern

S. Womack

Daily Telegraph, April 27th 2006, p.8

Echoing Wanless’ calls to change the rules that see seventy thousand people a year selling their homes to pay for care, Age Concern’s report “Who should pay for care” demands an immediate end to means testing and state provision of free care for all that need it.

Technology and personhood in dementia care

A.J. Astell

Quality in Ageing, vol.7, March 2006, p.15-25

Technology has emerged as a possible means of enabling people with dementia to stay in their own homes for longer. However use of technology can pose ethical problems. A balance needs to be struck between the concerns of care givers and protecting the human rights and personhood of the dementia sufferer. These dilemmas are explored with reference to electronic tagging, assistive technology and psychosocial interventions

Telecare matters for dementia

J. Buckley

Caring Times, April 2006, p.16 + 27

Article shows how telecare can enable people with dementia to remain safely in their own homes for longer, and reduce pressure on formal and informal care providers.

What has architecture got to do with dementia care? Explorations of the relationship between quality of life and building design in two EQUAL projects

J. Torrington

Quality in Ageing, vol.7, March 2006, p.34-48

Two projects in the EQUAL research programme explore the impacts of building design on the quality of life of people with dementia. Design in Caring Environments examined the quality of life of people with dementia in residential care homes in relation to building design features. INDEPENDENT (Investigating Enabling Environments for People with Dementia) is a current project which aims to develop technologies to enhance quality of life by supporting enjoyable activities.

Will Wanless inject hope?

J. Snell

Community Care, Apr. 13th-19th 2006, p. 34-35

The report on social care for older people by Sir Derek Wanless call s for a massive expansion paid for by a huge injection of state funding. In this article a range of experts comment on the government’s likely response.

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