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LONDON, England /
The Daily Mail / Debate / July 15, 2009
By Harry Phibbs
As the population ages, there is growing concern that care homes are combining poor quality with increasing unaffordability.
The present system punishes savers and home owners. Anyone who has saved £23,500 or more is not given state funding for a care home, or help from social services. So those who need care have to fund it from their savings or sell their home.
The system makes into fools the hard working and prudent who put money aside or those who spent years paying off a mortgage. It rewards the profligate.
Care in the home: Families should be offered
more help to ensure the elderly receive dignified care
In Scotland the means test doesn't fully apply - there is a personal care allowance paid to those in physical need, regardless of savings. But this represents another form of unfairness. Scotland can only afford it because of the public spending formula - the Scottish are subsidised by English taxpayers.
What is needed is a change in the system to allow future generations of elderly people to have the dignity of financial independence.
Just as the realisation has come that individual funded pensions are needed because the state cannot be relied upon to provide for us in our old age, the same applies to the extra care that we may need. So the Government is right to be considering options for insurance based care schemes.
The important point is that the elderly in need of care should have the money to buy it in the way they choose. For them to be shunted off to care homes against their will should be a last resort.
Some care homes, both state and private, have been subject to plenty of criticism for the treatment they offer. But monitoring the system with box ticking regulations is not the answer.
For example, the Care Standards Act 2000 forced the closure of hundreds of care homes whose layout didn't match their pedantic standards. If a room was 14.0 square metres instead of the 14.1 specified then the person living in it was forced to move out. Of course what really counts is the quality of the staff looking after the residents.
Many of us shudder at the prospect of an institutionalised old age - even if the institution is of the highest standards. Some face an unpleasant dilemma of agreeing to go into a home instead of being a 'burden' on their children.
Reform: Health secretary Andy Burnham will today unveil an insurance scheme to end the 'cruel lottery' of care for the elderly
Unfortunately, there will always be a practical limit to the level of care that can be provided in a private household. Still, the Americans and the British should embrace the culture of continental Europe where squashing a great big extended family under one roof is enthusiastically embraced, where grandparents and grandchildren look after each other.
In Europe, even when the elderly don't move in with their adult offspring they tend to retain control of their destiny more than they do here. In Holland the elderly are offered a 'care budget' in lieu of a place in a care home. Nearly 100,000 people have taken this option.
The money on offer is two thirds the cost of institutional care so it saves taxpayers money as well giving the elderly choice. They might stay at home - paying for the alterations and care that make this possible. They might move in with other family members and be able to pay for home conversions to give them their own living quarters and be able to make a generous contribution to the family budget. Importantly, they have less reason to feel they are a burden because in financial terms they are able to pay their way.
In Denmark there has been a trend for groups of elderly friends to manage by looking after each other in shared accommodation - tasks such as cooking and gardening are shared by the most able. They pool the cost of recruiting outside carers as and when necessary.
There can be no magic solution to the mental and physical frailty which is the natural consequence of old age. But let's do everything possible for the old to remain in control of their lives as much as possible and for as long as possible.
Let us all, when the time comes, go gently and with dignity into that final good night. [
rc]
© 2009 Associated Newspapers Ltd
Care in the home: Families should be offered
more help to ensure the elderly receive dignified care
In Scotland the means test doesn't fully apply - there is a personal care allowance paid to those in physical need, regardless of savings. But this represents another form of unfairness. Scotland can only afford it because of the public spending formula - the Scottish are subsidised by English taxpayers.
What is needed is a change in the system to allow future generations of elderly people to have the dignity of financial independence.
Just as the realisation has come that individual funded pensions are needed because the state cannot be relied upon to provide for us in our old age, the same applies to the extra care that we may need. So the Government is right to be considering options for insurance based care schemes.
The important point is that the elderly in need of care should have the money to buy it in the way they choose. For them to be shunted off to care homes against their will should be a last resort.
Some care homes, both state and private, have been subject to plenty of criticism for the treatment they offer. But monitoring the system with box ticking regulations is not the answer.
For example, the Care Standards Act 2000 forced the closure of hundreds of care homes whose layout didn't match their pedantic standards. If a room was 14.0 square metres instead of the 14.1 specified then the person living in it was forced to move out. Of course what really counts is the quality of the staff looking after the residents.
Many of us shudder at the prospect of an institutionalised old age - even if the institution is of the highest standards. Some face an unpleasant dilemma of agreeing to go into a home instead of being a 'burden' on their children.
Reform: Health secretary Andy Burnham will today unveil an insurance scheme to end the 'cruel lottery' of care for the elderly
Unfortunately, there will always be a practical limit to the level of care that can be provided in a private household. Still, the Americans and the British should embrace the culture of continental Europe where squashing a great big extended family under one roof is enthusiastically embraced, where grandparents and grandchildren look after each other.
In Europe, even when the elderly don't move in with their adult offspring they tend to retain control of their destiny more than they do here. In Holland the elderly are offered a 'care budget' in lieu of a place in a care home. Nearly 100,000 people have taken this option.
The money on offer is two thirds the cost of institutional care so it saves taxpayers money as well giving the elderly choice. They might stay at home - paying for the alterations and care that make this possible. They might move in with other family members and be able to pay for home conversions to give them their own living quarters and be able to make a generous contribution to the family budget. Importantly, they have less reason to feel they are a burden because in financial terms they are able to pay their way.
In Denmark there has been a trend for groups of elderly friends to manage by looking after each other in shared accommodation - tasks such as cooking and gardening are shared by the most able. They pool the cost of recruiting outside carers as and when necessary.
There can be no magic solution to the mental and physical frailty which is the natural consequence of old age. But let's do everything possible for the old to remain in control of their lives as much as possible and for as long as possible.
Let us all, when the time comes, go gently and with dignity into that final good night. [rc]
© 2009 Associated Newspapers Ltd
