No one wants to live in a care home: Need to provide alternative options for those in later life
Nick Sanderson, Guardian Professional
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| Residents in extra care housing are less likely to be admitted into a hospital for an overnight stay. Photograph: Linda Nylind for the Guardian |
These are turbulent times for the long-term care sector. Amid uncertainty about what the impact of the Health and Social Care Act will be and with the launch of the social reform white paper slipping to late spring, the debate on social care for older people continues..
While column inches have been crucial to raising awareness of the issues relating to ageing, the debate they are generating is flawed because it only considers how we fund the existing institutional care model, which is ineffective and unwanted. No one, whatever their age, wants to live in a care home.
Providing choice is crucial, as is listening closely to what older people want. In place of trying to improve a failed model, we must articulate the alternative housing options available, including those that provide fully flexible care in the home. Extra care housing is an alternative which offers people a legal right to their own self-contained home, while having additional support come to them as and when they need it. It promotes independence and allows individuals to be in control of their lifestyle.
There are other important benefits to extra care housing, not least the positive impact it has on health and wellbeing. We know from research conducted with the International Longevity Centre that where housing includes access to extra care, over 80s with care needs are half as likely to move into an institutional care home in the future.
The research also found that residents who have been in extra care housing for five or more years are half as likely to go into institutional care as those in standard housing. Residents in extra care housing are also less likely to be admitted into a hospital for an overnight stay compared to someone of a matched demographic living in the community.
In addition, the research proved that those living in extra care housing are less likely to fall, a contributory factor to a significant number of unnecessary deaths among the elderly in the UK. Altogether, it could allow the NHS to focus resources on those most vulnerable, while the remainder of us will be able to choose how we want our care needs met.
Beyond the benefits of care and wellbeing, there are significant financial and economic advantages to extra care housing. A report from the Dilnot Commission highlighted that older people will still have to fund their own care, although this funding may ultimately be capped. Embracing the extra care model allows older people to take their future in hand and stay in control of where they live, how they live and the funds available to them.
The success of this approach relies on giving those over 60 the opportunity to use their largest asset, their home, to fund their retirement. They are the first generation to be majority homeowners, estimated collectively to hold over £1 trillion in equity.
Sadly however, too many live in relative poverty with their assets tied up in their property until a crisis, such as fall, takes the decision out of their hands and they are forced to surrender this home to pay for institutional care.
With the extra care model in place, this scenario need rarely happen. Indeed, the health, social and financial benefits of extra care could make the institutional care model as we know it redundant. In time, 70% of care homes across the UK could close.
An integrated approach is imperative if the country as a whole is to move to extra care housing.
The government has to work with the financial services as well as the housing and social care industries to transform how we manage later life. It requires a new way of thinking about the future that encourages candid, open conversations about people's ambitions for retirement and how we best meet them.
The answer relies on a step change in approach. We have a unique opportunity to get it right and, if we do, it will mean that we can finally provide a future that the older people of both today and tomorrow deserve.
Nick Sanderson is chief executive of Audley Retirement Villages
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