Remember ME - You Me and Dementia

May 11, 2012

UK : The crisis in social care , Indifferent Civilised Society

LONDON UK / Mail Online / Society / May 8, 2012

By Dominique Jackson

The parallel universe of geriatric care is not somewhere most people visit willingly, nor regularly, if they can help it. Most of us cannot even begin to imagine the burgeoning twilight universe which exists alongside ours. After all, the care system only really hits the headlines when brave whistle blowers expose particularly shocking cases of neglect and abuse.
                     This is a terrifying indictment of how poorly we value the achievements of the older generation and of how quickly and how conveniently we forget the huge debt we owe them

I am not quite sure why most of us choose to remain so blinkered about the crisis in social care? After all, we are all going to get old one day; thus, someone, somewhere is probably going to have to help look after us and somehow, that care is going to have to be paid for. 

Today’s open letter, begging the Prime Minister to open his eyes to the care crisis, is signed by 78 charities and campaign groups, who are all working on the grim, often fraught and woefully under-funded frontline of care provision for the frail, elderly, disabled and otherwise most vulnerable members of society. They know all too well what they are talking about.

Surely, social care is the litmus test of a civilised society? The current crisis, both in funding and provision, is a terrifying indictment of how poorly we value the achievements of the older generation and of how quickly and how conveniently we forget the huge debt we owe them.

I sincerely hope that Mr Cameron takes a few minutes off from his busy day out with Mr Clegg, relaunching the aims of the coalition from a factory in Essex. I hope he takes enough time to read this important letter, to digest what it means and to decide to take some action.

Two years ago, when Messrs Clegg and Cameron stood side by side in the Downing Street Rose Garden, charities and the elderly lobby felt they had some cause for optimism. The coalition soon published a white paper on health care reform which promised “a sustainable legal and financial framework for adult social care” by the second session of parliament.

Yet today we are frustratingly no further on and the government looks increasingly out of touch with its growing numbers of elderly, and vocal, voters in the wake of the “Granny Tax” debacle.

The Queen’s Speech tomorrow is expected to include a vague nod to the importance of social care reform, but there will be no bill brought forward in this session. Thus, we have no hope of any realistic overhaul in long term elderly care for at least another two years.

This is two years too long for a shocking majority of elderly people and their family members, many of whom work as unpaid carers, and a huge number of whom are currently struggling to fund, or even to find, appropriate and adequate support and care. 

Tens of thousands of elderly pensioners are forced to sell their homes to pay for residential care. Many more thousands of senior citizens who do not have that option are trapped in the postcode lottery of care I wrote about on this forum only last week when I highlighted the plight of 99-year-old war veteran and dementia patient Bill Sandford, unable to move close to his daughter and her family because of a shortfall in local council funding.

The Commission on Funding of Care and Support, chaired by economist Andrew Dilnot, called for a limited liability model of social insurance, in which any individual’s liability for the cost of care would be capped at around £35,000, with the state coming in at this threshold.

However, implementing Dilnot’s proposals has reportedly been held up by rows within the Treasury over how to pay for the reforms. A much delayed White Paper on long term care will finally appear next month but is expected to focus mainly on issues such as improving service quality, safeguarding vulnerable patients and on personal budgets to allow greater freedom of choice. How on earth we are expected to pay for all of this is not expected to be directly addressed at all.

This is particularly bad news for those of our poorest senior citizens. Two thirds of the 400,000 pensioners in the country’s care homes are funded by the state and recent cuts to council funding have led inevitably to a drop in levels of staffing, recruitment criteria, provision of training and thus in standards of care.

A report on transforming social care for the poorest elderly people from the Centre for Social Justice think tank is also published today. It argues that the current means-tested system of funding is at breaking point and that the proposed Dilnot reforms ignore the plight of the war time generation who simply do not have any assets to sell.

The CSJ, which was established by work and pensions secretary Iain Duncan Smith while he was in opposition, hopes its findings may influence the politicians who are considering their response to Dilnot in cross-party talks ahead of the White Paper’s appearance in June. 

All this research and all these recommendations are all very well but what we really need  now is some joined-up thinking and some immediate action. We need an open and honest debate about the needs of the elderly and we should all, every single one of us, be involved. After all, we will all be elderly one day.

Our population is ageing and ageing fast. Almost 20 per cent, 11.8 million, of us are now over the retirement age. Of these, 1.3 million are already over the age of 85. Our rapidly ageing population means swiftly rising rates of dementia and growing legions of frail and vulnerable seniors, who are, whether they like it or not, dependent on younger generations.

It should not have to fall to a coalition of charities to have to highlight the scale and urgency of the challenge of social care reform but now that they have bravely brought the debate back into the headlines, it is high time for the government to wake up to this demographic time bomb and act.

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