Looking at the state of social care for the elderly in the UK today is like watching Monty Python’s Dead Parrot Sketch. There’s the same kind of cognitive dissonance – ‘he’s dead mate!’ ‘No he’s not, he’s just resting!’ Only this situation is not funny. If what we read is true, social care for the elderly is at the point of collapse and the government is in denial.

At a national conference recently health minister Jeremy Hunt, called for better help and support (i.e., social care) for people with dementia, and for more early diagnoses. GP’s are being told to stop being ‘fatalistic’ about dementia and are being sent guidance which includes the statement that people with dementia have a ‘basic human right’ to receive a diagnosis. GPs are not normally the clinicians who diagnose dementia, as I understand it; they make referrals to consultant specialists. Many are said to be reluctant because there is no cure, and very little effective treatment for the condition.  Conversely, people have a basic human right to choose what they want to know. And in the light of what is known about the care available after diagnosis, who could blame them?

Take the case of Mrs Gloria Foster, who died last year at the age of 81.   She spent her last nine days alone, thirsty, starving, confused and probably terrified. The Care Agency looking after her had been closed down, and Social Workers at the Council didn’t check how she was.  She was discovered by a District Nurse lying in bed, her eyes stuck together, soaked in ‘waves of urine.’  She died a day later in hospital.

After the Inquest, her brother in law, Tony De-Keyzer said, ‘what lay behind it was the fact that the care services are under financial pressure. It seemed obvious from the evidence that was read that they [county council workers] were struggling to cope.’

Mrs Foster’s story comes to life when you see photographs of her before dementia, happy with her family and husband. It makes you realise that it could happen to any of us; which is why we need to make sure that proper funding and care for vulnerable older people, including those with dementia is put in place now. If it continues on this trajectory the situation in a few years’ time is unthinkable.

You can read Mrs Foster’s story here:
http://www.getsurrey.co.uk/news/surrey-news/gloria-foster-death—coroner-7743444

If a combination of financial pressure on Social Services and the increase in case load meant that even self-funding Mrs Foster suffered badly, what hope then, for others who need Council funding for their care? Millions are currently relying on families and friends.

There are 6.5 million family caregivers in Britain, who save the economy £119billion a year, according to a recent report from leading charity Carers UK.  A fifth are receiving no practical help at all – leaving them unable to take a break from caring or even get a good night’s sleep.’ 84 percent care for 35 hours a week or more: 63 percent suffer from depression, and 79 percent have high levels of anxiety. Despite being ill, 46 percent had no choice but to carry on, as they were unable to access additional help from social care services or the NHS. When a caregiver suffered a breakdown (one in nine), emergency social care was put in place or the person being cared for had to be admitted to hospital or while their relative recovered.

Carers UK reports warns that it will get even worse. At a time when needs are rising, the social care services budget is being cut by £3.5billion, and carers’ benefits by £1billion. Many carers have had to give up their jobs and their income.
Journalist Virginia Blackburn asks, ‘Why is no one making a song and dance about this? Compare the amount of attention it receives to AIDS. The number of people suffering from AIDS is tiny compared with those with dementia, but it’s fashionable, so money gets thrown at it.’ (Daily Express, Thursday September 11 2014).

Here’s the Monty Python bit: the government is whipping GPs into getting more dementia diagnoses and calling for ‘a revolution in out of hospital care” to give more help and support to sufferers, but at the same time cutting Social Services’ budget by £billions.  And it isn’t as if they haven’t been warned.  David Pearson, president of the Association of Directors of Adult Social Services warned some months ago that the situation had reached saturation point.

There’s talk of removing the divide between the NHS budget, which is for medical intervention and nursing and hospital care, and the Social Services’ budget, which is for personal care, which is for help with washing, dressing, toileting and eating, which most frail elderly people need, and creating a ‘Better Care Fund.’ But this ignores the fact that the NHS is severely under financed, also.

Richard Humphries, assistant director of policy at the King’s Fund think-tank said, ‘What we are seeing now is a double whammy with both the NHS and social care simultaneously facing a crunch year next year. Most people cannot see how to get beyond this without extra money – not just money for more of the same, but for transformation of services. The Better Care Fund is OK, but it’s a very small step towards much bigger measures that are needed.’

Following a survey, the president of the Association of Directors of Adult Social Services, David Pearson, has warned that the social care system is on the brink of becoming unsustainable. He has called on wider society – that’s us, you and me, to say how far it is prepared to protect ‘countless vulnerable people who will fail to receive, or not be able to afford, the social care services they need and deserve.’

http://www.theguardian.com/society/2014/jul/02/adult-care-services-breaking-point-funding-cuts

Mrs Foster’s case shows that every vyulnerable older person needing care will be affected whether or not they can afford it. Inevitably, we may all be old one day, and may be frail enough to need care. If we don’t speak out now, there will be no point in complaining then.

But not to end on a depressing note, let’s remember how God has the answer to everything. For over 207 years He’s enabled this small charity, the Pilgrims’ Friend Society, to care for frail, old folk. You can see how, despite changes and pressures over the decades, the care remains.

Watch it here, and be blessed: https://www.youtube.com/watch?v=zufZ0AryBNg

Louise Morse

Louise Morse MA (CBT) is media and external relations manager for the Pilgrims’ Friend Society. She is a writer and speaker, and author of books on issues of old age, including dementia, published by Lion Monarch and SPCK. She is a cognitive behavioural therapist, and her Masters’ dissertation examined the effects of caring for a loved one with dementia on close relatives.

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