Tony Pilkington 07 February 2017

Care of the elderly should be a shared responsibility

The junior health minister, David Mowat has recently announced to MPs that the social care crisis is now so great that families should no longer rely on the state and that tackling the crisis will require people to be as responsible for their parents as they are their children.

I agree, in an ideal world we would all be taking care of our parents as they get older, but as they start to require more full time care, are we really expecting people to give up their jobs to become full time carers?

The high cost of living today, caused by inflation, stagnant pay rises and tax changes is having a significant impact on living standards for those on low incomes. Not everyone is in a position to give up work or reduce their hours to look after their parents as Mowat suggests, and many people are still supporting their children financially as their parents get older.

A reduction in work hours or giving up work altogether just isn’t an option for many people today irrespective of whether it’s to care for a child or an elderly relative. Given many people are on low incomes, to give up work to become full time carers could mean we’re just as likely to see more people rely on the state for benefits to support them financially.

Won’t this mean we’re just simply just taking from one pot of Government money, to support another - the cost of social care?

Perhaps there is an assumption that people with older parents may have more disposable income with mortgages coming to an end or perhaps having managed to build up some savings. Mr Mowat says that it is a short-medium term solution we need, but I cannot get my head around how this provides anything near medium-term. More and more people are in rented accommodation and thereby do not have diminishing accommodation costs.

Also if people give up work to support ageing parents and have to rely on those savings to make financial ends meet, when it comes to their own care in the future, they are more likely to be in need of support from the state themselves - in isolation this only defers the social care crisis.

I do agree with Mr Mowat however in that there are clearly many benefits to family members being more involved in the care of an elderly relative. But I would like us to move towards an ecosystem within which people in need of support can access care from the community as a whole, so that the responsibility doesn’t fall completely to a family member, nor are they completely reliant on the council either.

If you consider this aspiration and turn the ‘make care pay’ rhetoric into reality we can take a whole different approach to social care that is easier and genuinely does improve community cohesion and reduce the burden on state finances.

One solution that councils are working on is to develop ‘Community Assets’, to build and encourage capacity in communities to give people support and help address the pressure on formal care such as home care and residential care.

Imagine five people with care needs on one street and one other person on that street provides care to those five people, paid for by each of the five families. This could provide a distribution of wealth across six households and resilience amongst the neighbourhood, all at low cost to the people and next to no cost to the state - this is a simple example but it has worked in several pilots around the country.

I believe councils should be taking the lead in enabling such models to become the norm of how to meet care needs. Family first, then community and council next. But making this vision a reality needs investment to give communities a forum in which to promote ideas and families better access to information, helping them to access the care options that suit the care recipient’s needs. This will give them more freedom and the ability manage their care budgets simply.

Would such a model offer a true solution to easing the pressure on social care? It definitely doesn’t make the mistake of pushing the financial pressures around.

Ultimately it’s clear that a new way of working is required so people can access all options of support when they need it. I’d like to see councils help families and providers collaborate more closely; leverage modern technology to help people more easily self-manage their own care requirements; and for people and communities to get better at promoting and sharing what they can do for each other.

Local authorities have the green light from Government to move away from delivering restrictive care options and by creating a culture of shared responsibility across the community, one that encourages access to innovative and tailored support that suits individual families’ needs can be embarked on now to provide a short-to-long term solution.

Tony Pilkington is managing director of Younifi

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