It is
inevitable that most of us will reach the point where we become ‘the older
generation.’
With being in such a position, there will be the inevitable
questions about living accommodation and care needs.
There is a demand
to start looking at such issue. The World Health Organisation has calculated
that, by 2050, there will be 395 million people in the world who would have
reached their 80th birthday, a quadrupling of the current situation.
In the UK (and other developed countries), it will be the average age – more
than 10 years longer than expected during the 1960s.
This
significant birthday is the one where one in six people would have been likely
to develop dementia. A report by the Alzheimer’s Society has indicated that, in
the UK, approximately 80 per cent of present care home residents are living
with dementia or have significant memory problems, a situation that is only
likely to increase.
Statistics from
a public survey by Demos has found that only 1 in 4 people have said that they
would consider moving into a care home if they became frailer in old age,
whilst 43vper cent stated that they would definitely not move.
The second most
common reason given for not moving into a care home was the risk of neglect or
abuse with 54 per cent of the members of the public citing this. Statistics
show that there were 7,654 cases in
England in 2013, which was just under 2 per cent of the 432,000 of the people
living in housing with care (‘Personal Social Services Expenditure and Unit
Costs, England: 2012 – 13,’ Health and Social Care Information Centre, December
2013). To put these statistics into perspective, 23 per cent of abuses in care
home settings were as results of family and friends, 12 per cent by another
vulnerable adult and 20 per cent by staff. Obviously, no case of abuse or
neglect should exist and it is the role of the regulators and the owners of
care homes to eradicate such incidences.
Demos had asked
respondents what would be the most important things needed in later life. The
results were as following:
·
Remaining
independent (62 per cent)
·
Being
close to family (45 per cent)
·
Being
somewhere safe/easy to maintain (40 per cent)
·
Being
able to pursue my hobbies/interests (29 per cent)
·
Having
home comforts around me (29 per cent)
·
Being
connected to wider world (20 per cent)
·
Being
able to keep in contact with friends/networks (14 per cent)
·
Being
able to work as much as I can (13 per cent)
·
Having
carers/medical professionals nearby (13 per cent)
·
Having
someone at hand to look after me (9 per cent)
In a 2008
survey by Huddersfield University regarding care homes, it showed among other
issues that 50 per cent of residents had their own room compared with 88 per
cent of the general population; 55 per cent had several close friends (compared
to 78 per cent of the general population). Staying overnight with friends and
having friends to stay was rarer for those living in care homes (18 per cent vs
47 percent and 7 per cent vs 51 per cent respectively). People living in care homes
were less likely to choose their own décor (13 per cent vs 84 per cent), choose
where they live (52 per dent vs 76 per cent) and choose their own clothes (75
per cent vs 95 per cent). These factors are important when considering the
privacy, identity, dignity, relationships, choice and quality of life.
One of the
biggest problems for older people, according to research by Age UK, was
physical loneliness. The study showed that 6 per cent of older people (which is
approximately 600,000 people) leave their house less than once a week.
This finding is
reflected in the reasons why people consider living in care home later in life,
which were as follows;
·
‘So
I had carers on hand to manage my health and keep me safe’ (63 per cent)
·
‘Because
I wouldn’t want to be a burden on my family’ (60 per cent)
·
‘Because
I wouldn’t be able to support myself at home’ (51 per cent)
·
‘So
I had the support to stay active and pursue my interests’ (30 per cent)
·
‘Because
there would be no one at home to look after me’ (30 per cent)
·
‘So
I had company/could form social networks’ (26 per cent)
·
‘I
would be worried about my personal security in my own home (e.g. crime)’ (22
per cent)
There were a
variety of locations that people would consider living in when they were older:
·
Living
with family or friends (25 per cent)
·
In
supported/adapted housing (21 per cent)
·
In sheltered or warden assisted housing (20 per
dent)
·
In
a retirement village (15 per cent)
·
In
a care home or nursing home (2 per cent)
·
None
of the above (7 per cent)
·
Don’t
know (10 per cent)
Among the
recommendations of the Commission for Residential Care’s report (‘A vision for
care fit for the twenty-first century,’ Demos, September 2014) is more
co-location in the residential care sector, resulting in combining care
properties with educational institutions or community centres (such as child
nursery groups or libraries). This would enable residents living in care
villages to attend courses and be a vital part of a diverse community. The
Commission found that people living with first-hand experience of co-location
and housing with care were more likely to have more positive views in general
and were more likely to consider care homes for themselves in older age.
Another
recommendation was to encourage surplus land, such as that currently held by
NHS Trusts, to be sold so that care homes and supported living apartments can
be built to meet the increased demands of a fast ageing population and an
increase in younger people with complex health needs. Although the report did
not mention this, the building of one or two bedroom homes in retirement
villages (as constructed in countries such as South Africa and New Zealand and
evidenced in such places as Whitely village in Surrey) would encourage older
people to move into this secure area and, in turn, would release the housing
stock that is more suitable for younger families.
According to My
Home Life programme, these scenarios would fulfil the fulfilment of the
important six senses in residents, relatives and staff in order that they would
be in a good relationship with each other:
·
A
sense of security
·
A
sense of continuity
·
A
sense of belonging
·
A
sense of purpose
·
A
sense of fulfilment
·
A
sense of significance
An option that
has also been considered by some people is to send their older relatives to
care homes in another country, such as Thailand or Germany (‘Exporting Grandma
to care homes abroad,’ www.bbc.co.uk, 5 January 2014). It is acknowledged
that Thailand 9to pick on one example) has a strong culture of looking after
its elderly, has a reputation for quality that is high and has a significantly
lower costs for nursing.
By way of
contrast: in Switzerland, people are expected to contribute to costs in the
bracket of US$ 5,000 (£3,036) and $10,000 (£6,073) per month. In the UK, the
average costs range from £2,186 for basic residential care to over £3,036 a
month which includes nursing care. In Thailand, the figure is closer to £1,821
a month, which is likely to be a comprehensive package.
Markus Leser of
the Association of Care Homes for the Elderly in Switzerland is not convinced
that sending loved ones to care homes abroad is correct. He remarked: ‘The step
from their own house into a nursing home is a big step. And the step going to
Thailand is much, much bigger because there is the language, you are separated
probably from your family.
‘Of course it’s
cheaper if you go to Thailand. But the decision for my father or my mother, it
shouldn’t only be the costs in my focus.’
For the older
person who is still living on their own or with relatives, it is expected that
eldercare could be as common as childcare is at present (‘Will eldercare be as
common as childcare?’ www.bbc.co.uk, 26 February 2014). Presently,
according to research by YouGov, there are 2.4 million ‘sandwich carers’ in the
UK, who are experiencing the pressure of caring for children and older
relatives at the same time as working. Another survey by the charity Carers UK
found that 42 per cent of this sandwich generation were either struggling to
cope or were at breaking point.
It is the
opinion of Helena Herklots, the Chief Executive of Carers UK, that it will be the
situation that eldercare would be a standard reason for requesting changes in
employees’ working patterns. She commented: ‘It is a near-universal experience
for us all. At some point of our lives most of us will wither become carers or
need care. It is beginning to be a challenge as strong as the childcare issue
maybe 15 or 20 years ago. It’s that important for business, but not all
businesses have woken up to that.’
That strain
will increase as the number of older people in need of care is predicted to
outstrip the number of family members able to provide it for the first time in
2017. By 2032, 1.1 million older people in England will require care from their
families, which is an increase of 60 per cent, but the number of people being
able to care for older families will have increased by only 20 per cent. This
statistic represents a shortfall in our collective capacity to care for older
generations (‘The Generation Strain: Collective solutions to care in an ageing
society,’ IPPR, April 2014).
The figures
show that, at present, there are 315,000 working age carers who have left
employment and remain in that situation. Of this sector, 60 per cent are women
for women are the largest group of informal carers, care for longer hours and
for longer durations. The outcome is that this loss of working hours is worth
£5.3 billion per annum.
There is also
evidence that caring has a strong impact on the health and wellbeing of
informal carers. Of the 1.3 million people who provide informal care for more
than 50 hours a week, only 56 per cent reported that they had good health. It
was reported that stress and isolation was the greatest problems in caring for
others:
·
29
per cent stated that they had as much control over their daily lives as they
wanted, whereas 12 per cent commented that they had no control whatsoever.
·
16
per cent admitted that they had no encouragement or support in their role as a
carer. An additional 40 per cent said that they had some encouragement but not
enough.
·
14
per cent remarked that they had little social contact and felt socially
isolated.
The important
issue throughout the consideration as to where older people reside is the
opinions of those people. It is the duty of those who care for them to listen
and assist them towards the most appropriate decision.
In addition to
the commands to honour parents and to assist those who are widowed, we are told
by God to ‘show respect for the elderly’. (Leviticus 19: 32) This means that,
as a society, we are to provide the best and most appropriate accommodation for
older people.
After giving
their lives in serving others, it is only right that they ‘will long enjoy the
works of their hands.’ (Isaiah 65: 22)
The choices
that our parents and older loved ones have to make now will be the same ones
that we will have to make in the future – the need for affordable, suitable and
diverse accommodation to deal with the aspirations and difficulties that are
found in old age.
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