Community action alone cannot meet elderly care challenge

Alice Sachrajda is a researcher at ippr

A new report on social isolation in care homes has been launched by the Relatives and Residents Association (R&RA). The findings show that at least 40,000 elderly people in care homes in England are living in social isolation and that as many as 13,000 are completely ‘without kith or kin’ and receive no letters, calls or visits at all.

Elderly-careResponding to the report, care services minister Paul Burstow said:

“Caring for older people is everybody’s business. That is why the government is determined to strengthen community action. Citizen-led advocacy and community-based befriending services can make a big difference.”

But how effective can “citizen-led advocacy” and “community-based services” really be, particularly when the R&RA report refers to people who, largely, have dementia? On the one hand it is good to get communities engaged.

We need better awareness about the issues faced by older people in society, and particularly those living with dementia.

Encouraging communities to show more support and become better equipped for older people – particularly those with dementia – is an important step. But there are three reasons to be sceptical that “community action” holds all the answers:

First, caring for older people already disproportionately falls on families and communities. Six million adults are already carers in the UK and they save the economy £87 billion a year – this is a burden already largely being carried by society not state. There are big problems with family members and volunteers burning out and being unable to cope.

• Second, there is currently an acute need for specialist care and advocacy services and dedicated training of NHS and social care staff. Dementia is a complex condition that can require specialist support.

• Third, the number of people living with dementia is set to rise over the coming years with estimates that there will be over a million people with dementia by 2025. The scale of the challenge is simply too big to rely on community action alone.

The “Big Society” may go someway towards alleviating the problems of social isolation, and it is likely to help in raising awareness about the needs of older people – but it shouldn’t be at the expense of specialist dementia care, advocacy and support; communities need support from government agencies if they are to play more of a role.

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  • Jane

    Being a mature citizen and one who keeps an eye on more elderly neighbours some with alzeimers I do not agree with your assertions. I must challenge firstly your assumption that those who care or keep an eye on others are saving the economy £87 billion a year. What you are saying is that it is the State’s responsibility to care for every elderly citizen even if they have partners or relatives. Are you saying that every person wants to be cared for by the State in a residential home which is what your figures suggest when clearly the evidence suggest most elderly people want to remain in their own home. In addition, looking after people with alzeimers is mostly common sense with the exception of the few who require residential care. I know this as I have been to a specialist alzeimers unit which is staffed by a couple of nurses and untrained workers. Most elderly people myself included were not brought up to believe that the State provided – we believe that we should take responsibility for ourselves and the State only provides help if that is not possible. I have always had a career but nevertheless always kept an eye out for elderly neighbours stepping in when necessary to care for them. I have lived throughout the country and this has always happened. Communities care for each other and tap into state resources when needed.

    The debate that started before the election on an aging population has disappeared and will no doubt come back again. Every country is facing this issue – even China! There must be a demand on health and pension funds as people live longer. Whatever way we proceed, it is right that each citizen plays a role. We will not have others tell us that the State knows everything and what is best for us.

  • Mr. Sensible

    Alice, this is 1 of the fundomental problems with the ‘Big Society’ agenda overall; communities have their role to play, but this simply cannot be used as a substitute for public services, be that for care for the elderly, our schools, or anything else.

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  • merthyr_bill

    communities did everything until the last 50 years. what the government has done is attempt to replace civic society with itself. they have tried to replace fatherhood with the state. it’s nothing new, it was done in Sparta and it was done under the Khmer Rouge in Cambodia. it never ends well.