The rising cost of living longer

Philip Barron looks at some of the problems and possible solutions

In 1948 life expectancy in the UK was sixty-six for men and seventy-one for women. Now the national average is seventy-seven for men and eighty-two for women. For the first time, there are more people over the age of sixty-five than there are under eighteen.  While the fact that more people are living longer due to advances in medical science may be something to celebrate, it does put huge pressures on existing care services and radical reforms are needed.

In a national initiative designed to promote best practice and improve quality of life for people living and working in care homes, the Joseph Rowntree Foundation has just joined with the newly merged Age Concern/Help the Aged and London’s City University to develop and promote care homes as a positive option for older people. ‘My Home Life’ is a charitable venture developed with sixty academic researchers working in partnership with the care-home sector.

Having gathered evidence about ‘what residents want’ and ‘what practices work’, the researchers came up with several strands for the project. These include, for example, managing transitions (enabling residents to make a smooth transition into a care home and helping to ease pressures on family members) and maintaining identity (helping residents to retain their sense of identity through creative approaches, person-centred care and staff education and support). Residents should not only share decision-making but feel that they are having an influence.

What would be fairest?

There is a widespread feeling that the current system for financing care is unfair. An estimated 45,000 elderly people each year are losing their family home, and perhaps life savings, to pay for care. In England, all the costs of residential care must be met by the individual if they own £23,000 or more in assets (including the value of their home).

As a general election looms, politicians are taking the issue seriously. The care services minister, Phil Hope, is inviting members of the public to have their say in a ‘Big Care Debate’ (closing on 13 November, see careandsupport.direct.gov.uk). Health secretary Andy Burnham says that ‘everyone will get some help in meeting the high cost of care needs’.

Three alternatives are being suggested by the government. In the first, the state will provide between a quarter and a third of care costs, more for people on a low income. In a variation of this, the government would make it easier for people to take out insurance to cover the balance of an individual’s care costs. The third option is comprehensive insurance – everyone who can afford it would pay into a state scheme that meets all care costs.

At the recent Conservative annual conference, Andrew Lansley (shadow health secretary) promised a voluntary insurance scheme with a one-off joining fee (estimated at around £8,000, paid at age sixty-five) in return for a guarantee that all fees for permanent residential care would be waived for life. The average amount that someone has to pay in fees for residential care is over £50,000, but can be far more if they need to stay for a long period.

Asked for an independent view, Stephen Burke, chief executive of the charity Counsel and Care, said: ‘Any solution has to help older people fund their care wherever they live, whether in their own home or in a care home. Local authorities should be doing more to help people avoid selling their home to pay for residential care. And it has to be questioned whether a voluntary insurance scheme will get sufficient support to properly fund the cost of care homes. It might also create a perverse incentive to move into residential care.’

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