What has the coronavirus crisis told us about residential care? It has told us that residential care puts older people at far greater risk, which is ironic since the biggest reason for admission is the perceived risk of remaining at home.
Life expectancy in residential care for older people is 2 to 3 years and often less. Residential care for most people over 80 is not a positive choice but an indication that they have run out of options. Coronavirus has made it an even worse, “ choice”.
The conclusion must be to find a new way of supporting adults who cannot be at home.
One option is not strictly speaking new but was never really full explored or funded. Prior to changes in Housing Benefit and the onset of austerity budget cuts many Local Authorities had seen the future for housing and social care as very sheltered housing. Based on the simple idea that the help should come to the individual not the other way round and recognising that older people valued independence over institutional care. If an individual’s accommodation was unsuitable or their care needs increasingly difficult to meet rather than go into residential care they move to a purpose build flat in a scheme that had its own care team offering support and reassurance 24/7. Pilot schemes like the one I was involved in Birmingham showed that if schemes had waking night staff they could not only support very frail tenants but also those with dementia. Ideally people would be able to chose to move to a scheme well before they got to the point where their care needs undermined their confidence and their informal support ( family and friends) became exhausted. Making a move to very sheltered housing a positive decision, part of planning for the future, a future in which you had your own front door and a home not a room.
The shocking and disturbing death rate in residential care during the coronavirus out break should make us all think what sort of old age we want for our parents and ourselves. After this is all over let’s offer older people and their cares ( informal and professional ) a new deal. Let’s fund the type of accommodation and level of support which will enable old age to be enjoyed not endured. Let’s start by making a commitment to improve the pay and status of those working with older people and doing away with residential care homes.
Blair Mcpherson former director of Community services, author and blogger www.blairmcpherson.co.uk
