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