The High Price of Getting Old
More people need a costly care home place but the debate about who foots the bill is still raging
We take better care of our pets than we do of our old people, a former nursing home worker said to me recently. She said that prisoners were given better food. And that too many people with dementia were drugged up to keep them quiet so that fewer staff needed to be employed. Agency work gave her an insight into the way a number of homes were run and she didn’t always like what she had seen.
She was genuinely afraid of going public. She said that raising concerns – even quietly and informally – meant that she would be branded a troublemaker and that work would dry up. Many of the people she worked alongside went above and beyond the call of duty in low-paid jobs with almost non-existent budgets in understaffed homes. She said that some staff behaved in a way that was probably legal but not always ethical and she reeled off many reasons why this was so.
The cost and the quality of care have come up time and again. A report published last month by the Commission on Improving Dignity in Care for Older People was criticised for appearing to tell carers not to use terms like “dear” and “love”. And for stating the obvious about a need to employ staff who are genuinely compassionate. And yet the obvious seems to need restating.
An ill-tempered local doctor was struck off just over a year ago after a catalogue of complaints, including inflicting injuries on a distressed elderly patient at a Hove care home. He was in a hurry, she was old, slow and confused. The problems are compounded when the difficulties of dealing with people who have dementia are taken into account.
The costs of running a care home have risen over the past few years. Heating is dearer. Food and the cost of cooking have gone up. Rents and business rates have also risen and then there’s the cost of repairs and maintenance. A host of rules and regulations mean that many operators have needed to upgrade.
Some have closed rather than spend the money. Often these sorts of premises are owned and run by an individual or a couple. But even somewhere as large as Dresden House in Hove cited the cost of meeting the necessary standards – a reason questioned by, among others, the town’s then MP Celia Barlow.
There has been some relief for local care and nursing home operators after the council agreed to fund a general five per cent rise in fees last week. Council cabinet member Rob Jarrett said that, with a few exceptions, fees had not risen in the past two years. But energy costs had and that the council wanted to support fair rates of pay for carers. He said that the demands were greater than, say, working on a supermarket checkout. The rewards needed to reflect this to encourage the recruitment and retention of good staff.
A High Court judge also recently added to the pressure on councils to rethink the level of fees. But councils pay only in certain circumstances and they do not always foot the entire bill. This is still a contentious subject.
Many old people and their families resent having to sell their home to fund their care in old age. They ask why they should have to stump up after a lifetime of paying tax. The argument has raged for more than 20 years. John Major’s government looked at it. So did Tony Blair’s and Gordon Brown’s. They were unable to build anything remotely resembling a consensus, except deciding that things can’t go on as they have. But that’s exactly what has happened. With a growing elderly population, the time to care about this issue is now.
