Care Homes Out Of Cash

[(Blizzard)]

I think labour costs are the main factor that differentiates child care from care of the elderly costs.

More people, or better paid people?

[Olebrum]

Southern Cross sold off their properties (nice big bonuses for the management team) and

rented them out. Now they cannot afford the high rents (like Debenhams) and are up

5h1t creek.

I am sure the greedbot business school graduates who caused the problem will have

a similar genius solution to fix it. After all, that is why they earn the big bucks.

[SarahBell]

Don't they rent their buildings?

(I'd assume that the best tax fiddle in the world is to own your own buildings in one company, rent them to another of your companies, and take vast amounts of money in one, pay it to another and then have the one that does the work go bust leaving debts?)

[Mrs Bear]

More people, or better paid people?

You need 2 people to lift an immobile elderly person who may also have painful joints and can't be rushed, to get them in and out of a wheelchair, take them off to 'change' them, almost certainly to bath or shower them, too. If the person's mobile but difficult or aggressive, you may well still need 2.

For all these things you need only one person for a baby or toddler, and the whole process will be an awful lot quicker.

Better pay for carers ought to attract 'better' people, but I'm not sure it necessarily would. In my mother's home I do see a difference between staff; there is one in particular who IMO ought to be doing something else, she has a job to control her snappy impatience with people who might be bl**dy difficult, but who can't help it, any more than someone else can help having say MS.

There are others who are immensely kind and often go beyond the call of mere duty.

I would guess they're all paid about the same.

[(Blizzard)]

You need 2 people to lift an immobile elderly person who may also have painful joints and can't be rushed, to get them in and out of a wheelchair, take them off to 'change' them, almost certainly to bath or shower them, too. If the person's mobile but difficult or aggressive, you may well still need 2.

For all these things you need only one person for a baby or toddler, and the whole process will be an awful lot quicker.

Better pay for carers ought to attract 'better' people, but I'm not sure it necessarily would. In my mother's home I do see a difference between staff; there is one in particular who IMO ought to be doing something else, she has a job to control her snappy impatience with people who might be bl**dy difficult, but who can't help it, any more than someone else can help having say MS.

There are others who are immensely kind and often go beyond the call of mere duty.

I would guess they're all paid about the same.

That's interesting, but I'm not sure it exactly answers my question.

It seems to me that both childcare and elderly care have both become extremely expensive. It also seems to me that they are similar businesses, with similar costs and similar regulations. So the increasing cost may have a common cause.

It may be that the costs haven't increased, so that's one easy answer.

When I asked about better paid staff, I really meant more specialist staff. That would mean the comparison isn't really a good one since child carers aren't that specialist (there I go again, offending a whole bunch of childcare workers).

I can see that old people need more staff, but that will have always been true, and doesn't really spoil the comparison. Maybe.

So have costs increased? Is the cause the same as with childcare or is that just a coincidence? Where does the money go?

Edited May 28, 2011 by (Blizzard)

[porca misèria]

That's very thoughtful of you, I'm sure your family will be better off for it financially and emotionally. The states position on this at the moment seems to be a persons life should be preserved at all costs so many don't get the choice.

Can't last. Demographics will kill that off.

Care of zombies is already a 'scandal' and already unaffordable. 15 or 20 years hence when boomers start hitting the age of zombiedom in any kind of numbers, there'll be no question of keeping up this stupid charade.

Sometime between now and then we need a change to allocate resources to those with life, and let it end when there's no quality left nor prospect of recovery. Zombie care is a sop to the conscience of society, not for the benefit of the dying.

[porca misèria]

Elderly care is (no offence intended) similar to childcare, and that also seems to have become prohibitively expensive. Could there be a link?

Big difference: a child has a future!

(as does an old person in hospital but with a prospect of recovery).

[dances with sheeple]

For the last 6 years I have worked 1/2 days a week as a bank cook in a care home. The home has recently undergone a refurbishment to bring it up to standards required by the care commision, a lot of it was OTT. The home now takes 16 residents with advanced dementia, new rules and regulations, and the cost of the upgrade have meant our charges have risen considerably.

Due to cuts, the care trusts are no longer able to pay the new charges, and privately funded clients seem a little thin on the ground, so we are not operating at full occupancy, in a home of this size thats the difference between making a small profit or losing money, luckily we are part of a quite large company.

The second financial killer is red tape and regulations, meaning carers spend far to much time filling in pointless forms and, ticking boxes just to satisfy the hoards of inspectors that come round to analyze meaningless data, after which they only offer criticism. This then leads to carers being asked to do the impossible by inexperienced management resulting in total demotivation.

Just to give an example. We were told we needed to do more activities.

Our solution was to do a regular bus ride, this in the depths of winter, meant 5 people, who can't walk, barely talk, and are incontinent, have to be changed, dressed in warm clothing (which was not always the case), put into wheel chairs and loaded onto a minibus, then whizzed round the block for an hour. This is done regardless of the weather,............. but at least they can tick the box.

Yes, I was more or less forced to take a similar group to a ladies dance class some years ago.

[ken_ichikawa]

Can't last. Demographics will kill that off.

Care of zombies is already a 'scandal' and already unaffordable. 15 or 20 years hence when boomers start hitting the age of zombiedom in any kind of numbers, there'll be no question of keeping up this stupid charade.

Sometime between now and then we need a change to allocate resources to those with life, and let it end when there's no quality left nor prospect of recovery. Zombie care is a sop to the conscience of society, not for the benefit of the dying.

15-25 years I think we'll have developed nerve to computer chip interfaces, nerves can already be connected to computers in a rudimentary fashion. Thus when you're old it will be very much like the Matrix. You get plugged into an artificial reality construct with various pipes attached to your body for waste and nutrition. While your body outside this artificial reality wastes away.

[Kurt Barlow]

More people, or better paid people?

Both. Also elderly care is a 24/7 matter whereas childcare is more Mon - Fri 8-6am. I would anticpate the rates for elderly care especially Psychogeriatric are far higher than childcare.

[porca misèria]

15-25 years I think we'll have developed nerve to computer chip interfaces, nerves can already be connected to computers in a rudimentary fashion. Thus when you're old it will be very much like the Matrix. You get plugged into an artificial reality construct with various pipes attached to your body for waste and nutrition. While your body outside this artificial reality wastes away.

You've been reading ... dammit ... was it Iain Banks who gave us that as a bleak ending to a Kafkaesque story?

[Kurt Barlow]

Correct, if as much time was put into care, as is into meetings things would start to improve.

Here is another example of nonsense.

We had a handyman, and, well, he was quite handy really. Fixing things changing light bulbs, decorating ect. The powers that be then decided we needed a Health and safety officer, so said handyman was upgraded.

Away went the ladders and brushes, this was replaced by hours on the computer, writing risk assessments, and printing off silly notices.

During a snowy patch last winter an outside wheelchair ramp was covered in packed ice. A visitor to the home mentioned this to the nurse in charge, who in turn, informed the now, not so very handyman.

He immediately lept into action by printing off a few computer generated signs, complete with silly images of people slipping, and a warning of the dangers of walking on snow and ice.

Very sensible as without the warning and a fall occuring the homes insurerer would probably settle and effectively load the cost onto the next 3 years PLI

Edit - a more sensible option would have been to remove the ice and sprinkle some salt on it.

Edited May 28, 2011 by Kurt Barlow

[ChumpusRex]

Incidentally she said that in her own Med. area such people (with dementia) would be given chemical coshes to make them more docile. She couldn't understand why nobody would prescribe the same here.

This used to be quite common 10-15 years ago in this country. It was common practice for sedatives to be prescribed for people with dementia, especially if they were aggressive or otherwise disruptive (either to be given on a regular basis, or at the discretion of the sister/nurse in charge).

This had received a lot of bad press, after a number of "elderly care" pressure groups started protesting that this type of medication was 'chemical restraints', 'chemical coshes' and other such terms. This prompted a degree of public outcry, particularly among the media, which subsequently put pressure on politicians, which found its way back to the care homes, hospitals and doctors. As a result, carers were advised to find non-medication ways of doing the same: closer staff supervision, etc.

There was a second issue that came to light in the last 10 years, which was the realisation that many of the regularly used sedatives carried fatal side effects in elderly and demented people - causing a small, but definite increase in fatal strokes and heart attacks. As current Western orthodoxy is that life should be preserved as far as possible, the recommendation was that these drugs should not be used in the elderly or demented. Given that there is now clear expert recommendation that these medications should not be used, it would be a very stupid (or very brave) doctor who opts to prescribe them (especially as sudden deaths of elderly people are now particularly closely scrutinised following the Shipman affair).

[Mrs Bear]

This used to be quite common 10-15 years ago in this country. It was common practice for sedatives to be prescribed for people with dementia, especially if they were aggressive or otherwise disruptive (either to be given on a regular basis, or at the discretion of the sister/nurse in charge).

This had received a lot of bad press, after a number of "elderly care" pressure groups started protesting that this type of medication was 'chemical restraints', 'chemical coshes' and other such terms. This prompted a degree of public outcry, particularly among the media, which subsequently put pressure on politicians, which found its way back to the care homes, hospitals and doctors. As a result, carers were advised to find non-medication ways of doing the same: closer staff supervision, etc.

There was a second issue that came to light in the last 10 years, which was the realisation that many of the regularly used sedatives carried fatal side effects in elderly and demented people - causing a small, but definite increase in fatal strokes and heart attacks. As current Western orthodoxy is that life should be preserved as far as possible, the recommendation was that these drugs should not be used in the elderly or demented. Given that there is now clear expert recommendation that these medications should not be used, it would be a very stupid (or very brave) doctor who opts to prescribe them (especially as sudden deaths of elderly people are now particularly closely scrutinised following the Shipman affair).

[/quote

In a good many cases, hastening their end would be a mercy, and I do not say that lightly or flippantly. As for finding 'non-medication' ways of coping with the very difficult demented, I'd like to know what they are. One woman had to be moved from my mother's home not long ago because staff in a specialist dementia home couldn't cope with her.

And how does anyone, either at home or in a care home, cope with what I later learned was called 'a catastrophic reaction' - in my case, 3 separate occasions of someone flying into a truly terrifying and violent rage because he was unable to do some tiny thing he wanted to do? (By that I mean something he literally couldn't do, not something he was being prevented from doing.)

I 'coped' by leaving the house - I was too afraid for my own safety to stay - taking the dog with me in case he injured her, too. Might add that she was equally terrified, cowering behind the sofa. Even Mr B didn't believe how bad it was until he saw for himself another episode a few weeks later.

Quite frankly I am only surprised that there aren't more cases of demented people being murdered by relatives who simply can't cope any longer - and who get no real, constructive help - just a lot of earnest and doubtless well-meant advice from people who haven't got a bloody clue what it can be like.

Edited May 28, 2011 by Mrs Bear

[otters]

Quite frankly I am only surprised that there aren't more cases of demented people being murdered by relatives who simply can't cope any longer - and who get no real, constructive help - just a lot of earnest and doubtless well-meant advice from people who haven't got a bloody clue what it can be like.

I have heard several clients who are bed ridden vegetables, but able to mumble a few words state, they just want to die. Then some patronising social worker comes round to visit and after sitting with them makes stupid, unnecessary, and unworkable recomendations just to justify themselves. Mostly the carers, and nurses where I work are a good bunch, and would be able to do a far better job if they were allowed to get on with it, without busy-bodies frustrating them all the time.

[tim123]

Grauniad

1. This is going to be a growing story in next 10 years as the cost of caring for the old rises exponentially. None of it has been budgeted for and no projections done.

2. Southern Cross is a private enterprise looking after 31,000 residents. The company has been making money for its owners. What happens if it goes bust? Are the "customers " told to try elsewhere? The taxpayer will be handed the bill.

I fail to see any reason why this will cause the taxpayer to receive a bill for anything other than paying for the care of people that it already pays to care for.

The idea that the goverment will HAVE to bail out this company is complete nonsense.

tim

[Mrs Bear]

I have heard several clients who are bed ridden vegetables, but able to mumble a few words state, they just want to die. Then some patronising social worker comes round to visit and after sitting with them makes stupid, unnecessary, and unworkable recomendations just to justify themselves. Mostly the carers, and nurses where I work are a good bunch, and would be able to do a far better job if they were allowed to get on with it, without busy-bodies frustrating them all the time.

One thing I'm glad about in all 3 cases of ours, they were all self-funded so at no point did we have to involve social workers coming to 'assess' in half an hour people they had never once met before.

[The Preacherman]

Southern Cross is yet another story of financial engineering gone wrong.

The big companies moved in, including Southern Cross, buying up small care companies or building new homes. As they grew, private equity firms started to show an interest, among them the US firm Blackstone Capital Partners. Investors, when they look at a home full of older people, see a stream of guaranteed income, most of it from local authorities and underpinned by the 1948 legal requirement to provide care. Since the elderly population is rising, investing in care looked like a one-way bet for long-term profit.

Money can be made by separating the income flows from the actual business of care and packaging them as saleable investment instruments – securitisation. Blackstone took control of Southern Cross in 2004 from another private equity firm, West Private Equity. Significantly, that year it also bought NHP (Nursing Home Properties), whose business included leasing care homes to providers (Southern Cross was its biggest tenant) and turning the resulting rental income into high-yield bonds to be sold to investors.

Blackstone floated Southern Cross on the stock market, selling up in 2007. It also sold NHP to an investment fund, Three Delta, with controversial upward-only rental agreements with Southern Cross. This has left Southern Cross with an annual rent bill of around £240m.

There are no signs that revenue could pick up to match the higher rents. Placements by councils in Southern Cross homes continue to fall – they were down 15% from the previous year – in part due to uncertainty over the provider's financial security and pressure to reduce fees.

When are these charlatans at the banks and private equity companies going to brought to account for the havoc they have wreaked on the UK economy.

[cartimandua51]

Can't last. Demographics will kill that off.

Care of zombies is already a 'scandal' and already unaffordable. 15 or 20 years hence when boomers start hitting the age of zombiedom in any kind of numbers, there'll be no question of keeping up this stupid charade.

Sometime between now and then we need a change to allocate resources to those with life, and let it end when there's no quality left nor prospect of recovery. Zombie care is a sop to the conscience of society, not for the benefit of the dying.

As many posters on HPC are very fond of pointing out, the baby boomer generation has so far managed to get what they want in most things. As an early boomer with a pretty large aquaintance in the age group I only know one person (a devout Catholic) who isn't wholeheartedly in support of being issued with a suicide pill, or otherwise being given the means of ending life when they choose.

A combination of pressure from the boomers, economics and (hopefully) the booting out of the remaining 21 (?) bishops from a reformed House of Lords should get the job done within 15 years I hope.

[StainlessSteelCat]

One way or another we'll end up paying. Either for the carer or the caree.

Caring, in some situations, is a full time job and it's virtually impossible to hold down any other job alongside it. I had a brief taste of it a few years ago when the missus had chemo. Frankly the stress of being up half the night with her, taking phone calls throughout the day from her asking for help as well as trying to do a demanding day job nearly sent me over the edge. The lack of sleep meant I was actually halucinating at some points.

Thankfully, I only had 3 months of this - and a pretty good idea it would get better at the end. I can't imagine what years of providing 24/7 care, under much worse situations, with no obvious end in sight must be like. Carers deserve all of the support we can offer - including the chance to "offload" the person they are looking after for a period of respite or permanently if need be.

Personally, I'm hoping to go quick rather than a long slow decline as there won't be anyone to look after me.

[ingermany]

The costs of elderly care are already outsripping the resources available and it will get worse very rapidly. Governments have hit upon the solution of privatisation as a way of hiding the problem. It allows government to keep at arms length from the difficult realities. The coalition NHS plans should ring alarm bells. Costs are rising rapidly. Resources cannot keep pace. It is at this moment that government wants to hand over financial authority to private consortia of GPs, who will be charged with commissioning medical care from a wide range of sources, including private companies. We have the utterly insane position of massive privatisation of social and health care occuring while banking is being nationlised and run by government at a cost of £100s of billions.

[aa3]

We can't afford to keep millions of people who are no longer functioning alive for years and years. If the families want to pay like £500,000 pounds of their own money to keep a near vegatative relative alive for a number of years.. hey its their money and their choice.

Its getting to the point we'll probably return to a Victorian era like state. If you are a drug addict, old and decrepit, severely disabled, heck even disabled just enough that you can't work, mentally handicapped, diseased, etc.. Thats really too bad but its not our problem.

Most people can barely pay their own monthly bills, let alone their own and three people who are disabled.

[ingermany]

We can't afford to keep millions of people who are no longer functioning alive for years and years.

I would ask you what the alternative is, but I really don't want to hear it.

We don't need mass extermination. We are a wealthy civilized society. People are healthier and able to work well into their 70's. What we need is an honest long term solution, and housing wealth should be part of it. The stored wealth (including housing) of the old should be recycled to provide civilized standards of care for the old and affordable housing for the young. There does need to be a rebalancing of the interests of young and old. Yesterday's paper contained the worrying statistic of the massive rise in abortions for women over 40. The birth rate of our younger generation is unsustainably low because of a perception that they can't afford to reproduce. This is closley linked to housing costs. We can level the playing field in a way that respects human dignity. The impediment to this is the quasi scared status of UK property. It is regarded as the lifetime goal of the UK citizen to own and pass on to one's descendents a semi-detached suburban house. Even if this requires you to spend the latter part of your life eating cold beans and living in fear of winter and the fuel bills. Hence the howls of protest that the spiralling cost of care should be means-tested and paid for partially by liquidation of assets that an old person no longer needs (like family houses). I am sure that there is a solution that will release housing to the younger generation, whilst financing civilised standards of care for the old.

Or alternatively we could just gas them and turn their houses into BTL.

[cashinmattress]

The growing hoard of geriatrics in Britain had better prepare for hard times.

Think you're safe because of some previous governments promises? Think again.

There is no money in the pot. Everything is being 'borrowed' or whatever you want to call it.

Those 'pension' funds you think are going to take care of you? Guess what.

For the most part, they have been blatantly and legally stolen by your fund managers and government, right in front of your eyes.

If their families are not going to be human, or do the right thing and take them in to care themselves, these oldies are going to go for a scorched earth policy before the government raids whatever wealth they have left.

In a very typically British way, the social welfare system has failed again.

Who will get the blame? Oh, everybody but the person looking back at you in the mirror.

And like this guy here says:

We can't afford to keep millions of people who are no longer functioning alive for years and years.

Of course we can't, and we won't.

[stormymonday_2011]

I fail to see any reason why this will cause the taxpayer to receive a bill for anything other than paying for the care of people that it already pays to care for.

The idea that the goverment will HAVE to bail out this company is complete nonsense.

tim

+1

The financial problems at Southern Cross have got sod all to do with demographics, the rising number of elderly or the cost of carers (the vast majority of whom are paid the minimum wage). It had got everything to do with financial gerrymandering that has seen the company trapped paying ever higher rents for property etc. It is just another example of how our rotten financial system is dedicated to transforming all forms of enterprise be they private or public into rent streams. Rather than the money going into innovative treatments for the elderly such as better drugs and equipment (as I know from experience the latter is vital for dealing with those with physical disabilities) it is winding up propping up the commercial property market. If the company goes bust the government should let it fail and make alternative arrangements for those needing care.

Of course, this point has largely been missed by some on here who have simply seen the topic as the perfect opportunity to propound their Nazi solutions for dealing with useless eaters and other untermensch

Edited May 29, 2011 by stormymonday_2011