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Impending Crisis In Care For The Elderly

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I'd really like to know people's thoughts on how we solve the impending crisis of:

  • Growing number of elderly which will require care
  • Falling number of people working in care industry
  • Working age population not growing as fast, so tax revenue not keeping up.
  • Falling supply of care homes as smaller providers leave the market

This is a wicked problem...

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Just stop conflating the healthy elderly (have a life, but might need weekly or so help with some tasks) with the undead who can't get out of bed or feed themselves without help and will never improve.

Helping the former is cheap, and the main risk is that of bad carers. "Helping" the latter is cruel.

What, I hear you say there are intermediates? Indeed. Self-contained but warden-assisted retirement flats work well enough if you want help always available on standby without the expense of employing your full-time Jeeves.

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Spend a higher % of output on care obviously.

Average time spent in care homes is iirc somewhere between 1 & 2 years depending on age/sex. It's not long, but the outliers can be very long (20+ yrs). So costs need to be socialised/insured. It is longer for women than men and many men die within 3 months of residence sadly.

Most of the cost of elderly care goes to care home landlords. So keeping elderly in their own home as long as poss is desirable for all sorts of reasons. But build more social care homes. Same argument as for not handing social rents over to private rentier landlords.

Personally I suspect this will turn out not to be the "crisis" it is being made out to be as it also creates demand in the economy which is a +ve.

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I'd really like to know people's thoughts on how we solve the impending crisis of:

  • Growing number of elderly which will require care
  • Falling number of people working in care industry
  • Working age population not growing as fast, so tax revenue not keeping up.
  • Falling supply of care homes as smaller providers leave the market

This is a wicked problem...

Make the systems work to enable the elderly to live at home for longer, make it easier for families who want to, care and support their elderly relatives. Have a pool of trained and vetted individuals in the local community that can visit those close by that require help such as washing, dressing and help with meals...plus cleaners and gardeners, pay them a fair wage for the work they do.....organise and supply restbite for carers, someone to sit in whilst they can get out of the house once a week for a break or a week away......organise lunch and social clubs and transport, very many already do this on a voluntary basis.

Back to old style basics.......make working at home as valued as work outside the home....be it looking after young children or elderly people. ;)

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There is already a crisis.

What should IMO be done (but it never will be) is to stop 'striving to keep alive' so many very old people with a very poor quality of life whose time has come, if only they were allowed to go.

Only the other day I heard of a man in his 90s, poor physical health plus advanced dementia, who collapsed and stopped breathing. Family called ambulance, resusc. and oxygen given, taken to hospital, stayed there a couple of weeks, came home in a considerably worse state than before.

Family just couldn't let him go, and I think this happens a lot. It is very difficult for medics to let Nature take its course if the family are bent on keeping someone alive no matter how pitiful the state they're in. It lays them open to accusations of callousness and mere desire to save NHS money, when in fact it can often be the kinder option.

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Depends what you call elderly, for instance:

"According to the study, 48 percent of women under age 55 reported reaching orgasm almost or always. The second highest percentage of women to report the same was in the over 80 age group with 42 percent reporting the ability to achieve orgasm".

http://blog.chron.com/momhouston/2012/01/women-over-age-80-report-satisfying-sex-lives-but-may-not-be-having-sex/

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There is already a crisis.

What should IMO be done (but it never will be) is to stop 'striving to keep alive' so many very old people with a very poor quality of life whose time has come, if only they were allowed to go.

Only the other day I heard of a man in his 90s, poor physical health plus advanced dementia, who collapsed and stopped breathing. Family called ambulance, resusc. and oxygen given, taken to hospital, stayed there a couple of weeks, came home in a considerably worse state than before.

Family just couldn't let him go, and I think this happens a lot. It is very difficult for medics to let Nature take its course if the family are bent on keeping someone alive no matter how pitiful the state they're in. It lays them open to accusations of callousness and mere desire to save NHS money, when in fact it can often be the kinder option.

.

Hate to be cynical but I wonder if he had a final salary pension? My father died last year at 85 (retired at 60) and he had over £3000 pcm coming in after tax and owned his bungalow. He was quite frail for the last few years and my brother gave up work to care for him as the 1/2 of the care home fees he would have paid were worth more to him his income (I am sure there some sincere concern too!)

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Keep it in the family. ;)

Quite, another consequence of two wage families servicing mortgage debt.

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Spend a higher % of output on care obviously.

Average time spent in care homes is iirc somewhere between 1 & 2 years depending on age/sex. It's not long, but the outliers can be very long (20+ yrs). So costs need to be socialised/insured. It is longer for women than men and many men die within 3 months of residence sadly.

.

My mother has been in hers well over 7 years. She is coming up to 97 and is in a most pitiful state with advanced dementia. We would not allow any 'striving to keep alive' but the question has never arisen. Despite appearances she is tough as old boots - just goes on and on and on. It is so cruel.

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My mother has been in hers well over 7 years. She is coming up to 97 and is in a most pitiful state with advanced dementia. We would not allow any 'striving to keep alive' but the question has never arisen. Despite appearances she is tough as old boots - just goes on and on and on. It is so cruel.

Well, it keeps a bunch of staff in work, and unavailable to offer caring services to those old folks capable of benefiting from it.

[edit] Sorry, that sounds horribly unsympathetic to you and to the relic of your mother. My wrath is directed at the system. You - its victims - have my sympathy.

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Spend a higher % of output on care obviously.

Average time spent in care homes is iirc somewhere between 1 & 2 years depending on age/sex. It's not long, but the outliers can be very long (20+ yrs). So costs need to be socialised/insured. It is longer for women than men and many men die within 3 months of residence sadly.

Most of the cost of elderly care goes to care home landlords. So keeping elderly in their own home as long as poss is desirable for all sorts of reasons. But build more social care homes. Same argument as for not handing social rents over to private rentier landlords.

Personally I suspect this will turn out not to be the "crisis" it is being made out to be as it also creates demand in the economy which is a +ve.

I always felt a bit sorry for the men in my grans care home. It seems the minds of the women go and the bodies of the men. The few men that were in there seemed as sharp as a knife...surrounded by senile old ladies.

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It's possible that the crisis may be averted by older people becoming healthier. Changes in diet have meant that heart disease levels have fallen off a cliff and similarly better diets and more exercise in the older population will probably have some effect in reducing dementia levels. Heart problems and dementia is now linked.

We used to take it for granted that middle aged men just dropped dead in the past, that has just stopped happening. Perhaps the same will be true of dementia cases going forward.

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Carers should be paid more, irrespective of any other aspects.

It's funny how everyone accepts we need to save for our pensions, but (although we get frequent warnings about the costs) no one seems to think worry much about care.

1. Import cheap carers from 3rd world. Superficially attractive, as they are cheap and hard working and usually more sympathetic than locals. Only a short term fix, as it would have to be indefinitely maintained with ever increasing numbers of immigrants. The immigrants themsleves get old and have children that get old, let alone the fact that they are entitled to bring all their aged relatives with them thanks to family regroupment.

2. Mass socialised care. A NHS for the elderly. Will probably be just as expensive as the actual NHS. But no particular reason why we can't afford it, we just have to spend less on holidays and haircuts and cheap tat.

3. Care in the family. Does anyone actually live near their family these days? Would require the whole economy to be decentralised and dispersed to the communities so people can go back to living in villages. Lovely idea, maybe just possible with teleworking etc, but people have been saying that for the last 30 years.

4. Outsourcing abroad. Have seen a couple of doc/reportage things on this. I'd be happy with Thailand, but not really practical for most people.

5. Euthenasia in Switzerland. We have talked about it in my family, after the experience of the NHS, but hard to say if we'd have the courage when it comes to the crunch.

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I always felt a bit sorry for the men in my grans care home. It seems the minds of the women go and the bodies of the men. The few men that were in there seemed as sharp as a knife...surrounded by senile old ladies.

Did you meet any of the women before 'their minds went' ? ;)

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I always felt a bit sorry for the men in my grans care home. It seems the minds of the women go and the bodies of the men. The few men that were in there seemed as sharp as a knife...surrounded by senile old ladies.

My gran was unfortunate enough to have her body wear our. She could no longer tend the garden she loved. She was mentally fit until the end. I can not think of a more horrific way to end up.

My other gran had always been as crazy as batsheet and ended up with dementia.

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Outsourcing abroad is one that is deserving of strong consideration IMO.

Somewhere warm and dry to ease aches, with cheap land and labour costs. Big retirement homes in (say) Spain with progression through to additional care as your condition worsens.

Funded by the taxpayer on the same basis as here.

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2. Mass socialised care. A NHS for the elderly. Will probably be just as expensive as the actual NHS. But no particular reason why we can't afford it, we just have to spend less on holidays and haircuts and cheap tat housing.

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