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Two events in my life have given me insight into the workings and the inbuilt problems of elderly care. Not all of this can be blamed on the state, not that it excuses what is in many ways the abandonment of elderly people to their own devices.
The first goes back many years to the late seventies/early eighties when I first started out in building my landscaping business. In the beginning my objective was to be a garden designer and builder It was difficult to get the amount of work needed to put bread on the table when starting from scratch so I entered the world of maintenance as a back up to finances. It was commercial maintenance as that part involved twelve-month contracts and was based on job and finish which is a better system than hourly rates. It served me well for many years until I could slowly drop that side for landscaping and redeploy my staff seamlessly into the other side of the business.
One of my contracts was a nine-home trust of mixed-care residential and nursing homes. Unlike “granny farms” that are for-profit organisations, this was a trust with many working for free and donated properties and bursaries supporting it. It survived well until the properties needed refurbishment and several were listed, making upgrading a costly exercise outside the scope of their means, and it was sold.
I would visit the sites and got to know staff and even patients. As with all things not all was wonderful but in the main the organisation ran well and the majority of the staff at all levels were very good, but one incident remains with me to this day, an incident that is almost a blue print for the thinking of so many today when parents become old. Whilst waiting to see one of the staff a lady came into the hallway area who looked out of place in this home. She came over and said hello and started to talk. She had not been a resident long and obviously did not like being there. Her story is a familiar one: her husband had died earlier and her house was “wanted” by her children, and somehow they had convinced a lady who was quite capable of looking after herself that the house was too big and a care home was a better option; better for whom is all too obvious.
About six months later on another visit I saw and spoke to her again. She was distressed and had had a heart attack and though recovering, was alone and frightened. Other than spend a little time with her what could I do? Her children had made only nominal visits ! At a further visit at the end of the year I discovered the lady had died. a staff member I knew told me it was as much a broken heart as anything else.
What that showed was a prevailing attitude in many families that old people having passed their “use” date should be shunted off somewhere that means conscience won't be pricked and assets can be stripped with impunity. Families, don’t you love ‘em.
My second prod towards writing this is the current situation with an aunt, the last of her generation who at 95 has had a fall and the inevitable hip replacement. She lives alone - her husband died many years ago - and is fiercely independent. She had a very good job in publishing and is not without some means, so as she is not capable of looking after herself the spectre has risen of “accommodation." Her reply is she would rather die than tolerate that; the vision of communal bingo is simply not on her radar.
The problem there is that the home help that she has to have is expensive and she gets no help with that, nor will she if forced into a home. All that she accepts, yet of course she paid very large sums of tax when employed. I am not going into any other areas with my aunt's case as it is private but it explains a situation that affects many.
JD put it quite well with his “granny farm” tale of a man returning to the UK to set one up purely from a business point of view. The problem is not going away and after all those who have something left at the end of their lives have ever increasing amounts taken from them, you have to ask where will it all end.
Many years ago this country had philanthropy as part of its make up and mutuals thrived along with building societies, trusts etc; all now gone or disappearing. The avenues to create other ways to look after elderly people are narrowing to a model very few like the look of, and that's from the outside looking in.
Recent governments put the idea of immigrants as a part solution, a younger working sector paying taxes for the less fortunate in years. Except of course the immigrants from the third world are largely non tax-paying and themselves recipients of welfare and in their case have never paid into the system, plus a larger percentage demographically don’t work at all. All this is paid for by an ever smaller tax-paying percentage of the population, as are most taxes like council tax which makes successive claims seem rather like pushing a very large Ponzi scheme onto the general population.
Eventually as with all these "kick the can down the road" schemes they will have their day at everyone else's expense. I pray I am not around to be part of it, as it seems (as my football club manager says) “there is no plan B”. The other big change that impacts on the same problem is family: we have changed dramatically as a society since the Second World War. Before then it was almost a given that granny would be cared for by the family, but not any more; hence the “granny farm”.
The “family” still has a big role in the likes of Italian and other Med countries where all live together, maybe not as guaranteed as in the past but it still exists; yet here of all places it exists among many immigrant groups and is still a major part, as it was when I was a kid growing up in a Jewish neighborhood where there was no hesitation about accommodating elderly relatives, they just did it.
So what is the answer? At this juncture there simply isn’t one: there are ever more elderly people and fewer places to accommodate and less choice if any; and poorer care seems the way forward, at ever more cost for less. It is a problem that has been building for decades, yet not one political party has made any attempt to plan for the future. As with most things regarding the welfare state and especially the NHS in all its forms, it would seem untouchable for fear of losing votes, which says all you need to know about the current state of politics in this country - shown to be ongoing, as the current election has already given us claims that can only said to be mendacious at best.
