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Navigating the long road to long-term care funding reform
- Author:
- LLOYD James
- Journal article citation:
- Quality in Ageing and Older Adults, 11(4), December 2010, pp.36-39.
- Publisher:
- Emerald
Reform of the funding for long-term care is a challenging undertaking. However, debate on care funding reform has evolved steadily over the last five years. New thinking has explored the role of ‘matching contributions’ and ‘cohort insurance’. However, despite the emergence of a government green paper and a white paper, and significant resources expended inside and outside government, both consensus and the starting point for reform have proved elusive. This article, put in the context of a declining ‘elderly support ratio’ and the UK confronting a period of extended financial austerity, asks what are the key questions confronting policy-makers. It suggests that policy debate must be non-partisan and consensus based, and the role of informal carers needs to be clarified, and put at the heart of any new settlement. Finally, policy-makers must recognise the difficulties associated with financial restraints and rising demand, yet set out a path for reform that has all the characteristics of an ideal system.
Options for funding longterm care: the partnership model compared
- Authors:
- HUMPHRIES Richard, FORDER Julien
- Journal article citation:
- Quality in Ageing and Older Adults, 11(4), December 2010, pp.30-35.
- Publisher:
- Emerald
In this article, the authors examine options for the reform of adult social care funding. However, universal agreement on the need for a new system has not been matched by political consensus on how this could be achieved. The article summarises the costs and outcomes of some of the principal options for reform - including a revised version of The King's Fund partnership model and the policy of free personal care - and how these compare with the existing means-tested system if left unreformed. The authors suggest that these and other models are not mutually exclusive, and the selection of which options to pursue will involve balancing of political, economic and administrative criteria. The authors conclude that a revised version of the original partnership model offers the best outcomes in relation to costs, and one that can be blended with other funding options to reflect the changing nature of trade-offs between costs, affordability and simplicity.
Private route to funding care
- Author:
- SAMUEL Mithran
- Journal article citation:
- Community Care, 18.11.10, 2010, p.26.
- Publisher:
- Reed Business Information
The author talks to Chris Horlick, Managing Director of one of the UK's leading providers of long term care insurance produces. Chris Horlick explains why he believes that private insurance is likely to figure in any reform of long-term care funding.
Aging without agency: theorizing the fourth age
- Authors:
- GILLEARD Chris, HIGGS P.
- Journal article citation:
- Aging and Mental Health, 14(2), March 2010, pp.121-128.
- Publisher:
- Taylor and Francis
This article looks at the ‘fourth age’ as a manifestation of the fragmentation of old age, attempting to give it a more cogent status within gerontology. It argues that the fourth age emerges from the institutionalisation of the infirmities of old age set against the appearance of a third-age culture that negates past representations of old age. The historical marginalisation of old age is outlined from early modern society to the contemporary concentration of infirmity within long-term care which makes of old age an undesirable social imaginary. As old age fades from the social world, the article likens this to the impact of a social or cultural ‘black hole’ distorting the gravitational field surrounding it, unobservable except for its traces. At this stage, choice, autonomy, self-expression, and pleasure collapse into a silent negativity. Within this perspective, the fourth age can be understood by examining not the experience itself but its impact on the discourses that surround and orientate themselves to it.
The impact of devolution: long-term care provision in the UK
- Author:
- BELL David
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 41p., bibliog.
- Place of publication:
- York
This report on long-term care provision policies, from a series on the impact of 10 years devolved government in the United Kingdom, considers the constraint that tax and benefit structure (control of which remains centrally within the Departmental Expenditure Limits (DEL) system), has on Scotland, Northern Ireland, Wales and England. The importance of having secondary social care, funded from Annually Managed Expenditure by the Department for Work and Pensions (DWP) and less bound to annual budgets than DEL, in minimising diversity of delivered care is discussed. The inability of devolved governments to steer DWP, due to weak intergovernmental relations, is highlighted and in section 2 Scottish attendance allowances and Welsh domiciliary care charges are contrasted. Section 3 details demand for care varies more within countries than between them, while section 4 highlights divergence in older people’s ability to pay. A current snapshot of care provision across the UK in section 5, is followed by a focus on free personal care, personalisation and charging in Section 6. Section 7 reiterates that policies can be constrained as well as enhanced by devolution. Other reports, in this series, detail area based regeneration, indicators of poverty and social exclusion, employment and employability and housing and homelessness.
Black and minority ethnic elderly: perspectives on long-term care
- Author:
- PATEL Nina
- Publisher:
- Policy Research Institute on Ageing and Ethnicity
- Publication year:
- 2010
- Pagination:
- 48p.
- Place of publication:
- Bolton
Based on a series of seminars held in Leeds, London and Edinburgh in 1998, this paper presents the perspectives of black and minority ethnic elders, carers and managers of minority ethnic elders' organisations about long-term care for the elderly. The paper introduces the general context of care for black and minority ethnic older people, including an overview of demographic, socio-economic and health aspects. It considers the views and experiences of the seminar delegates and makes recommendations for the Royal Commission on Long-Term Care for the Elderly. The recommendations cover appropriateness of current models of care, accessing services, planning and paying for long-term care, reducing dependency and alternative models of care, and the future model of care.
Paying for long term care in England
- Authors:
- COUNSEL AND CARE, SOCIETY OF LTER LIFE ADVISERS, AGE UK
- Publisher:
- Counsel and Care
- Publication year:
- 2010
- Pagination:
- 5p.
- Place of publication:
- London
This briefing paper has been produced by the Putting People First Consortium in conjunction with Solla, Age UK and Council and Care to help people make better and more informed decisions about paying for long term care in England. It explains useful organisations to contact if you need care and support, where to go to for information about how care is funded and what else you need to consider, and things to consider when getting independent financial advice.
Long-term care in the United States: policy themes and promising practices
- Authors:
- LEHNING Amanda J., AUSTIN Michael J.
- Journal article citation:
- Journal of Gerontological Social Work, 53(1), January 2010, pp.43-63.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This overview of the federal, state and local level policies and practices for long term care of older people in the United States emerging in recent years details the themes that have dominated this field. These include, recruiting and retaining a qualified long term care workforce, devising financing mechanisms for those requiring long term care and evolving away from an institutional-based long term care system to more home and community based social care provision. The authors highlight in particular three promising practices which have evolved in the past few decades. Firstly, the culture change movement, which began in nursing homes, which is now influencing community based long term care. Secondly, service integration involving medical and social care which has improved service delivery overall. Thirdly, the various forms of community residential care which have brought together services and housing in a more home-like environment and improved user outcomes. The authors conclude by detailing recommendations for their twin goal future for long term care, how to improve the health and well-being of individuals of all ages to reduce the need for long term care of older people, along with providing accessible and appropriate long term care to those who do require assistance due to physical, psychological and cognitive impairment.
The Commission on Long-Term Care Funding Options: a roundtable summary
- Author:
- SOCIAL MARKET FOUNDATION
- Publisher:
- Social Market Foundation
- Publication year:
- 2010
- Pagination:
- 8p.
- Place of publication:
- London
Reforming the system for funding older people's long-term care is arguably one of the biggest public policy challenges confronting the UK. The problems within the current social care system include geographical variations in entitlement, and limited availability of advice and support. Following the 2010 general election, the new Coalition Government announced in its Programme for Government document that it would establish a commission on long-term care, to report within a year, to examine options for funding reform. In response to this announcement, the Social Market Foundation convened an expert roundtable on July 12th, 2010 in order to draw lessons for the new body from previous commissions on both long-term funding and other policy challenges. This briefing summarises the discussion at the roundtable, which included members of the Royal Commission on Long-term Care, the Wanless Review of Social Care and the Pensions Commission. It provides advice relating to: the timescale, size and independence of the commission; engagement of stakeholders and the public; the production of an interim report; and political feasibility. It also outlines some issues that the Commission should address.
360 degrees of care
- Author:
- BEGLEY Pat
- Journal article citation:
- Quality in Ageing and Older Adults, 11(4), December 2010, pp.47-50.
- Publisher:
- Emerald
Research has demonstrated the benefits of telecare. It helps those with long-term needs live more independent lives, improves well-being, and enhances the quality of life. Yet little attention has been focused on the impact of telecare on unpaid carers who look after relatives with long-term care needs. This article examines the evidence from “A Weight Off My Mind: exploring the impact and potential benefits of telecare for unpaid carers”, and the ways in which telecare has impacted on carers, and how it has improved their quality of life. The potential benefit for carers were identified as: reducing pressure on carers; supporting carers in their supporting role; enabling carers to get a better night’s sleep; and giving carers peace of mind about the safety and well-being of the person being cared for. Telecare has also been instrumental in enabling carers to remain in paid employment, thereby maintaining family stability. Finally, telecare also had a positive impact on the relationship with the person they cared for, enabling both to preserve greater independence.