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How will government defuse the demographic time bomb?
- Author:
- GOULD Mark
- Journal article citation:
- Health Service Journal, 22.11.07, 2007, pp.14-15.
- Publisher:
- Emap Healthcare
With an ageing population, how can the government fund a system of long-term care for the elderly? This article looks at the dilemma and possible solutions in light of next years planned government consultation and green paper.
Rowntree's retirement villages
- Author:
- STURGE Michael
- Journal article citation:
- Journal of Care Services Management, 1(4), July 2007, pp.341-352.
- Publisher:
- Taylor and Francis
This article describes the Joseph Rowntree Housing Trust's retirement village in York and its proposed village in Hartlepool. It contrasts the financial terms of the two developments. The benefit of these schemes for older people is discussed, along with the challenges that they face.
Financing long-term care for older people in England
- Authors:
- WITTENBERG Raphael, MALLEY Juliette
- Journal article citation:
- Ageing Horizons, 6, 2007, Online only
- Publisher:
- Oxford Institute of Ageing
- Place of publication:
- Oxford
During a decade of debate on how best to fund long-term care, British analysts have focused more on policy developments in other countries than ever before. Discussing criteria for appraising options, the paper argues that the objectives of the financing system must be considered in the light of the objectives for the long-term care system as a whole. The types of funding mechanisms discussed are private insurance, including private/public partnerships, tax-funded and social insurance models. The differences between tax-funded and social insurance models are discussed. Social insurance with hypothecation of funds is no longer part of the current debate, which now focuses on the three types of options whose properties are described in the paper: free personal care (adopted in Scotland), the retention of means-tested arrangements in some form, and a partnership model as recommended in the Wanless report. The paper agrees with the Wanless report that all three have strengths and weaknesses. Decision-makers have a window of opportunity to make reforms before the baby-boomers reach late old age.
Securing good care for older people: taking a long-term view
- Author:
- DAVIES Bleddyn
- Journal article citation:
- Ageing Horizons, 6, 2007, Online only
- Publisher:
- Oxford Institute of Ageing
- Place of publication:
- Oxford
The paper aims to explain and evaluate two key features of Securing Good Care for Older People, the Wanless Report on alternative mechanisms for funding long-term care of older people. The first is the new elements of the methodology for evaluating the alternatives. The paper argues that more successfully than previously and analyses in other countries, these elements focus attention on what are really the core issues: the means and ends which are the unique foci of long-term care, and estimates of the consequences of alternatives for them. By doing so, the report faces the politicians and policy analysis and research communities with a formidable challenge, to master and contribute to the development of the new framework and evidence. Failure to meet the challenge will increases the risk that the policy system will reinforce rather than weaken causes of gross inequity and inefficiency caused by the under-funding of long-term care seemingly unanswerably demonstrated by the report. The second key feature is the type of funding model the Report recommends given expected changes in the balance between demands and public expenditure. It is argued that the report’s analysis as successfully transforms the state of the argument about this as much as about the framework, methodology and evidence for evaluating alternatives, demonstrating the relative weakness of models widely advocated a decade ago. Part 2 discusses how to build on the Report. It discusses the framing of issues and the analysis of evidence for each of the key foci of the report’s main contribution to evaluation methodology. Finally the paper discusses whether the recommended model would be the wisest choice given the environment likely during the next few decades.
Public spending levels for social care of older people: why we must call in the debt
- Author:
- DAVIES Bleddyn
- Journal article citation:
- Policy and Politics, 35(4), October 2007, pp.719-726.
- Publisher:
- Policy Press
The author debates the funding of social care for older people.
A fair contract with older people?: a special study of people’s experiences when finding a care home
- Author:
- COMMISSION FOR SOCIAL CARE INSPECTION
- Publisher:
- Commission for Social Care Inspection
- Publication year:
- 2007
- Pagination:
- 96p.
- Place of publication:
- London
Whilst care homes are improving the information they give to prospective residents, advertised fees for places in the same care home can vary hugely, sometimes from £650 to £1,500 a week, without a clear explanation of why some people pay more than others and what their money will buy. The report also showed that sometimes people paying for their own care can subsidise those people paid for by the local council, where councils negotiate lower rates. In areas without enough care services to meet demand, even those people moving into care homes who are funded by the council can be asked to pay ‘top-up’ fees to cover higher charges – as many as 75% of homes in some areas required a ‘top-up’.
The pressure's on
- Author:
- FORDER Julien
- Journal article citation:
- Community Care, 8.2.07, 2007, pp.30-31.
- Publisher:
- Reed Business Information
With a rapidly ageing population and a growing number of people with disabilities services are coming under more pressure. The author examines the evidence, including the Wanless review, for more money from the comprehensive spending review for older people’s services.
Distributional effects of reform in long-term care
- Author:
- KARLSSON Martin
- Journal article citation:
- Ageing Horizons, 6, 2007, Online only
- Publisher:
- Oxford Institute of Ageing
- Place of publication:
- Oxford
Population ageing will intensify the distributional dilemmas related to provision and funding of long-term care (LTC) services. Several OECD countries have recently reformed their LTC systems, but as yet there is a paucity of evidence on how different reform options affect the financial position of different socioeconomic groups. Another neglected issue is how individuals adapt to changes as a result of LTC policy reform. One complication in the analysis of LTC reform is the great uncertainty in projections. This is largely due to the long planning horizon needed, and also the nature of LTC services themselves. The aim of this paper is to review two recent contributions to the literature: Hancock et al. (2006) and Karlsson et al. (2007). Particular emphasis is placed on the policy implications of these findings, but key issues for future research are also identified.
Looking ahead: paying for long term care
- Author:
- BELL Mark
- Publisher:
- CentreForum
- Publication year:
- 2007
- Pagination:
- 35p.
- Place of publication:
- London
There is widespread concern about how to fund long term care services for the elderly. The current system is thought to be unfair, complicated, and punitive towards those who save Looking ahead' assesses the existing system and the main options for reform against the principles of equity, efficiency, and sustainability. It argues that a partnership arrangement offers the best solution - whereby the state provides a certain level of care and encourages individuals to make contributions above that level. It offers two ways in which this could be implemented: a revenue neutral option which would substantially improve the current system without increasing government expenditure, and a more comprehensive, but costly alternative.
Time use and costs of institutionalised elderly persons with or without dementia: results from the Nordanstig cohort in the Kungsholmen Project - a population based study in Sweden
- Authors:
- NORDBERG Gunilla, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(7), July 2007, pp.639-648.
- Publisher:
- Wiley
The aging of the population has become a worldwide phenomenon. This leads to increased demand for services and with limited resources it is important to find a way to estimate how resources can be match to those with greatest need. This study aimed to analyse time use and costs in institutional care in relation to different levels of cognitive and functional capacity for elderly persons. The population consisted of all institutionalised inhabitants, 75 + years, living in a rural community (n = 176). They were clinically examined by physicians and interviewed by nurses. Staff and informal care-giving time was examined with the RUD (Resource Utilization in Dementia) instrument. Tobit regression analyses showed that having dementia increased the amount of ADL care time with 0.9 h when compared to those not having dementia, whereas each loss of an ADL function (0-6) added 0.6 h of ADL care time. Analysing the total care time use, the presence of dementia added more than 9 h, while each loss of one ADL function added 2.9 h. There were some informal care contributions, however with no correlation to severity in dependency. The estimated cost for institutional care increased with more than 85% for people being dependent in 5-6 ADL activities compared to persons with no functional dependency, and with 30% for persons with dementia compared to the non-demented. There is a variation in time use in institutional settings due to differences in ADL dependency but also whether dementia is present or not. This variation has implications for costs of institutional care.