Long-term care provision in the United Kingdom has been the subject of much debate and analysis over the past decade, yet the issue of how to fund the cost of that care for future generations remains unresolved. Much of the debate has revolved around how the State should address the problem. As a consequence, the general public are unsure as to where their responsibilities and liabilities lie. There is a perceived unfairness around the current system which leaves significant financial responsibility resting with the individual above basic income and asset levels. Insurance plans designed to cater for the cost of care in later life have not been popular. As a result, most insurers have now withdrawn from this market.Investment-based plans have failed to maintain protection levels and have now also been withdrawn from the market. Annuities specially designed to fund care fees and which recognise reduced life expectancy do provide a solution for some, but access to advice at a time of crisis may be difficult. Equity release or lifetime mortgages are popular but are not being used as a way to fund care. The current pensions ‘crisis’ bears many of the same hallmarks as those relating to long-term care planning. As with the Pensions Commission Report, there does not appear to be one single solution to the problems surrounding long-term care. A combination of measures may be more likely to succeed.
Long-term care provision in the United Kingdom has been the subject of much debate and analysis over the past decade, yet the issue of how to fund the cost of that care for future generations remains unresolved. Much of the debate has revolved around how the State should address the problem. As a consequence, the general public are unsure as to where their responsibilities and liabilities lie. There is a perceived unfairness around the current system which leaves significant financial responsibility resting with the individual above basic income and asset levels. Insurance plans designed to cater for the cost of care in later life have not been popular. As a result, most insurers have now withdrawn from this market.Investment-based plans have failed to maintain protection levels and have now also been withdrawn from the market. Annuities specially designed to fund care fees and which recognise reduced life expectancy do provide a solution for some, but access to advice at a time of crisis may be difficult. Equity release or lifetime mortgages are popular but are not being used as a way to fund care. The current pensions ‘crisis’ bears many of the same hallmarks as those relating to long-term care planning. As with the Pensions Commission Report, there does not appear to be one single solution to the problems surrounding long-term care. A combination of measures may be more likely to succeed.
Subject terms:
long term care, older people, pensions, planning, financing;
Working with Older People, 4(1), January 2000, pp.10-13.
Publisher:
Emerald
The Government is reported to have doubts about accepting the major recommendations at the Royal Commission on long term care that all personal care should be provided free. The author suggests how the recommendation could be implemented without costs running out of control.
The Government is reported to have doubts about accepting the major recommendations at the Royal Commission on long term care that all personal care should be provided free. The author suggests how the recommendation could be implemented without costs running out of control.
Subject terms:
long term care, older people, pensions, policy, standards, central government, financing;
The aims of the research were to explore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
The aims of the research were to explore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
Extended abstract:
Author
WRIGHT Fay;
Title
Capital offences: variations in local authority treatment of older home owners entering residential care: a summary of some key research findings.
Publisher
The Nuffield Foundation and Age Concern Institute of Gerontology, King's College London, 2000.
Summary
The aims of the research were toexplore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
Context
Government figures show that since 1951, numbers of old people have increased significantly, there has been a 61% increase in those aged 80-84 and an 81% increase in those aged 85 and over. As very old people are more likely than those who are younger to suffer physical and mental ill health, this has significant public expenditure implications for health and social services as well as for state pensions and other social security benefits. There are also implications for long term care costs. Although relatively few people above retirement age (approx 5%) live permanently in institutional care, over a fifth of those aged 85 or over do so. Unless the proportion of people entering care homes in the last phase of their lives declines, the issue of using a home to meet care home charges will continue to be a significant concern to older people and their relatives in the future.
Method
The study had three phases, (1) a national postal survey of senior finance officers in English and Welsh social service departments (response rate 77%). (2) Structured telephone follow-up interviews with a stratified sample of approximately one in four responding finance officers (28 interviews). (3) Case studies in five English local authority areas. Factors in choosing the five were the level of home ownership amongst older people and the level of deliberate deprivation of assets to avoid care home charges reported in the postal survey. Questionnaires were piloted in one of the case study areas. Each case study included interviews with: SSD staff involved in financial assessments of older home owners seeking care home admission; independent sector care home providers, 9 in the voluntary, and 19 in the for-profit, sector; residents recently admitted to independent sector residential or nursing homes who had previously owned their own homes; and relatives recently involved in disposing of property after an older home owner has been admitted to long term care. The postal survey and the structured interviews were analysed using Statistical Package for the Social Sciences. Data from qualitative interviews was analysed with Ethnograph.
Contents
This ten page booklet is divided into five sections. Section one gives background information on the numbers of older people in care homes, the means test for long term care and the issues surrounding selling a home to meet care home charges. Section two describes the aims and objectives of the research. Section three sets out the methodology and the research process. The fourth section is on the main findings of the study and is divided into eight parts each part dealing with the main findings, which are: variations in local authority community care packages; local variations in assessing financial situations; older home owners failing to obtain needs assessments; variations in obtaining a local authority contract; problems with entering a care home without a local authority contract; local variations in the treatment of a carer remaining in a property; a strained relationship between local authorities and independent sector providers; and a lack of impartial advice for frail older home owners. Section five draws together conclusions from the study. The appendix gives a summary of means-testing for residential and nursing home care, the current arrangements and government proposals for change.
Conclusion
"Most authorities operate ceilings to care packages in the community. In some areas these are very stringent. Older people needing significant support at home but with insufficient income or savings to purchase additional support privately will be pressurised into moving into care homes. Home owners are particularly vulnerable to these pressures as they will usually have to sell their homes and meet care home charges themselves."
15 references
Subject terms:
income, literature reviews, long term care, nursing homes, older people, pensions, care homes;
The Royal Commission on Long-term Care has reviewed systems in several countries to see what can be learned. Reports on how the Commission sees the Australian model as an effective system.
The Royal Commission on Long-term Care has reviewed systems in several countries to see what can be learned. Reports on how the Commission sees the Australian model as an effective system.
Subject terms:
insurance, long term care, models, older people, pensions, social policy, benefits;
Argues that plans to privatise pensions will only benefit a minority of older people. The rest face an increasingly uncertain old age as the state relinquishes its responsibilities for their welfare.
Argues that plans to privatise pensions will only benefit a minority of older people. The rest face an increasingly uncertain old age as the state relinquishes its responsibilities for their welfare.
Subject terms:
long term care, older people, pensions, policy, private sector, central government;
A comprehensive analysis of the major policy challenges created by Europe’s ageing population. It features contributions from the leading researchers in the field and uses cutting-edge scientific approaches to investigate later life from multiple disciplinary perspectives. Chapters cover: economic sustainability in ageing societies; extending working lives; healthy ageing; technological innovation; political citizenship; and the potential of social innovation and active ageing approaches in the area of long-term care for older people. It offers a policy manifesto to ensure that the future of ageing in Europe is transformed into a highly beneficial one for both citizens and societies.
(Edited publisher abstract)
A comprehensive analysis of the major policy challenges created by Europe’s ageing population. It features contributions from the leading researchers in the field and uses cutting-edge scientific approaches to investigate later life from multiple disciplinary perspectives. Chapters cover: economic sustainability in ageing societies; extending working lives; healthy ageing; technological innovation; political citizenship; and the potential of social innovation and active ageing approaches in the area of long-term care for older people. It offers a policy manifesto to ensure that the future of ageing in Europe is transformed into a highly beneficial one for both citizens and societies.
(Edited publisher abstract)
Subject terms:
ageing, social policy, long term care, employment, health, wellbeing, citizenship, pensions, older people;
This report examines the costs and trade-offs of reforming long-term care funding for older people in England, and identifies those who stand to gain and lose from a range of proposed reforms. It sets out findings from existing analyses of potential expansion of eligibility, subject to the current means test, for LA-funded home care for older people; some revenue raising options to fund extra public spending on long-term care for older people; and the likelihood of different ‘triple lock’ outcomes and their effects on state pension uprating and on how much an older person may be required to pay towards their home care. It also reports new analyses of some options for reforming long-term care funding, including: a £72k lifetime cap on care costs; suggestions for a cap on care costs which covers daily living costs in care homes as well as care costs; free personal care as implemented in Scotland; and the Conservative Party manifesto suggestion of including housing wealth in the means test for home care. The findings are based on pension and long-term care simulation models. The research has been carried out by the Care and State Pension Reforms (CASPeR) team, a collaborative project between the Pensions Policy Institute, the University of East Anglia and the London School of Economics.
(Edited publisher abstract)
This report examines the costs and trade-offs of reforming long-term care funding for older people in England, and identifies those who stand to gain and lose from a range of proposed reforms. It sets out findings from existing analyses of potential expansion of eligibility, subject to the current means test, for LA-funded home care for older people; some revenue raising options to fund extra public spending on long-term care for older people; and the likelihood of different ‘triple lock’ outcomes and their effects on state pension uprating and on how much an older person may be required to pay towards their home care. It also reports new analyses of some options for reforming long-term care funding, including: a £72k lifetime cap on care costs; suggestions for a cap on care costs which covers daily living costs in care homes as well as care costs; free personal care as implemented in Scotland; and the Conservative Party manifesto suggestion of including housing wealth in the means test for home care. The findings are based on pension and long-term care simulation models. The research has been carried out by the Care and State Pension Reforms (CASPeR) team, a collaborative project between the Pensions Policy Institute, the University of East Anglia and the London School of Economics.
(Edited publisher abstract)
Subject terms:
long term care, pensions, financing, older people, costs, local authorities, policy, eligibility criteria, adult social care;
EUROPEAN COMMISSION. Directorate-General for Economic and Financial Affairs
Publisher:
European Commission
Publication year:
2015
Pagination:
397
Place of publication:
Brussels
This report sheds light on the economic, budgetary and societal challenges that policy makers in Europe will have to face in the future as a result of the ageing population. Demographic trends mean that the proportion of workers supporting those in retirement will halve from an average of four today, to just two, by 2060.The report’s long-term projections provide an indication of the timing and scale of challenges that can be expected so as to inform European policy makers about the scale and timing of the challenges they must face. The report is structured in two parts. The first one describes the underlying assumptions: the population projection, the labour force projection and the macroeconomic assumptions used. The second part presents the long-term budgetary projections on pensions, health care, long-term care, education and unemployment benefits. Statistical annexes give an overview of the projection results by area and by country.
(Edited publisher abstract)
This report sheds light on the economic, budgetary and societal challenges that policy makers in Europe will have to face in the future as a result of the ageing population. Demographic trends mean that the proportion of workers supporting those in retirement will halve from an average of four today, to just two, by 2060.The report’s long-term projections provide an indication of the timing and scale of challenges that can be expected so as to inform European policy makers about the scale and timing of the challenges they must face. The report is structured in two parts. The first one describes the underlying assumptions: the population projection, the labour force projection and the macroeconomic assumptions used. The second part presents the long-term budgetary projections on pensions, health care, long-term care, education and unemployment benefits. Statistical annexes give an overview of the projection results by area and by country.
(Edited publisher abstract)
Subject terms:
ageing, demographics, older people, health care, long term care, financing, resource allocation, pensions, education, jobseekers allowance;
International Journal of Social Welfare, 9(4), October 2000, pp.270-284.
Publisher:
Wiley
This article argues that intergenerational tensions in the United States reflect a strategy for serving the aged that stresses the underlying values of individualism and self reliance. Using National survey data the article examines the extent to which Americans' view of public responsibility for the aged has shifted between the mid-1980s and late-1990s, a period characterized by the intensification of "generational" politics, as well as a growing hostility toward "big government". The results suggest that growing distrust of government and reluctance to help the poor has indirectly fuelled opposition to public spending on the older population.
This article argues that intergenerational tensions in the United States reflect a strategy for serving the aged that stresses the underlying values of individualism and self reliance. Using National survey data the article examines the extent to which Americans' view of public responsibility for the aged has shifted between the mid-1980s and late-1990s, a period characterized by the intensification of "generational" politics, as well as a growing hostility toward "big government". The results suggest that growing distrust of government and reluctance to help the poor has indirectly fuelled opposition to public spending on the older population.
Subject terms:
long term care, older people, pensions, private sector, public sector, social policy, social welfare, welfare state, ageing, attitudes;
Social Policy and Administration, 33(5), December 1999, pp.534-551.
Publisher:
Wiley
Against the background of a recent resounding rejection of substantial increases in user contributions for funding long-term residential care in Australia, and especially of measures that could require realisation of housing assets. This article examines the scope for extending to long-term care the "pillars" approach to financing of retirement incomes and health care.
Against the background of a recent resounding rejection of substantial increases in user contributions for funding long-term residential care in Australia, and especially of measures that could require realisation of housing assets. This article examines the scope for extending to long-term care the "pillars" approach to financing of retirement incomes and health care.
Subject terms:
income, insurance, long term care, older people, pensions, social policy, financing, health care;