The Guardian view on elderly care: a frail helping hand

http://www.theguardian.com/commentisfree/2015/apr/12/guardian-view-elderly-care-frail-helping-hand

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Last week a centenarian set a record with a 1,500m freestyle swim, and the world’s oldest woman, who put her longevity down to plenty of moisturiser and “treat[ing] everyone nice”, died at 116. Such stories breathe, well, life into the life expectancy statistics.

But not everyone can expect to be swimming laps in their eleventh decade. With longer lives come greater needs: growing numbers of people requiring care. Together with another deep tide of social change, rising female employment, this leaves families increasingly reliant on professional carers. So demand for care is growing remorselessly, and yet the quality often falls short. The work is generally low-paid, poorly supported and emotionally tough: many people would struggle to do it for their own parents. Hardly conducive to compassion and dignity, 15-minute care slots are just one symptom of a system that has at its heart a checklist of physical tasks, rather than the nurturing of meaningful relationships. Can we really wonder at the intermittent stories of neglect and abuse it seems to produce?

The care of older people has been far from centre-stage in this election. Perhaps little wonder: just 6% of voters say care is an issue that will decide their vote. Celebrating centenarian success stories is much easier than turning minds to what will happen when loved ones need care. The coalition did introduce significant reforms to care funding in the last parliament. Its cap on care costs has an appealing ring: hit the limit, and the state will step in. But significant costs like accommodation are excluded. As local-government funding continues to shrink and the pressure on care budgets continues, what’s covered by the cap will also surely diminish. The danger is that the cap turns out to be little more than a distraction from the honest debate about how we pay for good care, whether through taxation, compulsory insurance or private contributions.

Lack of funding is a symptom of deeper issues at stake. We have not figured out how to outsource at scale the caring that used to be done by families in a way that doesn’t undermine the fundamentally human endeavour of protecting quality of life. Professional caring is seen as low-status work, concerned with keeping older people physically safe rather than enabling them to live fulfilling lives.

Both parties are yet to develop an agenda that speaks to this. In government the Conservatives have focused on introducing the most basic of minimum standards for the profession and reforming the inspection regime. But can love and compassion really be regulated into the system? Labour’s approach has focused on integration of health and care; a useful debate, but one that easily teeters into technocracy. Besides, the motivating force behind these integration plans is on improving the quality of healthcare, rather than social care.

The politics of care reform are thorny and the electoral rewards for taking it on are nonexistent. So maybe the proper debate about how to ensure all elderly people receive quality care can continue to be postponed. But if so, the problem will only get bigger.