Dementia care support vs. Local authority care & accommodation strategy: its all about perception!

Dementia has become a media buzzword over the last decade as the appreciation for the difficulties those who suffer with the disease has become more prominent and the understanding has increased. Many local authorities have continually identified the need for increases and improvements in the care of those with Dementia and related illnesses. Yet the real course of action is the polar opposite of this analysis. With ever decreasing care funding and the hands off approach to social care offered from Central Government officials, with the obvious downgrading of Social Care as a concern (with the greatest respect) by recent cabinet changes since Brexit – it all seems to be media lip service to a genuine social and community issue we are facing right here right now!

Multiple national campaigns are out there from sources such as Alzheimer’s Society and Dementia Friends as a subsidiary, focusing on some of the main points:

The bottom line

·       Dementia is a major global health problem; in the absence of a cure there is increasing focus on risk reduction, timely diagnosis, and early intervention

·       Primary and secondary care doctors play complementary roles in dementia diagnosis; differential diagnoses include cognitive impairment due to normal ageing and depression

·       Cost effective drug and non-drug interventions such as cognitive stimulation therapy exist that help to delay cognitive deterioration and improve quality of life; information provision and practical support are also important

·       Discussions about a person’s wishes for future care should occur at an early stage of illness while the person has mental capacity

·       Family carers of people with dementia are at high risk of physical and mental illness as a consequence of caring and they require equal attention and support

With all this in mind and the wide understanding of Dementia as growing concern in that is in the public minds the 2 issues to do have a clear synergy. The truth is that the private sector and specifically residential environments such as Care Homes and Extra Care facilities will be the ones that will and are being innovative to ensure a positive reaction to the ever growing elderly population.

Society will need to embrace the private care sector fully because there is simply not enough focus on how this will be funded or how the growing numbers of people that will need support. Innovative solutions are out there in every county but access to them is not evidently understood. Embracing the funding opportunities and the need to ensure that long term care financing is available is becoming a reality and not an after thought. All of us at some point will need to consider how and whom we will be paying for our care for loved ones or ourselves. The after thought that “don’t worry the government will pay” is not the case and hasn’t been for sometime. More needs to be done to aid the understanding at public level about the affordability and access to financing care in later life. With ever increasing demands being pressed and austerity measures in place as publicly indicated the overall landscape is not necessarily clear to all who are not in the sector on a day to day basis.

Many local authority accommodation strategies are contradictive by assessing the need for people to stay in their own homes but this is a dangerous method putting too much emphasis on time & task home care agencies who are pushed to their limits of capacity.  The fundamentals of Dementia and the needs of care in this area are around support, companionship and the need to always being available in many cases the need for one 2 one support is paramount. The question here is how can this be achieved when people are isolated in their own homes with the prospect of causing themselves more harm as their illness begins to debilitate them further over the coming months and years,

The stigma of care homes and care environments publicly needs to change dramatically with many private sector care organisations offering excellent care services and facilities which include not only tangible offerings such as bistros, ensuites, cinemas and medical equipment. But also the intangible benefits of 24/7 focused staff teams who are experienced in this area support backed up with external schemes offered by organisations such as Oomph! (http://www.oomph-wellness.org ) and Ladder to the Moon (www.laddertothemoon.co.uk) – who work with Care Groups to develop meaningful measured human engagement designed to enhance lives and deliver true humanistic benefits in reminiscence and responses.

These types of access to facilities and services are simply not available to those who are almost advised to stay in their own homes. These individuals simply miss out on the life enhancing benefits being offered in outstanding care environments across the UK. This is the ultimate conundrum – as gone are the days of the old fashioned residential home – care homes are multi purpose care services with an innovative edge focused on the person not the purse. Obviously the financials need to be right when addressing where people may spend their time living but this should not have a cost when all is considered.

The Care Quality Commission (CQC) the regulatory body of the are care and health services across the UK consistently backed these types of services with the increase in Outstanding services evidencing the use of innovative people engagement services in the care being delivered. Having accessing to multiple services when dealing with Dementia and associated conditions are only going to help improve the quality of life of individuals and this is clearly being demonstrated across the care sector with extreme valour. So why is it that this not common knowledge.

The theory I have deduced (albeit an opinion) is that professionals and government officials have not been keen enough to ensure the wider public understanding that Health and Social Care are two completely different fields. We live in a country where we are fortunate to have a National Health Service, which defies logic everyday offering FREE healthcare to all that need it. Which sadly blurs into the fact that also Social Care is an extension of health. Indeed, maybe it should be but realistically this simply is not the case. Social care is the long-term support function for health and this is becoming ever present as we develop bed-blocking problems within the NHS hospital services. Social Care can be the shining light that picks up the long-term issue and encourages development in care scenarios.

As discussed in an article that supports this statement by Paul Burstow at the Guardian: Why has this been explored more as a major political issue? Most MPs acknowledge that social care is unfinished business, but this has not translated into sufficient political pressure. At a basic level, this is because most people make no distinction between social care, care and support and what the NHS does. It still comes as a shock to many families that social care is not free. Most people make no care plans because they have discounted the chances of ever needing it.

Today the most visible advocate for social care funding is the NHS England boss, Simon Stevens. He told the NHS Confederation conference earlier this year that social care, rather than the NHS, should be at the front of the queue for financial aid. Of course there is a healthy dose of self-interest in this. Health and social care are two sides of the same coin – underinvest in one and you undermine the other.

But this is clearly down to the perception the public is given, the care sector itself and government departments must embrace social care services for what it can do but in the same breath encourage those who need to use it how it can accessed more efficiently. Private social care enterprises will be the ultimate problem solving body in this conundrum and soon everyone will need understand it!

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