It’s a dryin’ lovely, Michalmas daisy kind of day;
A bulb planting, sow the seeds of spring beginning.
The old age starting of a new life, a year at a time.
My Garden Age.
Less of a young years rush,
De-cluttering the accumulated comfort clutter.
Tweetless, peaceful, forward reflections.
Winter cool and calm to come,
Smile in the certainty that a daffodil spring is not far behind.
Can I do a blog right out of the blue ?
Original, different, testing and true,.
The answer must surely be NO.
We are a product of our history,
Our lives are not new.
As the days go by, we are shaped by yesterday
And formed by tomorrow’s opportunity ?
Only with language does life begin to make sense.
Every new experience coded into patterns.
The picture of our life slowly taking shape.
Coloured by childhood, parents and school.
aaaaa bbbbb ccccc ddddd eeee fffff ggggg
Education / indoctrination — a fine line.
Freedom of thought caught in a moment of interest.
Gradually ingrained and sculpted into rock.
So forever after nothing is new !
Posted in SMILES
It was only at the end of July that the Last Laugh Looney Party successfully concluded their Brexit negotiations with Mr Junket of the European Union. Finally they have agreed to ban all SMALL PRINT. (See my blog in the Archive dated 31st July 2017)
Sadly this excellent new legislation came too late for our kitchen food cupboards.
Today I decided to sort out the cupboard where things fall out as soon as you leave the door ajar. Speaking of jars, they are usually the first thing to fall out. Jam jars and quarry tile floors don’t mix. Over the years I have spread more marmalade on the floor than on my toast.
In full de-cluttering mood I removed all 2,000 bottles, jars, packets and boxes from the shelves and laid them out in rows on the worktop. Lines of raspberry jam, strawberry jam, blackberry jam and damson jam. Then an essential row of marmalade — Frank Cooper’s Oxford Original, Robinson’s thick cut and thin cut —- some half empty, some unopened for at least a century. The longest row was for boxes of Aunt Bessie’s Stuffing Mix. We buy a box every Christmas and never use it all. The boxes date back to 1830 so we could send them to the British Museum. We have a similar problem with half-empty packets of spaghetti. You always want a fresh packet, so you are left with enough spaghetti to feed half of Italy. There are far too many more goods to mention, but I almost ran out of worktop before I had finished emptying the cupboard.
Now we come to the small print. I decided to throw out all the foodstuffs that were past their sell-by date. Manufacturers obviously don’t like the thought that their produce could ever go out of date. So, they put “best before” dates in the most obscure places, in the smallest print with the least contrast with the background. Not quite in the spirit of the legislation!
Still, I eventually figured it out with an electron microscope and a lawyer. (Lawyers are particularly good at small print). I was then able to send a heap of Aunt Bessie’s stuffing mix to Mr Junket for his food mountain. I do hope he enjoys stuffing balls. It will probably confirm his view of British cuisine as some of the best in the world, even if it is past its sell-by, use-by and best before dates.
This is a continuation in the series of posts about a new form of Community Retirement Villages. It follows on from my introductory post on 9 September. This post will focus on the most difficult question, which if how they can be financed in revenue and capital terms.
It is first with repeating some home truths, which successive Governments have failed to address :-
- Increased longevity and improved health care have outpaced the Governments ability to pay for later life support for older people. Over the years an expectation has been created that all health care is free from the NHS — this is no longer the case. Neither is it realistic to assume that social care will freely be available for all those who need it.
- Older people themselves, not knowing they were going to live so long in retirement, have not saved enough to pay for a good later life. Except that many of them are home owners and have lived through a period of house price inflation, so now have resources locked up in their houses.
- Until these two issues are faced up to by both Governments, who are afraid to be honest for fear of losing votes and by older people, who are hoping to hang on to a legacy, there will be no release of resources to address the problem.
Innovative financial models are the key to opening up new opportunities in the retirement housing and care market. Fluid use of housing capital assets and risk sharing to procure care-for-life reinsurance hold the answer. They are ideas that have been widely used in the USA, but have only rarely been offered in the U.K. :-
- down- sizing is the simplest option for releasing capital from your home, but it is only available if your home is of sufficient value. Shared-ownership needs to be an option for those with lower value homes.
- in both instances people may subsequently need to release more equity in their home to be able to fund care at a later stage.
- Ideally, when purchasing a new retirement home you want also to know you have your life time care needs can be funded. One option is to pay a non-returnable premium to move in to a new apartment which offers a care-for-life package. In the USA this is often called a Continuing Care Community.
The broad concept is that you buy into a retirement community which offers you housing and care for the rest of your life in exchange for a one time payment. The risks of how long you live and your future care needs are bourne by the retirement village operator. There has to be a caveat that if your care needs, particularly in terms of mental health require specialist treatment, you may need to move to another home, but this will continue to be funded by the village operator.
This approach was tested nearly twenty years ago by Rowntree in New Earswick Retirement Village in York, but sadly, it was not replicated because of the perceived risk. More recently The ExtraCare Charitable Trust launched a Care-for-life option on a limited basis, but again it has not been repeated.
It is an option that is completely different to the oughtright sale or even part purchase of properties. For that reason it would need an open and transparent approach and very careful marketing. It has the potential to give access to a Retirement Village at a price which is lower than the open market value of the accommodation, with no on going high service charges. The other big benefit is that you do not have to worry about the cost of your future care, as that is included in the initial entry price you pay.
After I have covered the other issue of Operational Management, I will bring together all the threads of my posts on Retirement Villages to try to point to a bold way forward.
I have written a lot about assisted dying almost since I started this blog. Although not since 2015 when Lord Faulkner’s Bill to legalize it was heavily defeated in the House of Commons. ( You can see all my earlier posts by clicking on ” Assisted Suicide” in the Topics List)
Recently I was prompted to re-read my blogs on this subject by a special report in the Daily Mail – 4th Sept. My blogs are full of apprehension about the potential for extension of assisted dying into the everyday care of older people. Nowhere is this more likely than in hard pressed, under funded, bed blocked hospitals.
The report into Gosport Memorial Hospital in Hampshire would seem to confirm my predictions. A high level of deaths and excessive use of pain medication typified treatment in the hospital, in a facility which uncomfortably they called “end of line” wards.
There have been several police investigations, Health Service inquiries and a ‘death audit’ over the years all with no clear conclusion. Now an independent review led by James Jones, former chairman of the Hillsborough disaster will report in the spring of 2018.
My prediction this time is that he will find that wilful neglect for the sanctity of life of older people is now endemic in the NHS.
COLLATERAL DAMAGE OF INCREASED LONGEVITY.
IN A SUPREME TWIST OF FATE, THE NHS THAT HAS DONE SO MUCH TO EXTEND LIVES, NOW FINDS ITSELF HASTILY ASSISTING THE ENDING OF LIVES.
Solving the Nation’s health problems is a big challenge for the Government, but at last they have begun to come up with the start of a Grand National Health Plan.
It has just been announced that all men over 60 and women over 75 should take statins. This could prevent 290,000 heart attacks and strokes over the next 10 years. Of course there are a few side effects but the Government is not worried about that because this new blanket approach could save the NHS millions of pounds in less strokes and heart attacks.
GP’s are concerned that many more people —- it could be over 11,000,000 people — will need to see them to get prescriptions. But the Government has an answer for that too — statin dispensers will be conveniently located on every street corner, just like parking meters. They will be painted in blue NHS colours and be as recognisable as your public telephone box. It will only cost you 10p a day for you daily fix. You won’t need to see your own GP, because the Government says it is OK.
The cartoon shows my heroine Pilly Galore trying out the new system, she says “It is a lot easier to get an appointment with a parking meter”. (You can see earlier blogs about Pilly by clicking on “PILLS” in the TAG CLOUD).
As the Government learns more and more from the big friendly pharmaceutical companies, it intends to do more national prescribing. Aspirins are likely to become Universally Required Drugs by 2020. Diet pills will be compulsory for everyone over 10 stone, as soon as the Government introduces a National Maximum Weight Limit. Anabolic Steroids will be a URD for very thin people.
Snake Oil is being trialed in Swindon, with the expectation that it will be introduced into the Nation’s reservoirs in 2018, providing nobody much dies in Swindon before then.
The lesson from all this is:-
P. S. Don’t take any notice of this I have no medical qualifications, just a sense of humour 😀
Posted in HEALTH, N.H.S.
I have built some ground-breaking Retirement Villages in my working career at ExtraCare Charitable Trust. I am pleased to say that many retirement villages have followed in their footsteps. But, are they transforming the understanding of housing and care for older people in this country? The honest answer is not yet, or at least only for some of the people who were lucky enough to move in.
So what has to be done to make this model more widespread throughout the UK and sustainable in financial and managerial terms? There seems to me to be four basic issues that have to be resolved:-
- There needs to be a focus on later-lifestyle opportunities, not housing and care. Housing and care tend to be the focus of developers, but they are not the key interests of the residents when they first move in. They are more interested in finding a new lifestyle in retirement and indeed, the lack of this in new villages is the reason that many people don’t contemplate moving. Encouraging this understanding is central to the marketing of new villages, but it is often overlooked, or not acted upon when the new village is opened.
- This is not a small-scale problem. (See my earlier blog which you can find by clicking on this link – https://grumblesmiles.co.uk/2017/08/29/yes-we-need-more-homes-with-care/). To deliver a lifestyle transformation for many older people in communities throughout Britain, will need substantial capital investment and adequate on-going revenue funds. Realistically, successive Governments have failed to do this for years and I can only see sufficient future funds coming mainly from residents’ own resources. This will need new and innovative financial approaches, which are not dependant on public funds. It will also need honest, transparent and forthright explanation to residents and their families !
- An holistic community wide approach with voluntary sector support. The new village needs to reach deep into its surrounding neighbourhood and not in any way be exclusive or gated. This idea is not always welcomed by the village residents themselves, who once they have paid to get inside like the idea of exclusivity. Nonetheless, there are many older people in the wider community who could enjoy the village facilities and bring in additional revenue.
- Enlightened management, listening and acting on residents comments and needs, is an essential ingredient of village sustainability. Much of the day to day running of village facilities will be supported by the residents as volunteers. They will in return be entitled to play a key role in the governance of the village,
OVER THE NEXT FEW WEEKS THERE WILL NOW FOLLOW A SERIES OF BLOGS ON INDIVIDUAL ISSUES AND HOW TO FUND AND MAKE THEM SUSTAINABLE.