Aimlessness

This is a new type of blog which I intend to write occasionally.  It’s just a series of random thoughts off the top of my head which is nothing to do with the elderly.  Or perhaps it is because I now qualify as elderly myself.

Today is a rainy day in the garden.  A dank, drizzly kind of day.

A day full of excuses

(Outside)

  • The garden bins are full, I can’t do anymore autumn pruning;
  • Anyway, everything is wet;
  • And the floor is slippery underfoot;
  • And the ground is muddy;
  • It’s too early to plant spring bulbs.

(Inside)

  • There is nothing in the newspapers;
  • There is nothing on the tele;
  • There’s no fire in my belly.

(So?)

  • Today is the day to stay in and read a book;
  • One of the many I have bought and then not read.

“Essentialism – the disciplined pursuit of less”

See my next blog>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

“A little nonsense now and then 

is cherished by the wisest men”

– Roald Dahl

Posted in SMILES | 2 Comments

Back to School

At last some imaginative ideas about involving older people with young children.   From Wales where else!

In Gwynedd, North Wales, four day centres for older people have invited in some nursery school children, with some very positive experiences for both the children and the older generation.

  • The childrens’ confidence and understanding increased;
  • An elderly stroke sufferer’s speech improved;
  • An 82 year old lady with dementia had singing lessons with a toddler and then spoke more lucidly afterwards;
  • Another octogenarian lady who was blind, taught a four year old to make jam tarts.

The experience ended with a sports day where the older residents and the young children teamed up to compete in races and other events.  Concerns about frailty and the childrens’ lack of confidence all went out of the window.  Better to focus on fun than frailty.

The project is being studied by researchers at Bangor University.

As I was writing this blog, there were two programmes on Channel 4 which documented the experience of a nursery school group of children visiting St Monica’s Trust Retirement Home.  They followed a similar path to the residents in Wales with equally encouraging results.

This sounds like two good news stories, with benefits all round.     If repeated across the country it could provide better support for nursery schools and build a positive bridge between generations.

Posted in SMILES | 2 Comments

Baby Boomer Plasters

There are 15 million older people in the U.K. and that number will increase by 24% by 2040.   So it represents the fastest growing sector of the population.     In marketing terms it is the least well understood part of the market.  It is full of stereotypes:- older people are a quiet consumer; compliant and conservative.   The baby boomer generation will change much of that.   They are likely to be more adventurous, more demanding and most importantly, more affluent.

So I have decided to follow up on a number of products which I have blogged about previously and for various reasons are certainly not “age friendly”.

The first product I’ve decided to follow up is plasters, because with impaired eyesight and slightly arthritic hands, they are not at all easy to unwrap and use.    “Baby boomer plasters” would need to be innovative, easy to unwrap and easy to use.      Below is a letter I have written to a number of plaster manufacturers.

Letter to Elastaplast

We always have a box of your plasters in the house.  As the brand leader, yours is the first name that comes to mind.  I recently had a minor accident in the garden where I cut my finger and reached straight away for one of your products.  Only to be reminded of how difficult it is to open your double protected packaging with one arthritic hand.  It drew me back to a similar experience a year ago which I wrote about in my GrumbleSmiles blog.

You can read about my earlier difficulties with your product by clicking on the link below:

https://grumblesmiles.co.uk/2016/07/11/getting-plastered-to-be-edited-cartoon/

I write a well read blog about improving later life for older people.   One of the issues that I have frequently written about is the difficulties older people have with many modern products and particularly their packaging.    The grey market is often overlooked and yet it is the most rapidly growing demographic sector of society.    Older people also have the largest disposable incomes.

I realise that from a hygiene point of view, your plasters may need to be sealed.  However, in a first aid situation, older people need relatively quick access which is difficult, given their more limited dexterity.   I would be very interested to know if you have any plans to develop more “age friendly” products?  If you do already have or plan to have in future more suitable products, I would happily include your reply in m blog.

Many thanks; I’ll await your reply.

P.s. The email I was actually able to send to Elastaplast Customer Services on their standard reply form, only allowed me to send 512 characters  and no cartoon so doesn’t contain everything in the above note.

I will publish their reply when I get a response.

Posted in ELDERLY MARKET, Grey Products | 1 Comment

Yes, we need more Homes with Care !

My last blog looked at the demand for more Care Homes.    With the exception of specialist homes for dementia, psychiatric support and small group homes for learning difficulties, I would not agree we need more residential Care Homes.     In my view they create dependency and only offer an institutional lifestyle.

I do accept we need more Housing with Care, to meet the growing need to better support frail older people to continue to live independently.    The Newcastle University study suggested an additional 71,000 older people will need support in the next 10 years.     I suspect the figure will be much larger even than that!

My previous blog suggested that this would need in the order of £15 billion of capital investment to develop around 300 new retirement villages.     That level of new investment by Government is usually reserved for aircraft carriers or ridiculous railways.      Currently all the Nation’s  available capital will be needed to compensate the European Union for Brexit.      So the likelihood of finding investment for older people from the State seems rather remote.

The good news is, older people themselves  have a huge amount of assets locked up in the homes they own.     The options they have for getting the money out of their homes are unfortunately not very good value.     Equity release products are still expensive and come with all sorts of limitations.     Downsizing from a larger family home into retirement housing is probably a better option, but unfortunately most retirement housing offers little more than sheltered housing and emergency pullcords.

If we are to genuinely transform retirement housing to make it an attractive proposition for a large number of people, then we need a much bolder approach which goes beyond retirement housing and offers a much more attractive lifestyle in later life.

If the Government isn’t going to be able to provide the capital, then older people will have to take control of their own resources and use them creatively to buy a new life in older age.

My blogs next week will begin to outline how that can be done.

 

Posted in RETIREMENT HOUSING | 4 Comments

Do we need more Care Homes ?

A recent report by Newcastle University looked at the forecast levels of frailty in the older population and reached the conclusion that there is a need for 71,000 new care home places in the next 10 years.

I don’t doubt that their figures are correct.  It is just their conclusion that is wrong !

As the population ages the number of older, older people requiring some degree of support is certainly set to increase.   The more critical questions are :-

  • ” Where do they want to receive the care ?”
  • ” Who do they want to be cared for by ?”
  • ” How can they or their family pay for it ?”

The Newcastle study didn’t seek to answer these questions.   They are the £64,000 questions and therein lies the problem.

I will attempt to move the discussion along:-

Firstly, most people would like to be looked after at home.   This is relatively expensive and quality control is difficult.    However, there are certainly psychological benefits from being in your own familiar environment.   Since the State has largely totally withdrawn from this area, you have to be fairly wealthy to afford this solution.

Secondly, they want help from a stable (not ever-changing) and trained support team.   People they know and trust and people who know them as an individual not just a set of tasks.     For many people this may be little more than domestic help initially.    Later some will need more hands on care at times during the day.  They would also benefit from a regular review of their support and health needs by a nurse ideally on a monthly/quarterly basis.    Preventative  well-being checks have proven value.

Thirdly, paying for this kind of care at home has been under-valued by the expectation that health care is free for those that need it.     It never has been free, we have all paid for it in taxes, but we have not paid enough.     No one foresaw the big increase in longevity, nor the improvements in medical care that have kept us alive for longer, albeit with the frailties of old age.     The good news for many older people is, they are living in an asset that has over their lives accumulated in value.      Now they must use the value of their house to secure their future care and support needs.

What I have just outlined in housing and support terms is a retirement village.     But to deliver 71,000 new homes  would amount to around  300 retirement villages, at a capital cost in the order of £15 billion.

I will figure out how to do it in my next blog 😀

Posted in Residential Care, RETIREMENT HOUSING | 3 Comments

Care Home Confidence ?

At a time when lots of Care Home companies are on the verge of collapse and many homes have already closed, one company is moving in the opposite direction.      HC- One is company that grew out of the ashes of Southern Cross.  (You can see my posts on the Southern Cross storey by clicking on it in the Tag Cloud)

HC-One was set up  by Chi Patel, a doctor who moved into merchant banking.     Not an obvious career path, but one which led him to later switch to developing and managing nursing and residential care homes.     Now his  most recent incarnation has bid to takeover BUPA’s clutch of former Southern Cross homes, at a reported cost of up to £450 million for 150 homes.     This will make HC-One the largest residential care provider in the U.K. with 22,000 beds.

This, in a market full of gloom.    Squeezed Local Authority funding for Social Services, a jump in staff wages on the way and a vendor in BUPA  that has reached the opposite conclusion about its Care Homes.    Generally thought to be ” low quality”, they have been trying to sell them for more than a year.

So is Chi Patel a fool or just foolhardy ?

Well he has made himself a fortune out of running Care Homes, so I don’t think he is a fool.      But he is taking a big risk, probably with other people’s money.

The things in his favour are :-

  • the demographics of the older population and their increasing frailty won’t go away;
  • NHS hospitals are being swamped with older people who can’t be discharged;
  • later stage dementia cannot easily be coped with at home, but neither is hospitalisation a solution;
  • capital funding should be able to be secured against the homes, at relatively low rates compared to the past;
  • many residents will have homes that can be eventually used to fund their care, which would suit future Governments.

He is betting on older people’s lives, but I wouldn’t bet against him.    In the aftermath of the Southern Cross demise there were many lessons learned :-

  • the Regulaters can precipitate a collapse, but they can’t prevent it;
  • lenders have no easy exit routes, once they are in, they are in for the long haul;
  • the residents may be in for a bumpy ride if things start to fail, but they are also locked in, probably literally.

Even though I don’t favour Care Homes as answer, at least he is trying to do something.

 

Posted in Nursing Homes, Residential Care | 2 Comments

Discontinuing Continuing Care

Not a lot of people know that the NHS has a responsibility to provide Continuing Care.    It’s not surprising because the whole issue is shrouded in confusion and complexity.    I will try to unravel the issues in this blog.

Basically if you have a continuing need for health care from a clinician, the NHS should provide it FREE.    But therein lies the problem, because the NHS is short of cash and has been for some considerable time.    The issue is about people who are chronically ill and have a long-term condition which requires the regular attention of a clinician, usually a doctor but it could be another clinical specialist such as a physiotherapist.

That continued involvement, particularly if it involves a hospital stay, can be very expensive.    Hence the confusion and complexity.     My first experience of the issue was in running nursing homes in the 1980’s and 1990’s.  Some of our residents with serious health conditions, were paid for in full by the NHS.      This was usually an alternative to them staying in hospital.

Then in 1993 everything changed when Social Services became responsible for assessing peoples’ eligibility for admission to nursing and residential care homes.     Along with that responsiblity came the liability for providing public funds for people with limited resources.   The conundrum was that there were still some individuals who were paid for entirely by the NHS because of their continuing health care needs.

Individual Health Authorities and Social Services Departments intepreted the boundaries of this type of care differently, which led to accusations that the NHS was not providing a universal service for people with the same condition.     The other big anomaly was the treatment of patients with dementia where previously many dementia patients were looked after by the NHS in long-stay wards.  Progressively those wards were closed and the patients moved into nursing homes.       This shunting of costs from the NHS to Social Services led to endless disputes and delays in transferring people out of hospital.

Then came the Coughlan case where a woman who had previously been funded by the NHS, was refused further financial support on the basis that there was no further treatment that the NHS could give her.  She contested that view in the Appeai Court and won, which opened the door to an ongoing argument about “Continuing Care” which exists right up to today.

In researching this blog, I looked up the Government Assessment Form for Long-Term Health Conditions, which was only eventually published in November in 2012.     It’s 18 pages long and full of loaded questions which can only easily be answered by qualified staff, even though it is intended to inform patients of their rights.

The ongoing arguments have spawned a host of legal firms specialising in advising on patients’ rights to long-term care.     Equally, on the NHS side of the argument, there are private health care consultancies whose aim is to restrict the number of people entitled to claim NHS financial support.    This whole issue has developed into a multi-million pound industry.

All because successive Governments have not had the courage to face up to the problem.    The reality is, particularly with dementia, the NHS cannot afford the cost of caring for the increasing numbers of people with a serious health issue to which there is no cure.

Posted in N.H.S. | 5 Comments