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Dignity at Home - Carers UK Forum

Dignity at Home

Share information, support and advice on all aspects of caring.
This is a lengthy article but covers so much....

http://politics.guardian.co.uk/publicse ... 47,00.html
Well worth the read, Rosemary. I hope their email bank is overflowing with stories, as I bet this is only the tip of the iceberg.

In Scotland we have free personal care, but it is also very limited, and the bathing issue falls on deaf ears. I fought to get a walk in shower for my dad so he could go in it every morning and be clean and relieve the soreness of his arthritic bones without the hauling in and out of a bath he was too big for anyway...........by the time he got it he wasn`t allowed to use it every day, only twice a week. Luckily he is able to get in it himself and it is not the first time the carer has arrived for breakfast duty to dad sitting on the shower seat dripping wet. Let`s face it they then have no choice but to deal with it.

On a weekend he is lucky to have ten minutes care in the morning and night and when his regular homecarer returns on a Monday from her weekend off there are dirty dishes all over the house for her to collect and wash up. Staff shortages and folk in greater need are always the excuse, but it needs corrected.

Take care
hi meg

thats interesting to read. in england we are always being told that care issues are so much better and free in scotland.

its a wonder that we have not all moved to scotland to join you.

Morning Meg,

I am glad you found the article worth reading.It brings to light yet again just how much the care system needs an overhaul.Too many times we read where boroughs are cutting corners to save money ahead of peoples needs.
I dont know if you are aware Meg, that as well as being a carer for my brother that I also work 15 hours per week as a paid personal assistant under the Direct Payments scheme looking after an elderly couple.Just recently, a review was done and council wanted to cut them down to 15 mins each meal time.Bearing in mind that was 15 mins for me to cook and feed the both of them.What do they expect a paid carer to do,make sandwiches forever more,leave a flask of soup.No way.
Dignity at home,independence,however they want to name it, should mean exactly that.I did a time and motion on myself for a week and gave it to the family.Using that they asked for a re assessment and after a bit of a quibble their hours were increased from 15 to 27 and 1/2 hours per week.That was not done for me to get the payment as now they need another PA to cover those extra hours.
For anyone in receipt of DP's or thinking of applying, here is a few things to consider ( in England ).....

Personal care on a morning ,breakfast

Domestic hours
Social hours...some boroughs trying to stop this.

Like you said Meg,I too hope their email box is overflowing.I sent mine last nite.

Hope you are well
Hi Pam,

It`s not all its cracked up to be believe me.

I have just had dad on the phone to say he got breakfast at 11.30 and is now sitting in his dressing gown. Homecarer doesn`t come back until 5pm. Obviously he wants me to go and see to him, but I have hubby laid up in bed today and can`t leave him without he knows where I am. as he suffers night terrors, even in the daytime!

I could write pages about when free personal care isn`t free, or what is covered by personal care and you would be shocked by how little that is, but that`s for another day, if anyone is interested.

Take care

As long as you feel comfortable telling us,please post as much as you can about any of your experiences re :- care.These issues need brought out in the open as much as possible.

Once again like many others,you are in a position where needed in 2 places at once.

I hope both dad and your hubby are ok but especially that you yourself are too.
If you need to let off steam later,get rid of any frustrations just holler away.

Is dignity at home too much to ask for our elderly?

Hundreds of thousands of Britain's elderly rely on home care visits to live a dignified life in their own house. But as local authorities reduce funding, an increasing number of our most vulnerable citizens are being neglected and are suffering as a result. Now, with our elderly population set to rise dramatically, we launch our campaign for the right to stay at home

Jo Revill, Denis Campbell and Amelia Hill
Sunday June 17, 2007
The Observer

It is hard for an elderly woman who is infirm and immobile to retain her dignity when she relies on strangers to wash her, or help her out of bed and on to a toilet. Valerie Tugwell, 72, is seen by paid carers at home in Maldon, Essex, for an hour in the morning and 45 minutes at teatime because her severe arthritis means she is virtually housebound and can only move using a wheelchair or a walking frame. She has been disabled for 19 years.

Even though Miss Tugwell is doubly incontinent, Essex county council's social services has reduced the number of baths she is entitled to every week from two to one, on a Monday, when her pair of morning carers spend an extra 15 minutes with her. Recently, the council suggested an end to the Monday bath, saying that she must make do with a daily sponge-down.
'I feel unclean half the time', she says angrily. 'I felt deprived when social services cut me down from two to one bath a week in 2004 - deprived of feeling like a normal adult . Then they told me I had to stop having the one bath a week I have now because my care was taking longer than the one hour I was allocated. 'I told them I was doubly incontinent and why on earth couldn't I have a bath? Wasn't I entitled to be properly clean? They told me that time and money wouldn't allow it. But we're talking about 15 minutes.' After her protests, the council agreed she could keep having one weekly bath.

Today The Observer launches its Dignity at Home Campaign, to fight for the right of such people as Miss Tugwell to receive the care she needs in order to maintain a decent life in her own home. We have discovered that an insidious kind of rationing is happening in England and Wales, more covert - and in some senses more cruel - than the kind we read about when an expensive cancer drug is not prescribed by the NHS. It is a rationing that involves not giving baths to frail elderly people who are unable to clean themselves, cutting back on the daily visits from care staff, closing day centres, not visiting homes to ensure they have the right medication. No dramatic headlines perhaps, but home care is a lifeline for thousands of old people.

Nearly 160,000 households occupied by pensioners have stopped receiving the care they need from social services in the past decade - a tide of neglect that will have long-term consequences for the whole country.

As local authorities' budgets have come under pressure, the eligibility criteria that an older person has to meet to receive free care have been made so restrictive that in many areas only someone who is dangerously ill will be given support. Under means-testing, anyone who has savings will end up paying for their care, with families, friends and charities left to fill in the gaps. And for those whose children don't live near them, the isolation and the sense of abandonment can be utterly devastating.

'More and more of us are seeing this indignity and disgrace inflicted on our elderly relatives,' said Mervyn Kohler, director of Help the Aged. 'It is shameful that as people in such a wealthy society, we can treat our elderly in this way. The care services have been eroded to a point where they are no longer meeting the needs of people who really deserve more than this.'

The issue, if not tackled now, will worsen as an increasingly ageing population with complex medical needs starts to demand more care.

During the 35 years she worked as a nurse at teaching hospitals in London, every day was different for Jennifer Clark - different patients and different medical challenges. Today, her life follows a monotonous routine. She is up at 8am, spends most of the day in her living room lodged in an armchair watching TV, listening to the radio, doing crossword puzzles, until 8pm.

Immobile unless she is in a wheelchair, with very limited eyesight, and ever-more debilitated by the eff ects of the brain haemorrhage she suffered 12 years ago, the 65-year-old depends on a small army of carers to help her get through every day. At 8am two Polish women, Monika and Klaudia, arrive, help Miss Clark out of bed, help her wash and then prepare her breakfast.

At around 11.30am, one of them returns, clears away her breakfast dishes and prepares her lunch, usually a prepacked meal brought in by her friend Ken, who does all her shopping. Then at 7.30pm two more helpers come, push Miss Clark in her wheelchair into her bedroom in what used to be the front room. They help her 'freshen up' on her commode then use a hoist to lift her back into bed.

Until April she was paying £588 a month for these services. Then Bromley council in south London increased her fees to £665. Her care charges went up by more than 10 per cent but her occupational pension only increased by 2 per cent. 'The trouble in this country is that everything is means-tested,' said Miss Clark. 'I feel that I'm being penalised financially for having been prudent with money during my life, for building up savings and so on. I have to pay half the cost of my care and Bromley council pays the other but if I hadn't saved and didn't have assets, I'd get it all free.'

In the past 10 years, one in three elderly households in England stopped receiving any care at all from their local council, according to Department of Health figures. A total of 159,100 fewer households, each containing one or more elderly people, have fallen victim to local authorities making their eligibility criteria to receive care tighter and tighter, as their own finances have come under increasing pressure.

When an older person starts to need help, social services carry out an assessment of their social care needs. They will rank them as falling into one of four categories, low-level, moderate, substantial and critical. In many authorities, an individual will then be meanstested, so that if someone has savings of more than £21,500, they will probably be asked to pay for the home care they receive, unless they fall into the 'critical' category.

Over the past decade, all of England's 150 councils which provide social services have stopped providing care to anyone with 'low-level' need. The definition of low level is someone who cannot do without help and needs support shopping or leaving the house.

The situation is getting worse. It is expected that by the end of 2009 no council in England will offer any support to older people occupying the 'moderate' rung on the assessment ladder . These are people who need help getting into and out of bed, washing and keeping the house running.

As the total number of elderly people receiving social care has fallen, so the care that remains has become increasingly concentrated on fewer, needier cases. This is why the figures show that the average number of hours of care being received per household every week more than doubled, up from 4.7 to 10.1 hours.

One of those providing such care is Sharon Russell, a South African who came to Britain five years ago. She now works for a private company commissioned by Hertfordshire county council to provide domiciliary, or home, help and is paid around £8 an hour for her work, for which she has done a great deal of training.

'I love my job,' she enthused. 'Elderly people just have so many stories, and I learn something from them all the time. You end up forging a very close relationship.' The aspect of the job that hurts is that she does not have enough time to spend with her clients. She has strict periods allotted by the company, depending on their needs.

'I have one wonderful 86-year-old man, who is blind. I go round in the morning, help him dress, give him his medications, prepare his breakfast and make sure it is all shipshape because everything has to be in the right place. I have just half an hour for all of that, and it's not long enough.

'I hate rushing people. Sometimes I'd like to have a bit more time just to enjoy a cup of tea and a chat.'

An unknown number of families are already paying for private help, because there is no other way of allowing a relative to stay at home given the lack of social services support. The costs depend on where you live, and range from £3.60 an hour in Bradford to £18 an hour in Brighton and Hove.

The cost of an average weekly care package - 11 hours' help with washing, dressing and eating - has risen from £114 a week to £133 in the past year, according to a Public Finance magazine survey of 87 local councils in England.

It appears that almost a quarter of councils are planning to raise the fees they charge old and disabled people for home care services by 40 per cent. Eight are planning increases of at least 100 per cent, such as Brent in north-west London. Until April it charged local senior citizens £5.30 an hour for those with savings of under £21,500 and £14.50 for everyone else. It has replaced those fees with a flat-rate charge of £16.

Behind all the changes lies one unalterable fact: the demographic time bomb is ticking. The number of people aged 85 is growing quickly, and stands at a record 1.2 million. Medical advances have pushed up survival rates, with the post-Second World War baby boomers now reaching old age. The number of over-85s is predicted to reach between 1.6 million and 2 million people by 2022.

In a frank interview, the Care Minister, Ivan Lewis, told The Observer that things had to change. He admitted the picture for social care was now 'very patchy'. 'Caring used to be about someone else doin
[quote]Lewis, who within the government has pioneered a campaign for dignity for the elderly, is blunt about what is ahead. 'There are some very difficult choices to be made. We have to be honest about this, and spell out to people what those choices are. There are different eligibility criteria, differing quality, different services. That's the reality and we need to consider is this new challenge - the balance between laying down national minimum standards and the capacity for local flexibility and local priorities.'

He made it clear that if the public carries on fighting plans to close large acute hospitals, which are deemed by many in the health industry to be inefficient and money-wasting, the price for that will be that money cannot be transferred into the communities to care for the elderly]

So long as these people are allowed to get away with arguing that the choice is between care in hospital and care in the community they will continue to waste the vast sums of money that go on unnecessary layers of management chasing each others' tails, building their own little empires, and reorganising departments whhich already work very well (against the advice of their own staff) in order to make it look as if they are achieving something. What is needed is a vast reduction in non-productive management and the savings ploughed back into services and front-line staff. A starting point would be for one out of every two admin staff to be offered a choice between voluntary redundancy and retraining into a worthwhile job.
I have posted this following link in the campaigning section but some members may miss it so repeating it here...

http://www.scie.org.uk/publications/pra ... /index.asp

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