I applied mine heart to know, and to search, and to seek out wisdom, and the reason of things, and to know the wickedness of folly, even of foolishness and madness Ecclesiastes (7:25 KJV). In my studies and career, I have continuously searching to uncover ontological issues why older people are not been perceived as individuals with distinctive needs but to no avail. The perceptions of the national and local governments as well as the wider health and social care organisations have revealed the folly of the widely held societal belief systems against older people. They should be recognised and their contributions acknowledged for laying the foundations and structures of the universal welfare systems in the UK.
In the welfare discourse, older people are seen as one entity rather than individuals who have different care needs. Naturally, humans are individuals with special characteristics and genetic makeups, which is unique to identify their needs from others. However, health/social care institutions and professionals tend to see older people’s care as homogenous thus, devising policies and practices that justifies the implementations. Practice observations have revealed that such policy/service frameworks can sometimes encourage discrimination and abuses of older people mostly, those who are unable or have no family members to advocate for them. These act of inequality, negligence as well as poor services delivery for older people; who are in care triggered the development and implementation in the UK; the “National Service Framework for Older People” and “Personalisation of Services”. The aims and objectives of these polices were to eradicate discrimination, so that older people could be seen as persons with individual needs.
In contrast, cuts in services and restructure of human resource in the sector indicated that older people’s service have been perceived as a weak sub-system, which could be targeted for savings. The reforms have ignited the debate whether the above policies are political rhetoric or manipulation of ideology. With older people’ population expected to increase substantially in the next two decades, politician, physicians, health/social care professionals and managers need to be prepared for overwhelming challenges they will face looking after this user group. In practice, health and social work teams are swept over with referrals from this group, their families and other professionals. Casework are growing daily at alarming rate and that is an indication of what lies ahead. In most developed societies, nearly one in five will be 65 or older by 2030 (according to the UK census (2011). People in this age group constitute the majority of referrals to health and community welling organisations in the UK when compared with the rest of the population.
Consequently, the austerity measures have affected all parts of the welfare systems but, services for older people have been severely embattled and that has led to care support structures been rationed under the umbrella of the “Eligibility Criteria Matrix”. This is despite personalisation of services (“Cash for Care, Personal Budget”). Unfortunately, this has become the fate of some older people who are in receipt of care hence care giving and packages of support plan systems are undistinguishable. Most social service departments up and down the country in the UK only assist those with “critical” needs; whilst a significant minority of others provide assistance to those needing “critical and, or substantial” care and those requiring medium and low needs have to fend for themselves. However, the danger is; this policy might be contributing to users’ health deteriorating conditions and would cost more money in the long term to care for them. This is a common experience of those users who are unable to buy care privately and, or may not have family members around that are willing to support them. Current policy frameworks are not supporting preventative strategies, which could reduce future costs and admission into hospitals; rather the focus is to make substantial savings in line with the coalition government’s ideologies such debt reduction and promotion of “the Big Society” agenda.
However, the consequences of quick fix solution and reactive measures would be to the peril of older people, their family and the wider health and social care organisations in the long run. On reflection, a significant majority of older people who are in receipt of care tend to be frail and or, disabled and suffer from hearing deficit or dementia. Based on this understanding, homogeneous or residential care setting appears to be cost effective for the authorities. The setting offers more environmental friendly services as well as providing safety net for users and their families because most of their needs could not be met in the community. Most users’ needs are complex, unpredictable, and intense; associated with challenging behaviours. These meant that individual programme plans may be over exaggeration for this age group as care giving is offered according to presented condition at the point in time.
In hindsight, offering standardised care without due consideration for individuality meant that a considerable number of older people would suffer and their care needs and health condition worsens. Practice observation discloses that hospital readmissions are higher amongst those service users whose needs are not adequately met. Addressing these issues requires a complete change of attitude and perceptions held by the government, professionals and service managers. Older people should be seen and not heard; whilst a whole systems approach should foster individual programme approach to later. This has the potential to accommodate older people and their holistic needs within systems approach, which would promote psychosocial wellbeing and assurance that their needs could be met in their own house/community for as long as possible.
Conversely, recent census in the UK as well as the USA and other developed countries illuminated decline of younger people whilst the population of older people is growing at arithmetic progression and a significant majority may need care in that circumstance. The question is how could the increasing needs of older people be handled individually? Apparent a higher proportion of younger people does not like to seek employment or trained to offer care of any sort to older people due to the nature of tasks involved such as intimate personal care and domestic chores. These observations justify change of government policies and legislation such as the “Immigration and education”. Relaxing these have the tendency to promote migration of people from developing nations and it is hoped, this would boost labour force in care industries in the UK and other developed societies. The caregivers would act as surrogate employees in the host nations particularly in the wider welfare services. The anticipated outcome is that immigrant workers would cover the vacuums in the care sectors, which was created by the declining younger people’s population in the counties in question.
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