Income, Capital and the Cost of Care in Old Age

1991 ◽  
Vol 11 (4) ◽  
pp. 373-397 ◽  
Author(s):  
Ian Gibbs
Keyword(s):  
Older People ◽  
Old Age ◽  
Home Ownership ◽  
Cost Of Care ◽  
Nursing Home Care ◽  
Background Information ◽  
Care Needs ◽  
Ageing Society ◽  
The Uk ◽  
The Cost

ABSTRACTAccording to ‘conventional wisdom’ older people are now relatively well off and, as a result, many are in a position to pay for their own care and housing needs in old age. In reviewing the evidence for this latter proposition the article provides a brief overview for the UK population and the implications of an ageing society for the care services. A summary of the main sources of income available to older people is undertaken, including home ownership and ways of releasing equity which might be employed to generate extra income. On the basis that it is also important to match information about financial resources available to older people to the cost of different services, the article reviews the likely costs of residential and nursing home care and the little that is known about the costs of domiciliary services. In short, the article presents a summary of the relevant background information and examines the issue of whether elderly people could (but not necessarily ‘should’) finance their housing and care needs in old age.

scholarly journals THE HISTORY OF BEAUTY AND THE AESTHETICS OF LONGEVITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S307-S307
Author(s):  
Naomi Woodspring
Keyword(s):  
Gender Differences ◽  
Older People ◽  
Old Age ◽  
Sense Of Self ◽  
Research Question ◽  
Central Research ◽  
Self Presentation ◽  
Cultural Narrative ◽  
The Public Sphere ◽  
The Uk

Abstract A long standing cultural narrative is aging appearance is neither attractive nor acceptable. This has not always been the case; the aesthetics of older appearance has been appreciated other times in history. Significant numbers of older people in the public sphere, as a result of the longevity revolution, has created a sense of visibility of among older people, particularly women. The aim of this qualitative study was to explore current notions of beauty and age among the postwar generation. A diverse group of thirty-four women and men (born between 1945 -1955) from the US and the UK were interviewed with a focus on their own self-presentation and the acts of seeing and being seen. This paper explores the some of the findings from this study which asked the central question – can old people be beautiful and, if so, how is age and beauty defined? The majority of research participants answered in the affirmative and responded with clearly defined notions of age and beauty. The findings found significant gender differences; not within the central research question but in regard to their own appearance. There were also significant gender differences in terms of a ‘competitive’ or ‘cooperative’ gaze when observing other older people. This small study invites further research and points to a possible shift in the aesthetics of old age, in part, as a result of the longevity revolution. It provides an outline for further exploration of the importance of appearance, meaning, and a sense of self in old age.

scholarly journals Older and ‘staying at home’ during lockdown: informal care receipt during the COVID-19 pandemic amongst people aged 70 and over in the UK

2020 ◽  
Author(s):  
Maria Evamdrou ◽  
Jane Falkingham ◽  
Min Qin ◽  
Athina Vlachantoni
Keyword(s):  
Older People ◽  
Daily Living ◽  
Community Action ◽  
Living Alone ◽  
Care Needs ◽  
Different Types ◽  
Household Members ◽  
The Uk ◽  
Staying At Home ◽  
At Home

On 23 March 2020 the UK went into lockdown in an unprecedented step to attempt to limitthe spread of coronavirus. Government advice at that time was that all older people aged 70and over should stay at home and avoid any contact with non-household members. This studyuses new data from the Understanding Society COVID 19 survey collected in April 2020,linked to Understanding Society Wave 9 data collected in 2018/19, in order to examine theextent of support received by individuals aged 70 and over in the first four weeks oflockdown from family, neighbours or friends not living in the same household, and how thatsupport had changed prior to the outbreak of the coronavirus pandemic. The researchdistinguishes between different types of households as, given with guidance not to leavehome and not to let others into the household, those older people living alone or living onlywith a partner also aged 70 and above are more likely to be particularly vulnerable. Theresults highlight both positive news alongside causes for concern. The receipt of assistancewith Instrumental Activities of Daily Living (IADLs), especially shopping, has increasedparticularly among those living alone or with an older partner, reflecting the rise ofvolunteering and community action during this period. However, not all older people reporteda rise, and the majority reported ‘no change’, in the support received. Moreover, amongstthose older people reporting that they required support with at least one Activity of DailyLiving (ADL) task prior to the pandemic, around one-quarter reported receiving no care fromoutside the household and one-in-ten of those with two or more ADL care needs reportedreceiving less help than previously. Although formal home care visits have continued duringthe pandemic to those who have been assessed by the local government to be in need, it isimportant to acknowledge that some older people risk not having the support they need.

scholarly journals When Frail Older People Relocate in Very Old Age, Who Makes the Decision?

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Fiona Scheibl ◽  
Morag Farquhar ◽  
Jackie Buck ◽  
Stephen Barclay ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Old Age ◽  
Residential Care ◽  
Care Home ◽  
Later Life ◽  
Old People ◽  
Care Needs ◽  
Health Crisis ◽  
Age In Place

Abstract Background and Objectives Older people are likely to transition to a new home closer to family who can provide assistance or to long-term residential care as their health declines and their care needs increase. A minority choose to move to “age-friendly” housing before the onset of disability, but the majority prefer to “age in place” and defer moving until health crises compel a transition. Older people living with dementia are likely to move into residential care, but not much is known about the role they play in decision making around these moves. This qualitative study addresses this gap in knowledge by examining how a rare cohort of “older old” people, most with some level of cognitive impairment, were involved in decisions surrounding assistance seeking and moving to a care home. Research Design and Methods Thematic analysis of qualitative interview data from Cambridge City over-75s Cohort (CC75C) study participants aged 95 years and older, who had moved in later life, and their proxy informants (n = 26). Results Moves at such an old age were made due to a complexity of push and pull factors which had layered dynamics of decision making. In most cases (n = 22), decision making involved other people with varying degrees of decision ownership. Only four older people, who moved voluntarily, had full ownership of the decision to move. Many relatives reported being traumatized by events leading up to the move. Discussion and Implications “Older old” people are sometimes unable to make their own decisions about moving due to the urgency of health crisis and cognitive decline. There is a need to support relatives to discuss moving and housing options at timely junctures before health crises intervene in an effort to optimize older people’s participation in decision making.

Providing a Medical Home: The Cost of Care Coordination Services in a Community-Based, General Pediatric Practice

PEDIATRICS ◽  
2004 ◽  
Vol 113 (Supplement_4) ◽  
pp. 1522-1528 ◽  
Author(s):  
Richard C. Antonelli ◽  
Donna M. Antonelli
Keyword(s):  
Care Coordination ◽  
Medical Home ◽  
Cost Of Care ◽  
Measurement Tool ◽  
Coordinated Care ◽  
Pediatric Practice ◽  
Care Needs ◽  
Community Based ◽  
Medical Home Model ◽  
The Cost

Objective. To determine the cost of unreimbursable care coordination services for children with special health care needs (CSHCN) in 1 community-based, general pediatric practice. Methods. A measurement tool was developed to quantify the precise activities involved in providing comprehensive, coordinated care for CSHCN. Costs of providing this care were calculated on the basis of time spent multiplied by the average salary of the office personnel performing the care coordination service. In addition, data were collected regarding the complexity level of the patient requiring the service, the type of service provided, and the outcome. Results. During the 95-day study period, 774 encounters that led to care coordination activities were logged, representing service provision to 444 separate patients. When these encounters were examined on the basis of clinical complexity of the patient, the most complex patients constituted 11% of the population of CSHCN yet accounted for 25% of the encounters. In addition, care coordination activities for these clinically complex CSHCN engaged office staff 4 times as long when compared with less clinically complex CSHCN. Overall, 51% of the encounters were attributable to coordinating care for problems not considered typically medical and included activities such as processing referrals with managed care organizations, consulting with schools or other educational programs, and providing oversight for psychosocial issues. On the basis of national salary and benefits data, the annual cost of the time spent coordinating care for CSHCN in this medical home model ranged from $22 809 to $33 048 (representing the 25th and 75th percentiles, respectively). Conclusions. The costs of providing care coordination services to CSHCN in a medical home are appreciable but not prohibitive. Standardization of care coordination practices is essential because it makes the medical home more amenable to quality improvement interventions. Mechanisms to finance unreimbursable care coordination activities must be developed to achieve the Healthy People 2010 objective that all CSHCN have access to a medical home.

Privatization, Hybridization and Resistance in Contemporary Care Work

2020 ◽  
pp. 97-108
Author(s):  
Pat Armstrong ◽  
Donna Baines
Keyword(s):  
Nursing Home ◽  
Older People ◽  
Nursing Home Care ◽  
Non Profit ◽  
Main Form ◽  
The Uk ◽  
Market Relations ◽  
Care For Older People ◽  
Integrated Processes

This chapter identifies seven forms of overlapping and interwoven privatization. In the current era of austerity, privatization has been able to extend its reach through these integrated processes and, in some cases, operate almost by stealth as an overarching ideological force that legitimizes private-market relations in places where it once would have been thought to be contrary to a public sector ethic of entitlement and equity. This is a growing dynamic across many public and non-profit/voluntary services and organizations. The chapter discusses the seven forms of privatization in the provision of long-term residential or nursing home care for older people in Ontario, Canada and in the UK. Private ownership is commonly thought to be the only or main form of privatization, but austerity analyses can be more incisive and specific, with a greater awareness of the complexity and multiplexity of the forms of privatization operating within formerly public and non-profit spaces. The chapter then looks at resistance in the sphere of care for older people, some of which has been successful.

Too old to sedate: How old is too old?

Dental Update ◽  
2021 ◽  
Vol 48 (2) ◽  
pp. 106-113
Author(s):  
Natalie Bradley
Keyword(s):  
Older People ◽  
General Anaesthesia ◽  
Old Age ◽  
Dental Care ◽  
Clinical Relevance ◽  
Older Patients ◽  
Dental Treatment ◽  
Anxiety Control ◽  
The Uk ◽  
Dental Work

The UK population is ageing with over a quarter of people predicted to be over 65 by 2040. People are retaining their teeth into old age, often having experienced complex restorative dental work over the years. The increasing complexity of dental treatment that older people require will create challenges for those who provide care for this population, including dental treatment under sedation or general anaesthesia. This article discusses the medical, dental and social considerations that need to be taken into account when planning dental care for older patients under sedation or general anaesthesia. CPD/Clinical Relevance: Dentists who provide sedation must be able to appropriately assess and manage their older patients safely if considering this method of pain and anxiety control for dental treatment.

scholarly journals Early-onset dementia

2009 ◽  
Vol 15 (5) ◽  
pp. 380-388 ◽  
Author(s):  
Kate Jefferies ◽  
Niruj Agrawal
Keyword(s):  
Older People ◽  
Old Age ◽  
Early Onset ◽  
Healthcare Professionals ◽  
Clinical Excellence ◽  
Liaison Psychiatry ◽  
Early Onset Dementia ◽  
The Uk ◽  
Dementia Services

SummaryDementia is is stereotypically associated with older people. However, in a significant minority it can affect people in their 40s and 50s, or even younger. Currently there is a lack of awareness, even among healthcare professionals, and there is a dearth of appropriate services for such patients. Despite the attention given to this condition by National Institute for Health and Clinical Excellence guidelines, provision of specialist early-onset dementia services in the UK remains patchy. Carers and patients often find themselves being passed ‘from pillar to post’ between psychiatry and neurology, and also between adult, old age and liaison psychiatry. The responsibility for identifying available and appropriate help is often left with carers. This leads to unnecessary delays, causes undue distress to patients and places an added burden on carers.

Reinventing the nursing home: metaphors that design care

2018 ◽  
pp. 45-62
Author(s):  
Susan Braedley
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Old Age ◽  
Nursing Home Care ◽  
Standards Of Care ◽  
Social Imagination ◽  
The Us ◽  
The Everyday ◽  
The Uk ◽  
Team Nursing

Drawing on findings from team nursing home ethnographies in Canada, the UK, Sweden and the US, this chapter argues that new designs for nursing home care draw from a social imagination limited by contemporary ideals of individualism, practices of consumerism and structures of inequality. As newly built or renovated nursing homes are designed to support better care for frail older adults, a contradictory mix of policy aims has emerged, including improvements to economic efficiency and sustainability, better standards of care and wellbeing for residents, and efforts to create appealing, hospitable environments. The research brings critical attention to walls, gardens and furnishings, arguing that they not only shape the everyday life of frail old age but also reveal tensions between what residents and those who provide care require, what is designed for them and what is expected of them.

scholarly journals Co-resident care-giving and problematic sleep among older people: evidence from the UK Household Longitudinal Study

2019 ◽  
Vol 40 (6) ◽  
pp. 1195-1222 ◽  
Author(s):  
Emma Maun ◽  
Karen Glaser ◽  
Laurie Corna
Keyword(s):  
Longitudinal Study ◽  
Older People ◽  
Longitudinal Research ◽  
Sleep Problems ◽  
Poor Sleep ◽  
Care Needs ◽  
Care Givers ◽  
Care Giving ◽  
Resident Care ◽  
The Uk

AbstractIn light of current pressures within formal social care services, informal carers assume an important role in meeting the care needs of a growing number of older people. Research suggests relationships between care-giving and health are complex and not yet fully understood. Recently, wide-ranging associations between sleep and health have been identified, however, our understanding of the links between care-giving and sleep is limited at present. This study assesses longitudinal patterns in co-resident care-giving and problematic sleep among older people in the United Kingdom. Our sample included 2,470 adults aged 65 years and older from the UK Household Longitudinal Study. Problematic sleep was defined as two or more problems in going to sleep, staying asleep or sleep quality. Using logistic regression models, we assessed how co-resident care-giving status, intensity and transitions influence the likelihood of problematic sleep in the following year, adjusting for potential confounding factors. Adjusted analyses found co-resident care-givers were 1.49 (95% confidence interval = 1.06–2.08) times more likely to report problematic sleep in the following year, relative to those not providing care. Care-giving over 20 hours per week and continuous co-resident care-giving also significantly increased the odds of problematic sleep. This suggests older co-resident care-givers may be at greater risk of incurring sleep problems than non-care-givers. Further longitudinal research is needed to investigate care-giver-specific consequences of poor sleep.

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