Prevention before cure

It is all very well for the government to call for better preventative care for older people.  It is a noble aim – and a cost effective policy too. But I can’t help but be a little bit cynical.

As long as the Fair Access to Care bands exist and restrict care provision to Critical and Substantial needs only (as is the case in the local authority where I work), a great opportunity at preventative care is being lost.

The minister’s focus is on health care for the elderly, but so much preventative work could be done if more support were given through social care services at an earlier level. Changes could be spotted, companionship afforded and sometimes just someone coming around weekly to tidy up the garden, can provide incredibly positive long term effects and potentially save hospitalisation in the longer run.

All this is very difficult to quantify but it calls to mind a woman I visited this week who had just been discharged from hospital following a very-nearly-successful suicide attempt.

Through talking to her and piecing together the parts of her life, it was clear to see that she had had absolutely noone in the world. At the age of 83 she didn’t see any point in continuing. She had no friends locally, no family within 150 miles. She had been assessed for care services about a week before she attempted to kill herself but had low level needs relating to housework that could not be met by the local authority.  I don’t think that some housework would have changed her mental state significantly but some additional human contact could have flagged her needs more humanely than a hospital admission.

Although I haven’t come across many people who have attempted to harm themselves as a result of not requiring services directly, I have assessed countless older people, living along without any social contact, support or networks who just don’t meet the ‘substantial’ criteria for provision of services.

You can look into the future and see some of these same people costing the health service increasing sums because social care needs were not linked to potential health care needs in the future.

I think additional social support would have a massive role to play in longer term preventative care if only the purse-strings could be loosened a little.

2 thoughts on “Prevention before cure

  1. Amen to additional social support. Also
    a maddening problem in US health care.
    Well done, & please keep typing.

  2. Thanks and I didn’t really consider this from a US perspective but I suppose some things, unfortunately, traverse boundaries. I think as long as social support is separated from some of the cost of health care, it is a false economy as prevention is also much cheaper than treatment in the long run.

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