We can’t escape the fact that we are growing older – it creeps up on us at first – it is easy to ignore – and then seems to gallop alongside us a while – keeping pace, seen only went sought and then, becoming ever more visible next to us and later as we slow down, it can overtake and eventually beat us down.
The Guardian and Observer have been running a series about Ageing Britain – it isn’t a terribly positive one either and seems to have a focus on the ways and means that the country has lacked the foresight or else the cash to manage an ageing population.
One of the more poignant stories, to me anyway, is that of Rhona Johnson. She delivers hot meals at lunchtime in the local community.
Working as I do in services for over 65s, I have a lot of time for the ‘meals on wheels’ service. Unfortunately, my borough doesn’t have any money for them anymore – and that’s where the poignancy comes in.
We offer a service, contracted out, of course to the lowest bidder (the provider was changed a couple of years ago). There is a block on providing a hot meals service at the moment. Instead, we can offer a fortnightly delivery of 14 frozen microwaveable meals.
It’s a cost thing, of course although there is a standard charge for a ‘meals on wheels’ service. It’s not always easy to sell.
And we don’t have any Rhonas – who stop by for a chat – however brief or even a cup of tea.
It is a false economy of course – like all the services offered, it is reactionary by it’s nature. There is no scope for prevention. Sometimes by the nature of the criteria needed to be eligible for meals delivery (even frozen ones) is that they cater for the loneliest individuals.
In order to be eligible you pretty much have to be housebound or in the case of a couple, both housebound – namely unable to get meals by any other means – no family members popping in regularly to get the shopping.
So what do we do? Provide carers to go in and actually make the meals – possibly at a higher cost because they times they stay at longer – although this is highly discouraged of course, because of the increased costs. So perhaps it is a better system but it seems to miss some of that human contact that is explained in the article in the Guardian.
One of the worst parts of the job and it is a legacy of the 1990 NHS and Community Care Act in my view, is that choice for users has all but disappeared. There is some semblance of choice with direct payments packages but they barely touch the edges of the services, especially for older people.
There are services and lists of timings and availabilities and criteria that need to be satisfied in order to access these services. There is little scope for creativity although ‘making a case for an exception’ has become something of a mission for me and has, to be fair, a reasonable success ratio.
And the future is Individual Budgets and the Personalisation agenda promising greater choice. I remain sceptical but we can always hope.. I suppose. The Triumph of Hope over Expectation….