So what exactly is that money for?

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Again the unedifying debate over care for the elderly - characterised by the sons and daughters of comfortable middle-class folk arguing that their parents assets shouldn't be use to provide care for those parents.

"It seems so wrong that after mum and dad worked hard all their lives, everything that they saved for had to go. The day we sold the house my sister and I could barely speak for tears, as we packed all their belongings up." 

The mum in question is on her own, is 85 and has dementia. Of course it's sad that lives end this way, dementia can be a terrible slow death and is traumatising for the person's family. But what exactly did mum and dad save for? It seems to me (and always has done) that part of the reason for saving is to provide care when we can't look after ourselves any more.

There really is a need to look at how we provide care for the elderly, it is one of the biggest public health challenges that faces us. But the standards and breadth of care will never come about so long as we carp and wail about the loss of inheritance. Is it not worse that people with significant assets (or more commonly those who stand to inherit those assets) expect someone else to pay for their care? Especially when that someone else is a struggling family or a young man earning just above minimum wage.

And while we're talking about tax - we are still living with the consequences of Nye Bevan's great lie. With this idea that we "pay in" to the National Insurance system. It is - and always has been - just another tax on income but we still hear this:

"They paid into the system all their lives"

No they didn't. They just paid taxes to provide the things government was providing - they had the benefit of hospitals, schools, roads, police, an army and all the other things we've voted for having. The truth is that they've eaten the cake. And it was a pretty big slice.

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"Selling off the family home..."

Tomorrow Andrew Dilnot presents his report on the funding and structure of long-term care for the elderly - a subject of enormous importance but sadly one characterised by an obsession with not "selling off the family home". Take this example from the Sunday Telegraph - described as 'examining the issues' but, in reality, saying that it's terrible to have to sell the "family home". One case is cited at length:

This was precisely what happened to retired librarian Doris Cutler. At the age of 80, she was fit and well, and enjoying life in the bungalow overlooking Swansea Bay that she had bought with her husband 30 years ago.

After his death, she had been determined to stay in her home, surrounded by friends and neighbours. Even when signs of dementia emerged she was resolute, and an army of carers were hired to keep her at home.

After a fall this winter, at the age of 85, everything changed.

Her daughter Diana said: "It was just untenable for her to stay at home. She was extremely confused, and needed around-the-clock care and that meant a nursing home."

Selling the home was the only option.

Absolutely - a significant asset perhaps with sufficient capital to provide for a comfortable and dignified end to Mrs Cutler's life. What exactly is the problem? Are we suggesting - as this article does - that somehow using this capital is wrong? Or that taxpayers - many of them without good incomes or significant assets - should pay for Mrs Cutler's care so her daughter can inherit the "family home"?

And, of course, Mrs Cutler's home is not a 'family home' and this sort of statement presents a lie:

Inevitably, many who spend decades working hard to provide a home for their family, will still be forced to sell up when frailty overwhelms them. 

In the case cited the "family" appears to consist of a 53-year-old daughter - who is probably employed and living in her own "family home" somewhere else.  That is the typical situation - there will be exceptions (and, I've no doubt sad and tragic exceptions) but most octogenarians aren't providing a home for their families.

Rather than this emotional (and misleading) tugging at the heart-strings of family, we should be asking how we get people to plan for the likelihood of care requirements - indeed the inevitability of such needs. We should be speaking with our own families about how we deal with the funding of care. This means considering savings, releasing asset value and, yes, should it be necessary, selling property. After all, you can't take it with you, can you!

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How old is "old" - Bradford's over-50s housing strategy

Readers will be aware that I currently chair Bradford Council’s Social Care Overview and Scrutiny Committee. For our meeting next week we have a report – on its way through the Council system – entitled:

“Development of the Bradford District Housing Strategy for the Over 50s”

Now I don’t wish to bore you with the content of this report but to discuss whether there is any substantive case for the Council having a “strategy” for housing people who have managed to stay alive for half a century. First though here’s the Council’s patronising “case for age 50”:

The district’s Older People’s Partnership works on behalf of those aged 50 and over; this strategy uses age 50 as a threshold to align itself with the Partnership.

Most people in their 50s won’t think of themselves as being old, indeed we’re constantly

hearing phrases such as “50 is the new 40” in the media. But it’s a time of life when many will start to see their children leave home, and some will be lucky enough to start thinking about easing off, taking a bit of time to enjoy life a little more or take part in volunteering activities.

Using age 50 allows the strategy to be more than sheltered housing and care homes. Fit, healthy and active people in their 50s and 60s are in an excellent position to start thinking about where they would like to live in the future. Cohousing, co-operatives and Local Housing Trusts all present additional opportunities for those that plan ahead.

Now, I’m a little sensitive about this having just reached that half century mark but I really can’t see anything about the housing needs of people aged 50-65 that differ from the housing needs of those aged 35-50. And, more to point, most fifty year olds are getting up every morning and travelling to a job. They are paying off the mortgage on their family home, tending the garden, having a holiday if they’ve got the spare cash and carrying on in the same manner as they did prior to reaching that great landmark age.

The really worrying thing about this strategy is it’s inference that people aged over 50 are likely to be inappropriately housed – in the state’s opinion at least:

“Enable older people to have their families living close to them by freeing up much needed family accommodation. Ensuring our existing housing stock is used as effectively as possible and reduce pressures on land.”

So there you go – government thinks we’re greedily taking up important “family housing” by staying in our four-bed detached with garage and garden. Yet again we see the triumph of patronising state planning directed at a section of the community who really aren’t asking for any special treatment and for whom – in the main – the private sector will provide more that adequately. Indeed, when we want to move house that’s precisely what we will do and nothing that this strategy says or does will change this truth.

There is a good case for supporting the very old – people who really do need support of some kind or another. But very few of these people are aged 50-65 – indeed you’ll struggle to find many under the age of 80 living in sheltered and extra-care housing. The housing needs of this group can be met through the existing housing strategies – we do not need a strategy for “Over-50s housing” especially one with the title:

“Great Places to Grow Old”

Patronising or what?

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Death doesn't become us - a thought on mercy killing

Anna Raccoon, in that knocked-back, slightly laconic manner she takes, describes yet another travesty of life sourced from the Court of Protection – the tale of Wally which she concludes with:

He was a success story by Court of Protection standards too. Probate had been obtained, building society funds duly accredited, house put up for sale to fund his care home, Statutory Will made out, Receiver changed to local solicitor.  Not much left in the account after all the legal bills had been paid.

I drove past the houses on my way to the next appointment. All one colour now, the second front door blocked up – I dare say the courtyard had been gentrified too. I could guess who’d bought it.

Everybody patting themselves on the back – job well done.

And, like these things do, it reminded me of the stories my Mum used to tell – of rapacious relatives, incompetent and venal solicitors and idle carers. Above all, Anna’s tale reminded me of my Mum’s argument against “mercy killing”.

My Mum spent 25 years and more working with old people in and around Penge – delivering meals-on-wheels, driving the mini-buses and running Penge & Anerley Age Concern’s lunch club and day centre on Melvin Road. In this time she saw every sort of folk – from Mr Squirrel who worried that he couldn’t (at 96) dig the garden as in times past to Dr Arnott, communist party member, academic historian and employer of a maid.

Every day, my Mum would tell us, one or more of the people she saw would proclaim – in that depression of loneliness so common among the old and infirm – “I’m just a burden, I’d be better off dead”, or some similar formula of despair. Mum’s response would be to tell them not to be so silly, have a cup of tea and a chat.

But Mum’s view – informed by bitter experience – was that not all the relatives and carers took the same view as she did. And, Anna’s tale of Wally reminds us of this:

The local Doctor was persuaded to sign a form for the Court of Protection – Wally ‘wasn’t taking care of himself’, ‘had no appreciation of the need to pay his council tax’ – Mrs Wally had been paying for both sides of the house for years, unwilling to let Wally’s negligence lose her a desirable home – it was sufficient. ‘Mrs Wally’ was duly installed as Receiver, and everyone assumed that she was his Mother.

All Mrs Wally did was to arrange to part Wally from his property and cash – imagine a world where that form is placed before Wally and his sort? The one where a depressed, slightly confused, sad old person signs to say they want to die, where the bureaucracy takes this as consent and Auntie Sissie or Grandpa Geoff is shipped safely across the Styx leaving his worldly goods behind for the inheritors to enjoy.

It is a depressing truth that much of the debate about our treatment of the old is informed less by understanding or sympathy than by totting up the banknotes tied up in these people’s homes and chattels. Banknotes that could make some old persons last few years more comfortable but which we leave there instead for the relatives to scrap over after they’ve died. And it’s a further depressing truth that “liberalising” euthanasia would grant the opportunity to bring forward the time for that division of spoils – all it will take is a consent form.

Anna’s tale of Wally reminds me why mercy killing – for all that it’s wrapped up in soft words and informed by tragedy – remains killing. And we shouldn’t make that easier, should we?

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The impact of the smoking ban on the old...

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For all my opposition to the smoking ban, I never really thought about how it would create loneliness, depression and illness in the old. Here's one real example (lifted from here): 

“I am getting too old to stand outside pubs or restaurants. Plus I was taught that it was only 'ladies of the night' that stood in the street smoking. 

I have been 3 years away from any social contact other than the odd hello with neighbours. 

Being a widow with no family it was always going to be hard to get back into some semblance of normality with regard to socialising, but I didn't think that it would be this bad.

I used to meet up in a cafeteria with some lady friends, but now that has stopped as a few of the ladies were smokers and didn't want to stand in the street to have a cigarette. 

I went to a quiz night at the local pub as there were quite a few elderly 'singles' there. That has stopped. I also played bingo once a week and that too has stopped as there is no pleasure in having a drink there with no cigarette. 

I am now on anti depressants and wish that I had the courage to kill myself and join my dear husband.

Thank you politicians for making my life not worth living after working from age 14 until 68. I am now 74 and have lost my soul and will to live in this lonely place.”

Depression, loneliness, even suicide - what have we done to these poor folk with our insistence on a total ban. The 'Freedom2Choose' site records a dozen of so examples - real examples of real people with their pleasure destroyed by the smoking ban. Plus this comment from some kid:

“OMG these ladies are my nans age and its people who are younger than them who made these horrible laws that make them stand out in the cold and they should be ashamed at throwing their parents in the street, my nan smokes and says she would rather be at home and i thought it was because she was old but now i think its because she dont want to stand in the street, i cried when i read this letter and wish that my nan could go out to see people and not sit indoors unhappy, they are bastards who do this to old people.”

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What were they thinking? Of course prisoners shouldn't get the vote.

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My decidedly liberal attitude to criminal justice faced a challenge as the great "should prisoners get the vote" debate raged. And yes, the quite hideous John Hirst did a pretty good hatchet job on my willingness to support liberalisation but that wasn't the clincher. The clincher is this blogpost from SadButMadlad on Anna Raccoon's site where he suggests we treat prisoners in the same manner as many of our elderly, nursing home 'customers':

The criminals would get cold food, be left all alone and unsupervised. Lights off at 8pm, and showers once a week.  Live in a tiny room and pay £600.00 per week and have no hope of ever getting out.

Now I know not all old folks homes are like this - especially the creative, modern ones in the private sector - but it's a strong point. And bear in mind that plenty of those old people are effectively denied the vote too since no-one bothers to make it possible for them.

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"I can't dig the garden like I used to..." - some thoughts on getting older.

I thought that, for a change, I’d write about getting old. And how our attitude to age – and the process of getting older – changes and evolves. But first a little story from my Mum.

Many years ago – back in the 1970s – my Mum delivered meals-on-wheels in and around Penge. On one of the rounds there was a couple called Mr & Mrs Squirrel. Rest assured that these are human squirrels rather than the beady-eyed, bushy-tailed variety. Now Mr & Mrs Squirrel were well into their nineties – which back then was deifinitely a ripe old age – and lived in a sizeable house in Sydenham (or rather that bit of Penge that folk liked to call Sydenham so as to avoid using the ‘P’ word).

On one occasion, my Mum was delivering Mr & Mrs Squirrel’s dinner and she got to chatting with Mister. He explained how – it being a nice day and all – he had been out in the garden pottering about. After a few minutes chatting about the garden (my Mum being an especially keen gardener), Mr Squirrel complained that:

“I can’t dig the garden like I used to.”

And therein lies the point. This elderly – very elderly – gentleman refused to accept that the things he did in days past were no longer possible. Digging the garden may take a little longer, he might not be able to dig as deep or turn as much soil but we’re going to dig! And so it should be.

However, as we age, society still expects us to become less able and more dependent until we reach a point when in our dribbling, dotage others must care for us entirely. And much planning for this seems to assume that old age begins at 50.

I’m not joking here – nor am I moaning about the rapidity at which my 50th birthday approaches. Planning for services assumes that someone aged 51 has similar needs to someone aged 97 (ceteris paribus). Housing strategies for older people begin at 50. Saga holidays begin at 50. We are old at 50!

Except we’re not. Old that is – not even remotely old. Most 50 year olds in England can expect to live at least another 30 years – nearly all of those years independent and active. While three of my four grand parents were dead by the age of 76, my son’s grandparents are all alive and all past that age (with three passed 80). And all those people are living in their own homes, driving their own cars, feeding themselves and getting on with enjoying life. In truth they place a little more of a burden on health services – the jokes about rattling with pills do apply – but they are not old in the way previous generations were old.

All this is a good thing – unquestionably. But costly. The entire system of pensions, healthcare and social care is predicated on most people dying in the ‘70s rather than – as will be more and more the case – in their ‘80s or even ‘90s. And, as medical and surgical interventions allow (wonderfully) further extension to active life, those costs will continue to rise.

The question for us all is how much longer the present system can last until it breaks beyond repair. We can’t carry on with the assumption that our property assets will remain undisturbed by the costs of old age. And we have to recognise that pension schemes beginning at ages below 60 are unsustainable. We must also question why we have not raised the retirement age for the ‘active’ professions – police, fire, army and so forth. Finally, we will get used to the idea of people working well into their ‘70s – perhaps not full time but working nonetheless.

The market – as we see from adverts, new products and the images of older people used therein – has already got there. Sadly, the public sector – and the delivery of its services – remains stuck in the 1970s. Time to catch up I guess?

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Use your own money....

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Amid all the froth and anger about the "Death Tax", we are still staring like rabbits at the real scam in all this. The Sunday Telegraph "special report" on care of the elderly opens with this:

"Grace Young had lived for more than 50 years in the terraced house her husband Edward had worked hard to provide. Her only son, John, was brought up in the three-bedroomed home in Carshalton, south London; the couple intended the house to become his inheritance.

Last year, that dream was shattered. When Mrs Young, now widowed, and 87, became increasingly confused as the result of a rare syndrome, her son realised that she would need to move into a care home.

Under the current rules of "means-testing" that meant one thing: selling their much-loved family home to pay the fees. "

Allow me to translate. This couple are expecting the taxpayer - you and me - to pick up the tab for their Mum's care so they can inherit her house. They're not living in that house - they have their own "much-loved family" home somewhere else.

In just how many ways is that wrong?

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