By Debbie le Quesne

Archive for July 2013

Dementia guide ‘first’ published

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A year ago an all-party parliamentary group commissioned to study the far-reaching issues of dementia published the Unlocking Diagnosis report.

A year on and as a direct result of its shocking findings, a new booklet to help guide people diagnosed with dementia and their carers was launched yesterday by Alzheimer’s Society.

The guide, a first of its kind, offers advice to help people come to terms with their diagnosis and plan ahead.

I was appalled to discover that the all-party report found that many people said ‘nothing’ happened after the initial diagnosis.

The guide will also offer GPs and psychiatrists the opportunity to provide people with dementia carers at the point of diagnosis.

How good is this!

Whilst diagnosis rates are increasing, some doctors still appear reluctant to diagnose the disease, Currently, more than 50 per cent (428,000) of people living with dementia still do not have a formal diagnosis.

The dementia guide, has been part-funded by the Department of Health.

It tackles the emotional impact of a diagnosis and drug regimes, ande; signposts services available.

The guide is available free of charge and to order visit alzheimers.org.uk/dementiaguide  or phone 0300 303 5933.

NHS professionals should order direct from NHS England’s Health and Social Care Publications Orderline (using product code 872).

A raft of advice on how to navigate the help systems is included, including financial support.

Diagnosis of dementia is truly daunting and the disease’s progression challenging. Please make use of this invaluable free tool.

Safeguarding: A need to open doors

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Action on Elder Abuse is campaigning for sweeping changes in the Care Bill – with safeguarding issues grabbing the headlines.

The pressure group is also defining a course of action rank and file care sector workers can take to help place existing infrastructure of adult protection onto a statutory basis.

In 2007, following publication of the Prevalence Study into the extent of elder abuse within the community, the Government committed to a refresh of the No Secrets guidance on safeguarding vulnerable adults, with particular reference to the legislation underpinning adult protection policy. This review was finally concluded in 2009. A large number of issues were identified by that review, the majority of which are not addressed by the current Care Bill.

Simply, AEA is saying the current clauses are not stiff enough to protect those who cannot protect themselves.

So what’s AEA looking to achieve?

Powers to stop abusers imprisoning victims in their own homes.

Some 40 per cent of referrals are regarding victims in their own homes. The law needs to allow, through a court process, entry into the homes of potential victims. All too often that access is dependent upon the co-operation of the abuser.

A duty on agencies to notify the Local Authority if they believe an adult may be at risk of abuse. There is a need to underline the responsibility of all agencies to report if they have reasonable belief that an adult is at risk.

Adequate Funding:

The greatest number of referrals to adult safeguarding is older people and, referrals are increasing year on year by at least 11 per cent. At the same time local authorities are making significant cuts in services, with a significant proportion affecting older people’s services. Funding limitations must not dictate whether an abused adult receives intervention.

There must be a minimum expectation of what we will collectively consider financially acceptable to invest in these activities, and this must be reflected in our financial priorities.

Clearly, given the gravitas of AEA and its robust response, something is wrong. Our most vulnerable it appears are still vulnerable.

What can you do?

  • Write to peers indicating your support for Baroness Greengross’ amendments. She is supporting the AEA proposed amendments.
  • Encourage others to get involved
  • If you work in this area, send examples to the AEA enquiries@elderabuse.org.uk of where a power of access would have been necessary

Already on deck pushing for powers of access are Mencap, the College of Social Work, the Equalities and Human Rights Commission and Age UK.

Care minister seeks help from frontline workers

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When you don’t know the way ahead, ask a care worker on the frontline.

Well, at least that seems exactly what the government is doing at present.

Care minister Norman Lamb has called for everyone in the care mix – service users, carers, managers and directors to submit ideas on how to make the home care system work.

Earlier this month Mr Lamb held a crisis summit with home care providers on how to improve standards.

Simultaneously, business secretary Vince Cable told us that he is undertaking a fact-finding review of zero hours contracts – and some, if not an awful lot, of domiciliary staff have them.

The care minister’s crisis meeting followed a Beeb story showing video footage of neglect by a community provider.

Reported in the online CommunityCare, Colin Angel of the UK Home Care Association, who attended the summit, said the meeting recognised there was little new money available to help the cause.

“It was about how we can harness what good practice and innovation there already is across the country to improve the situation,” he was quoted as saying.

Mr Cable has stated that over last ten years there had been a rise in the use of zero hour contracts. True, but inevitable given the financial stranglehold of the economy and government.

With claims of abuse in the air over such working practices, Mr Cable was quoted as saying in the CommunityCare article: “Whilst it’s important our workforce remains flexible, it is equally important that it is treated fairly. This is why I have asked my officials to undertake some work to better understand how this type of contract is working in practice.”

As far as I understand there’s no timescale involved in this review and it’s all about “understanding” the working arrangements.

I know only too well the financial rigours care businesses face and news of no more financial help is not good. Many can only stay in business by offering zero hour contracts. It’s simple economics – no work, no pay.

Other issues in focus are unpaid travel times, shorter calls to clients and compliance with the national minimum wage. The waters get very muddied here.

I am heartened that Mr Lamb wants our views, though I doubt the care sector will be very responsive. Everyone is just too busy trying to survive, Mr Lamb!

I’m also ever so slightly worried that the call for help smacks of desperation. Truth is, care workers aplenty would probably have some excellent best practice to share and not least a few politically uncomfortable home truths.

Dementia dogs are just ‘paw-fect’

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Friday is always deserving of a happy ‘tail’ or two. So today I have one for you – and I love it.

A golden retriever called Oscar and a Labrador called Kaspa are the nation’s fist dementia dogs.

They have been working with their new owners for four months after 18 months of training.

These clever creatures have been taught to respond to alarms and bring medicine pouches, to nudge their owners to go and read a reminder, and to encourage them to get out of bed in the morning. Just how clever is that!

The dogs work with two people who are in the early stages of the memory-loss condition.

The idea came from students at Glasgow School of Art’s (GSA) Product Design department and was then developed by a partnership between Alzheimer Scotland, Dogs for the Disabled and Guide Dogs Scotland.

Both animals have been highly trained to help offer practical assistance and reduce social isolation and anxiety levels. And there are a couple of other dogs now in training too.

A further two dogs have already begun their training.

Clearly this could herald a new era in the way people with dementia and their carers are supported.

Oscar was withdrawn from guide dog training and passed across to the Dementia Dog project, whilst Kaspa came from the Dogs for the Disabled socialisation project.

Volunteers started work with them as puppies and at just over a year old they moved into the Guide Dogs Training Centre at Forfar, where they were trained for their new role, with help of staff from Dogs for the Disabled, based in Banbury, Oxfordshire.

I’m such a softie. I love these dogs soooooo much, but seriously, their work opens a whole new approach to dealing with this awful disease.

Hope this blog is just ‘paw-fect’ to raise a smile. Have a good weekend.

Ping Pong! Why you’re never too old to go for gold

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Every now and then the care industry throws up a gem – and none more so than a project called the Ping Pong Care Campaign.

It’s all about a BRITDOC Foundation UK tour centred on a remarkable documentary film.

The aim is to show the film – Ping Pong – to 2,000 “older person settings” in the UK.

And the clips I have seen from the film are amazing. People pushing towards 100 years of age playing ping pong . . . and some, playing well, One woman recalls how the game had been her lifeline after the death of her husband and another, who had survived cancer twice, was determined to just keep playing.

In short, the film is nothing other than inspiring and shows how stereotypes can be torn down in a moment.

The film was released in July 2012 and has already been screened to some 50 cinemas in the UK. It’s been shown in the US, Canada, Poland and Taiwan.

Campaign bosses are urging care homes sheltered housing schemes, care villages, community and day centres to screen the movie as inspiration for more active lifestyles in senior years.

My first recollections of table tennis were at youth clubs in church halls. But all that has changed

“Ping! is a street table tennis project funded by Sport England that has changed the face of ping pong.  What began as a tentative flirtation with the game has turned into a massive love affair that has changed the landscape of ping pong across England,” Care Industry News reports.

The project has been running for three years and to date 800 public ping-pong tables have been installed as part of the Ping! project.

I love these kind of stories that expose just what older people can do. We hear too often all the things elderly cannot do.

Please, please, please, catch www.youtube.com/watch?v=8Qru5cnfxE0#at=16  . . . the link is wonderful.

Funding care: My worries at the latest government plan

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Last Thursday the Department of Health published yet another proposal on how to fund care for the elderly.

I confess I’ve been putting off doing this blog in the hope that I could over time understand more fully the government’s plans. Sadly that has not happened.

The original Dilnot plan – or should I say, the revised Dilnot plan, was complex enough – but this latest offering seems worse.

The Guardian noted that “relatives wishing to investigate the costs of a care home for a loved one will need expert guidance to explain how the funding will work.” Too true.

This latest initiative is essentially an insurance system for elderly care in England which promises to cap costs for one in eight poorer pensioners and cut bills for the wealthy by up to a fifth.

Postcode lotteries of how much care is delivered and for how much money will be swept away in 2016 and replaced by a national level of eligibility.

Individuals will pay into a government-backed “care account”.

We know the cost of care will be capped at the proposed £72,000. But this will only pay for someone’s care. It will not take into account the hidden “hotel costs” for bed and board, which could be another £15,000 a year.

Where is this shortfall of cash coming from?

Deferred payment has also been mentioned, so that settlement will come from the estate of the deceased. Essentially those needing care will also be able to borrow money from local councils at a nationally agreed interest rate to pay for the service but will have to pay it back when they die.

All we seem to be doing here is putting off the inevitable: The government seems to be saying the plan will stop people having to sell their homes to pay for care – but only while they’re alive. Outstanding care costs will still have to be met and I suspect for most, through the sale of property.

Given that local authorities are squeezed financially as much as the rest of us, how are they going to fund care ‘up front’?

Critics are already forecasting this system will be a field day for lawyers as disputes erupt between households and local authorities over the levels of care provided, the cost and whether someone has been properly assessed.

‘Premium bond’ model to fund care for elderly

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For those of us who feel forever young, the prospect of long-term social care in coming years seems unreal.

And this is one of the hurdles any funding process for older age must overcome.

Perhaps, though, a new proposal from the International Longevity Centre could make the pill less bitter.

The Financial Times rolled out a story last week explaining that personal care bonds may be the way ahead.

The bulk of social care costs are borne by the public sector, but national reforms aim to shift some of that responsibility to individuals.

From 2016, those needing care packages will be expected to fund up to a limit of £72,000, and the state will only step in thereafter if the individual’s assets are worth less than £118,000. The government hopes that a raft of health care packages will be available in the finance market by then.

The ILC proposal targets modest income families with a saving scheme product that Britons have come to know and love – premium bonds.

The Times explains PCBs would retain what is perhaps the most inviting aspect of premium bonds: the possibility of winning a big prize.

They would also enjoy tax-free winnings just like premium bonds.

Unlike premium bonds, PCBs would accrue interest.

The scheme also proposes that these savings would not be redeemable until the saver has been assessed as needing social care. Premium bonds, however, can be cashed at any time.

Will this work? Indeed the idea is a novel one, but we are still left with the old chestnut of just where will people find the money to invest in such a scheme.

The insurance sector has been terribly slow on floating policies to cover needs in old age and I can only assume the reasoning is that they will struggle to work.

Similarly, even though this scheme seems much more appealing, I don’t think it will attract many investors unless there is a dramatic upturn in the economy and more jobs and extra disposable income is apparent.