Re-thinking dementia care: Day Care vs. Recreation

Despite very welcome increases in investment in research to find a cure for Alzheimer’s Disease and other the causes of dementia, it seems that a breakthrough is still some years away. In the meantime the numbers of people living will dementia are expected to continue to increase, and it seems that this will happen at a faster rate than the numbers of potential carers. The MODEM project (Modelling Outcomes and Cost Impacts of Interventions for Dementia), a large collaborative research project based at the LSE, will be modelling how we can better the meet the needs of people living with dementia and their carers by 2030, using the best available evidence

Ageing at high speed. The Indo-UK ‘Ageing’ Workshop, Mumbai

Ageing is a global achievement that deserves to be celebrated. At the same time it is a phenomenon with human, social, health and economic implications that need to be understood. There are both opportunities and challenges arising from ageing, which need to be addressed. PSSRU’s Adelina Comas-Herrera reports from the Indo-UK “Ageing” Workshop in Mumbai

How unpaid carers “pay” the costs of dementia

Our recent “Dementia UK” 2014 report for the Alzheimer’s Society, in collaboration with King’s College London suggests that two-thirds of our estimated £26.3 billion cost of dementia in the UK is shouldered by carers and people with dementia. These results, which are also discussed in Martin Knapp’s recent blog post have been reported widely in the media as a “dementia tax”, and contrasted with the fact that most of the care needed by people diagnosed with conditions such as cancer is funded publicly through the NHS

Building on Hope or Tackling Fear? Policy Responses to the Growing Costs of Alzheimer’s Disease and Other Dementias

In most countries, it is clear that the costs of care, treatment, and support of people with Alzheimer’s disease and other dementias will rise considerably in the next few decades. This paper discusses dementia as an economic concern and looks at the policy questions addressed by the current literature on the costs of dementia. It then considers the policy responses to concerns about the growing cost of dementia, distinguishing between ‘hopeful’ policies that seek to reduce or contain the costs, and policies to address the capacity of the health, care, and social protection systems to respond to dementia care in a way consistent with public expectations. We conclude that the costs of dementia care do not necessarily equate to dementia care being unsustainable, but they do highlight the need for policy action. Additionally, it is relatively easier for policymakers to adopt ‘hopeful’ policies, such as investment in research to find a disease modifying treatment for Alzheimer’s or strategies for dementia risk reduction, than it is to tackle the more politically complex decisions needed to ensure that health, care, and social protection systems have the capacity to respond to the challenge of dementia

Summary of international policy measures to limit impact of COVID19 on people who rely on the Long-Term Care sector

This summary of measures has been compiled mostly from contributions to the LTCcovid.orgwebsite by members of the International Long-Term Care Policy Network (see below for references to each report). This list of measures is not exhaustive, it only contains examples of measures that have been reported or identified by contributors to the website so far

Did the UK government really throw a protective ring around care homes in the COVID-19 pandemic?

Context: COVID-19 has disproportionately impacted mortality in English care homes. Objectives: To examine COVID-19 policies for care homes in England and to describe providers’ experiences of those policies in May and June 2020. Methods: Mixed methods including policy analysis and an anonymous online survey of English care home providers, recruited using webinars and WhatsApp groups about their experiences of funding, testing, PPE, isolation and staffing until the end of May and early June 2020. Findings: Although social care policies in England have aligned with those advised by the World Health Organization, they were arguably delayed and were not implemented effectively. Testing had taken place in 70% of care homes surveyed but only 36% of residents had been tested, of whom 16% were positive. Managers were unable to effectively implement isolation policies and reported that workforce and funding support did not always reach them. Guidance changed frequently and was conflicting and could not always be implemented, for example when personal protection equipment was extremely expensive and difficult to source. Limitations: Although this was not a representative sample, care homes responded from across the country and we report the most consistent themes. Potentially, care homes that found it harder to implement national guidance may have been more inclined to respond to our survey than those who more easily changed practice, although those with outbreaks may also have had less capacity to respond. Some aspects of policy will have also changed since early June. Implications: Despite policies that were put in place, care homes amongst our survey respondents were still unable to access sufficient funding, testing, PPE, workforce support and practical support to isolate residents by the end of May and early June. Future cross-country policy analyses must examine policy implementation as well as content.. Future cross-country policy analyses must examine policy implementation as well as content

The role of care home fees in the public costs and distributional effects of potential reforms to care home funding for older people in England

In England, Local Authorities (LAs) contribute to the care home fees of two-thirds of care home residents aged 65+ who pass a means test. LAs typically pay fees below those faced by residents excluded from state support. Most proposals for reform of the means test would increase the proportion of residents entitled to state support. If care homes receive the LA fee for more residents, they might increase fees for any remaining self-funders. Alternatively, the LA fee might have to rise. We use two linked simulation models to examine how alternative assumptions on post-reform fees affect projected public costs and financial gains to residents of three potential reforms to the means test. Raising the LA fee rate to maintain income per resident would increase the projected public cost of the reforms by between 22% and 72% in the base year. It would reduce the average gain to care home residents by between 8% and 12%. Raising post-reform fees for remaining self-funders or requiring pre-reform self-funders to meet the difference between the LA and self-funder fees, reduces the gains to residents by 28-37%. For one reform, residents in the highest income quintile would face losses if the self-funder fee rises

Financing Long-Term Care for Elderly People

Last year’s report of the Royal Commission on Long Term Care (1) and the expected Government response have prompted fresh interest in the debate on how to fund long-term care. To inform this debate the Personal Social Services Research Unit (PSSRU) has conducted a study, funded by the Department of Health, of long-term care demand and finance. This has involved the construction of a computer model to make projections of likely demand and expenditures to 2031. This article describes the model of long-term care demand and expenditure developed by the PSSRU. It then presents some of the results obtained and sensitivity analysis around them

Future demand for long-term care, 2002 to 2041: projections of demand for long-term care for older people in England

The financing of long-term care raises a great many questions. How many older people are likely to require long-term care services in the coming decades? How much are these services likely to cost? Will the cost to public funds prove affordable? Who should pay? How should costs be divided between public expenditure and private sources of finance? In order to address these issues, reliable projections are needed of future demand for long-term care and future long-term care expenditure. This paper presents projections of demand for long-term care for older people in England to 2041 and associated future expenditure. The projections were produced using an updated and expanded version of the Personal Social Services Research Unit’s (PSSRU) long-term care projections model. The version of the model used here has a base year of 2002 and incorporates the 2004-based official population projections. The first part of the paper describes the PSSRU long-term care finance research programme and recent associated projects. The second part of the paper describes the updated and expanded PSSRU long-term care projections model, including details of the data used in this updated version. The third part presents a set of base case assumptions and the projections obtained using those assumptions. The fourth part investigates the sensitivity of the projections to changes in those assumptions. Section five discusses the findings. A final section sets out some conclusions