What older people need is not choice, but companionship

24^th June 2013

ResPublica Associate Alex Fox writes in the Guardian on our Putting People into Personalisation report

Government policies for older people’s care aim to offer them choice and control over their support. This choice-based approach reflects similar developments in support for working-age disabled adults, and has come to underpin many of our public services. But as we argue in a ResPublica paper, published on Wednesday, the choice to remain an active, valued and included member of the local community has become increasingly out of reach to many older people.

The approach also doesn’t offer what older people really want and need – other people. As the UK’s population ages dramatically, so does the number who are lonely, isolated and poorly housed.

Some argue that this demonstrates that older people don’t want choices, just more reliable traditional services. Another interpretation is that choice is only valuable where a range of good, safe options is available and at least one fits the chooser’s particular wishes. Older people know that good support enables them not only to be cared for as an individual, but also to keep in touch with old friends and make new ones. It ensures their needs are met and that they can feel useful to those around them.

There are ways of delivering services that do just that. Shared Lives (SL), the UK network for family-based, small-scale ways of supporting adults, is increasingly being adapted for older people. SL carers are matched with an adult who needs support and, where possible, has a shared interest. They then share family and community life. For younger adults this often means living with the SL carer as part of their family for a short or extended period. An older person with dementia more typically becomes a regular visitor at the SL carer’s house for day support or short breaks in a familiar homely setting.

Another scheme, Homeshare, links up isolated, older adults with carefully vetted young people. Again, they are matched for compatability, and share housing, helping to meet each other’s needs. Both schemes are funded by the charity, Shared Lives Plus, which receives most of its income from government grants, charitable trusts and membership fees.

The goal is for everyone to be able to contribute, as well as receive the support they need. It is a far cry from the image of older people sitting around the walls of a care home lounge or waiting alone for the next 15-minute slot of home support from their “chosen” agency.

But these alternatives are little known, victims of their own success in blending into their communities. Crucially, though, they are cheaper than traditional alternatives. The average saving of someone transferring from residential care to a SL scheme is about £13,000 a year. To bring them into the mainstream, councils need to match the energy they invest into creating ways to exercise choice with an effort to ensure that there is a genuine range of opportunities for older people to become active members of their communities, rather than passive consumers of services.

The Guardian Article

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