Jacquie Roberts, head of the Care Commission, has warned that looking after older people in big institutions is more likely to create the conditions for abuse and neglect and potentially breaches their human rights.
In an exclusive interview with The Herald, she called for a far more individualised approach with a greater emphasis on telecare technology – which allows people to be checked on remotely through sensors and other equipment to assist independent living.
The elderly population in Scotland is rising, with a corresponding decrease in those of working age.
From 2006 to 2016 the population over the age of 65 will rise by 21%. By 2031 it will have risen by 62%. By 2031 the 85-plus age group will have risen by 144%.
“Scottish Government officials have estimated that if we carry on in the same way, record numbers of hospitals would have to be built and the majority of school-leavers would have to work in the social care sector,” said Ms Roberts.
“Government figures show that by 2020, some 40% of the country’s school-leavers would have to go into working in the care sector to cope with demand.
“According to Scottish Government estimates, if the older population in Scotland grows and services continue to be allocated at the same rate with same distribution and if we make the assumption that there will not be an increase in resources, 175,000 people or more who are currently receiving some level of service would not receive anything in 2031, and we will have to build the equivalent of a new 50-bed care home every two weeks for the next 20 years.
“We can not carry on thinking that we can only afford to care for older people en masse in an institution, because this is depriving them of their rights. If we treat people with respect and not as an object – even if they are challenging or very dependent – there should be a reduction in abuse and neglect.”
Her comments follow this week’s Herald investigation into elder abuse, which indicates it could be a growing problem across the country.
The Herald found that dozens of people over the age of 65 are on new “at risk” registers held by local authorities and that hundreds of complaints have been received by the Care Commission in relation to concerns about neglect or abuse.
“Together with leaders in health and housing, we should be looking to community provision, which would mean that a very, very small minority of people would have to spend their last days in an institution,” said Ms Roberts. “It is about much more innovative care solutions, and care home providers could come up with some of the solutions.
“The management of telecare is the future. We should be bringing care into people’s own homes in this way and ensuring there is someone to call on if there is a problem. West Lothian is developing this faster than most places.
“People do need people, so it is not just about the equipment. I would like to see much more diversification, so people have individually tailored programmes which they and their family can rely on.
“When you’re 95 you might still be interested in art or football, so why are there not programmes which include trips to art galleries, football matches? This would keep people feeling far more alive and with a much greater sense of purpose and achievement rather than sitting around waiting for someone to visit or cut your toenails.
“It is about redesigning what we are doing. What we do now costs a lot, with highly paid institutional care, but the same money could be more effective with a more person-centred approach. We cannot keep building care homes for the older population, the vast majority of whom will be relatively well until they die.
“We have got to start much earlier with preventative and community support measures. If a golf fanatic is showing signs of dementia we need their friends to take them out to play golf. Practical help with household tasks can be just as important as a hastily delivered meal.”
Telecare equipment can sense risks such as smoke, floods and gas, and can remind people to take pills or call for help if they fall. A help centre can be contacted automatically if any of these problems occur in the home.
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