To wonder (setting aside immigration) how the elder care sector can be improved?

I find it disturbing that OP wrote so much about assisted dying. To me, elderly social care & assisted dying don't connect at all.

OP wants : 1. deprivatisation, 2. higher pay & 3. training & status. Also much 4. more [stringent] checks on quality of homes.

Yeah... coz closing down more care homes will do so much to increase capacity in the residential care sector.

Anyway, everything on OP's list means raising taxes. British public have consistently voted against any party that proposed raising taxes to fund social care. Theresa May tried & failed. So nothing on OP's list is feasible.

Tommy Tiernan did a hilarious bit about cutting off healthcare at 80 if you have time. I do think that it’s not necessarily sbout age I know some 70/80 year olds who are in good health, fitter than me, enjoying travel and retirement.

It’s more about the growing gap between a healthy life and death. I think there’s little point keeping people with advanced dementia propped up by lots of medication, kinder to withdraw and shift to palliative care. I’m pretty pragmatic though and would be happy enough to be treated like a beloved pet.

Hopefully I’ll of had a good innings but once the back end goes, in a decent amount of pain and quality of life declines then I’d much rather be euthanised than have to go through a long decline.

Out of curiosity, if someone is over 80 and completely healthy would you also consider them to have had 'plenty of years on this earth'?

Me too. Renting from a housing association, local authority, or almshouse charity would be preferable. But those are in short supply, especially for homeowners.

I’d far rather take a pill and check out as soon as my faculties have gone . The indignity of old age fills me with dread .

You'd be surprised how many people get no visitors dispite having 3 or 4 children, it's heartbreaking because they do know

As someone who works in a care home, one word staffing, never enough I care so much but can only physically do what I can do and it upsets me so very much I haven't got time to spend with people that I should some people in bed have no radios no tvs as it's not standard to provide them, weeks with barely interacting with people unless needs been met it's terrible

I can tell you from working/visiting independent living homes and domiciliary care homes. If you are paying for 30 mins care the average you will be getting is 15. Most of the carers do not care and the ones that do carry a very unfair weight of the load. The comments I have heard from managers when they didn't realize I was there or did not share their humour have been vile. One of the schemes I worked at had a manager that ran 2 of the schemes close to each other. One resident there was a lovely lady so polite, her daughter used to do most of the care anyway as she rightly it turns out, didn't trust them. I walked into the office one day and the scheme manager was joking with the 2 assistant managers with other staff present that she must be having a good old play every night as her pull ups kept being found twisted, was one of the most shocking things I have heard. I reported back to head office who did not do a lot and as far as I know she still works there. I am tempted to tell the ladies daughter, but it would upset her so much. So I wait and wonder what to do for the best. I am thinking of getting her daughter to change care company. It was vile. Totally dehumanising.

Probably an unpopular opinion but I don't want to live to past 80 with health problems and costing anyone over 1k a week. Bring in dignitas and let us chose how we die with grace.

Don't consider moving into sheltered housing. If you need to downsize, just buy somewhere smaller, you can have an alarm system fitted and bath aids. Retirement complexes are awful places.

You keep on about leaving immigration issues aside and I cannot for the life of me see what immigration has to do with the subject in the first place.

It's up to us to decide what we want to happen to us when we get old, we need to think about while still in our right minds.

Also remember that many elderly people stay quite fit well into old age and don't need care.

I know I don't want to go into a care home, if I am in need of assistance I can have it at home, so can most people if they don't develop dementia which requires 24/7 supervision.

Make time for the elderly people in your life, ensure that they are safe and comfortable. If carers are employed, get to know them so you're satisfied they are kind and do their job properly. Set a good example to your children.

Keep yourself as healthy as you can with good diet and hope for the best.

I would be very reluctant to buy one of the purpose-built flats for the elderly, for myself or a relative, due to the issues in reselling and in paying huge service charges even when the flat is empty.

There’s a fixation with keeping people alive. Just because modern medicine can keep someone’s pulse going and air moving in and out of lungs doesn’t mean it should. People have to die from something.

My elderly mum was recently in hospital. When I arrived to see her, she was on a trolley in the queue for x-rays. Every person in that queue was very elderly, and they all looked not just ill, but like they were one foot in the grave, and I couldn't help wondering how many of them would truly benefit from the procedures they were getting.

My mum has had poor quality of life for the last few years, and over the last few months she has deteriorated greatly, and now is barely eating. When I mention this to people, they say, "Well can't they put her or a drip? Or give her liquid food?" But what for, really? So that she can have an extra few months of pain?

More options for Independent living for older people would be a start! A flat, with a lift if not ground level, with a walk in shower, would reduce the number staying in hospital because their homes are unsuitable. The right housing, with support, if and when needed, has been proved to delay the need for residential accommodation.

Living in the right housing can reduce isolation and loneliness, a scourge for many elderly people rattling around in family sized homes with family long gone. Unfortunately there are not nearly enough, and many owned by the private sector are not only expensive to buy, but have hefty charges on top.

How do the not-for-profit care trusts perform? Honestly curious on this point, as I've only worked in the private sector.

Having seen my dad wither and die in a care home - one considered to be one of the better ones - I am utterly determined never to end up in one, even if it takes a short visit to the nearest tall cliff.

People are not being allowed to die with dignity. Their lives are viciously, artificially prolonged with the force feeding of antibiotics. No thanks.

Looking at areas where it’s state run, and the comparative performance of those facilities and their running costs might give you some insight.

(Spoiler - no cheaper, and not top performing).

Yes.

We should all be given the opportunity to live with good quality of life, and with dignity. Where that line is drawn will be different for different people (as has come out very clearly in the assisted dying debates).

This isn’t about knocking people off before their appropriate time, but it is about not prolonging life beyond that just because of fear of complaints or to postpone family upset.

Plan A is ring round all the staff you have and see if someone can do overtime.

Plan B is agency staff.

Plan C is grit your teeth and get through the day understaffed.

I assume care homes have minimum staffing ratios? What happens though if you just can't fill that ratio?
If it was a nursery, worse case scenario, you could just close for the day. You can't do that in a care home though.

DD works in a care home and she loves her job, however some of the staff do as little as possible and spend ages outside smoking. The owners are not saying anything because they need to keep the staff as most homes are short staffed at the best of times.

There arecalsi regulations regarding supplies especially in Dementia care homes with the amount of pads they can get from the NHS and they aren't nearly high enough so the home has to either buy more or leave them on the people who live there until the very last minute

I think the problem with these difficult conversations is that they're not even allowed to happen.
I read about Jill Sinclare, the wife of Trevor Horn, she was in a coma for years after an accident and then awake but extremely poor state, unable to communicate, walk, toilet or eat and seemed to only be in pain. She died eventually of breast cancer. I always wonder if her cancer was treated or just allowed to take her.
It's an absolute tragic story.
en.wikipedia.org/wiki/Jill_Sinclair

More sheltered housing and what if it could be say one live in carer for 2-3 elderly - split thr cost

Caring for the elderly is a job that not many people want to do and with good reason: poor pay, stressful, employees probably run ragged in an understaffed care home or client’s own home (and often with poor working conditions). And, generally, there’s a pretty poor attitude towards the elderly further impacting the likelihood of anything improving.

I worked on the periphery of the NHS until fairly recently organising services for elderly people in and coming out of hospital. Over a ten plus year period, I watched EVERYTHING (hospital and respite care as well as social services) decline immensely. The whole health and care system is now a complete shit show for everyone and not likely to improve for decades (if at all).

So, although I have huge reservations about assisted dying, I’m hoping it will be available for me when the time comes because I’ve seen ‘care of the elderly’ close up and it’s often very frightening.