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

[PrincessSophieFrederike]

There's been so much recent coverage of how bad the situation in care homes is. Short-staffed, owners pocketing money that should go to the staff, elder abuse...

I don't want this to be an immigration debate. So setting aside that, what I wonder is how can we improve the care sector? Whatever amount of immigration we have, we will need workers from here as well.

It's very difficult as elder care is just the kind of job for which you need a specific type of person. The government can't just put people in it in some big initiative to get people into work. Two big things that would help would probs be higher pay (and probs deprivatisation of the care sector) & higher prestige, making it a job you train for & can progress in. It's disgusting the comments one can see in discussions (mainly nor here, but elsewhefe) where caseworkers are dismissed as interchangeable bottom-wipers. Our society needs to make changes so they are properly valued.

This ties in to attitudes to old age. I sympathise with people who supported assisted dying due to their personal experiences. But it feels very dangerous for the government to bring this in (even if in a limited way) without better safeguarding for elderly people. If the only government effort to help them is assisted dying, then it gives a disturbing impression...

I noticed that many people who supported assisted dying spoke of terrible experiences with family who had severe & irreversible dementia, & wanted to avoid this. The assisted dying Bill doesn't cover this though ad you need to be of sound mind. Is it not though possible for people to write their wishes down, making clear that if they develop dementia in that way, they don't want to receive excessive treatment? Many families speak of parents who wanted to not be given medication for repeated UTIs & pneumonia if they had severe dementia, but as they hadn't recorded their wishes, medication was repeatedly given. Surely this could be changed in other ways apart from assisted dying bills?

Another issue is at-home care vs care homes. One problem is that lots of elderly people now live further from family- maybe more extended families could help? But this ofc wouldn't change quickly, and would only be possible for people with relatively mild medical needs, or at least not ones which involve potentially dangerous behaviour like dementia. And there's ofc plenty of reasons why people might not want to live with a healthy patent, let alone one needing constant care.

. Some family friends can afford live-in carers for their parents, but obviously this isn't possible for a lot of people. And care agencies can be just as risky as care homes...

TLDR : What can we do to improve care homes, (leaving immigration issues aside)? The main things I can think of are deprivatisation, higher pay &training & status. Also much more stringent checks on quality of homes.

Shipping someone abroad is not going to do them any good. Imagine being frail, elderly and with dementia and suddenly you’re surrounded by people who don’t speak your language and you never see a familiar face. Never mind the risks of the flight to get them there.

Being surrounded by people you don't know who don't speak your language sounds like a care home in the UK. If shipping our elderly abroad became a thing (don't worry, it won't) the homes would be full of other British residents and staffed by the same staff that would have been working here.
And not doing the elderly any good to ship them across the world (agreed) it doesn't do a two year old any good to separate them for years from their mother either.

It needs nationalising.

Not all of them. My friend has quite recently moved into a new complex, and she is loving it. She has her own flat, but there are also some communal spaces for exercise, socialising, hobbies etc. The flat is really nice, and the service charges are reasonable. She feels secure, which is a big plus for people living alone.

I mentioned immigration because an obvious issue is whether migrants will continue to be a major source of care workers or whether we will focus on recruiting people already here, or a combination. There's clearly a terrible shortage of workers so it will need to be fixed somehow. As I said, I didn't want this to get sidetracked into an immigration debate, but I thought it should be acknowledged.

Like nearly all other businesses these days, we need to stop the profit chasing foreign millionaires/billionaires who own them/finance them. Get back to privately owned homes run by local people. Just like we should get back to locally owned privately owned GP surgeries, dentists, opticians, accountants, solicitors, vets, restaurant chains, retailers, etc. The nationalisation/globalisation of our service industries are ruining the service quality in so many ways - all so the foreign billionaires can pocket even more money!

I agree with this. I used to feel bad that my mum only gets two visits a week, one from me and one from my brother. But soon realised that is two more than some residents get and one more than a lot get.

I worry about this too. Other threads I've read on MN have given me the impression that some people think the economically inactive are dispensible. It's giving off strong dystopia vibes.

(Not talking about anything I've read on this particular thread btw, although I haven't read every single post.)

All of the above.

Sadly I have seen this too.

I get you now, Princess.

I doubt there will enough loca/home grown people wanting to do that sort of work. Some will, some do, as always. My ex neighbour worked as a home carer for many years before retirement, was very good at and enjoyed the work.

What matters is training, quality of care and reliability, and it needs to be monitored. Where the carer hails from doesn't seem relevant as long as they have a good work ethic and do care.

Just to add, I've been watching last night's Question Tim on iplayer and much was discussed that was relevant to this thread.

It's like any other insurance. You hope you never have to use it.

Like National Insurance Contributions- if you die before State Pension age, you don't get anything.

Absolutely would be advocating for the difficult conversation.

You can have that conversation with many different outcomes.

You can also have it with the active, with it 93 year old, so that everyone is clear on how much invasive treatment they want should they have a massive stroke.

You should also have the conversation with your loved ones. For you and for them. Regardless of your current health.

Many people can be kept alive weeks/ years even as a human vegetable, no quality of life, no visitors, in rooms hour after hour, no TV (don't come as standard in every room) people often die and leave tvs that get passed on,
Personally if I can put something in place I'd say no hospital admissions a dnr and don't feed me let me go it's no life, but has to be that person's decision at a time they are capable to make it

An excellent idea and we are starting to see this . Still doesn’t solve the really advanced years of you can’t take care of yourself though