By Dr Denise Tanner, Senior Lecturer in Social Work
Department of Social Work and Social Care, University of Birmingham.
“We need to recognise that beneath the headlines of the neglect of social care and the neglect of social care workers lies another neglect – that of older people.”
Pre Covid-19 and the outlook for adult social care was bleak, with insufficient funding, stretched resources and a lack of political will to tackle the knotty issue of how to fund social care. Looking back now, even those who were arguing the need to address the problems that beset social care were unaware of just how urgent this was.
March 2020: We had just completed our series of interviews with older people who pay for their own social care when Covid-19 struck. We couldn’t ignore the significance of this global catastrophe that has disproportionately affected older people, so we went back to a small number of the older people we had interviewed previously to ask them about the impact of the pandemic on their social care.
The stories they told
- We heard that no longer being able to go to a day centre could add to already high social care costs if it now meant paying to have a meal and extra care at home. It could also mean feeling lonelier and more isolated and increase the pressure on carers.
- Health problems that were not addressed led to deteriorating health and increased needs. Some of the carers we spoke to were older people with their own health and care needs and the additional demands on them adversely affected their own health and wellbeing.
- One woman we spoke to had been desperate for her husband, who has dementia, to have respite care. By the time she was offered this, the media was featuring news of the high number of deaths in care homes so her response was, ‘I can’t send him in there because I might not see him again’. She struggled on.
- Most of the interviews were flavoured with stoicism and fortitude. Older people adapted and tried to manage as best they could. One talked of letting the carer she paid for by the hour leave early so she could go on to her next visit: ‘You go; I can manage’. ‘You just feel you are helping a bit’.
Older people are paying a high price for the pandemic, both financially by having to use more of their own resources to pay for increased care, and socially and emotionally by the impact of disrupted care on their day-to-day lives. They are anxious about the care staff who come into their homes not wearing the correct PPE and, quite often, worried about the wellbeing of the carers themselves.
There is little prospect of things getting better in the shorter-term. Councils are predicted to have a funding shortfall of £2bn this year because of a huge surge in spending combined with decreased income resulting from the pandemic. Given that older people constitute around two thirds of all those who use local authority care, and that unmet need in this group continues to rise, it is older people who are likely to be hardest hit once again by further cuts to adult care services.
Greater public acknowledgement of the neglect of social care is to be welcomed. But this has yet to translate into better pay, conditions and higher status for social care workers and ultimately this reflects on the value we place on the people they care for. We need to recognise that beneath the headlines of the neglect of social care and the neglect of social care workers lies another neglect – that of older people. Just because many of them bear this stoically does not mean it is morally just to let them.