"Assess the success of the' community care' policies over the last two decades in providing for the long-term needs of the elderly."

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Laura Duncan        98057758        BA Social Science

Sociology of Welfare – Coursework           3rd Year

“Assess the success of the’ community care’ policies over the last two decades in providing for the long-term needs of the elderly.”

Longevity has increased for both men and women during the course of the 20th century. Life expectancy at birth rose by over 28 years for females and 24 years for males between the years 1900 and 1980. Caring for older and more dependant people is therefore a major social policy issue nowadays. Although increased life expectancy is obviously a positive achievement, with it unfortunately comes the perception of being a burden. Many older people do want to feel that they are a burden. They want to live as independent a life as possible. The government introduced the Community Care Reforms, first described in a 1989 paper called ‘Caring for People’. The NHS and Community Care Act 1990 made the necessary legal changes, which were fully implemented in 1993. This essay will aim to assess how successful the community care policies have been in meeting the main aim of elderly people and how much of a change the reforms have made to their everyday lives and what effect this will have on their long-term care needs. To do this, the essay will consider what problems existed in community care policy in order to bring about the reforms. It will then examine these reforms and the issues raised within them. It will then go onto look at the necessary legal changes that were made to make these reforms the law.

Initially, the question that must be answered is ‘what are the long-term care needs of the elderly?’ The answer to this question is fairly simple. Although the majority of people over the age of 65 live independently and have no major care needs, a significant minority do have some problems with physical and mental health. The figures show that 9% of people over 65 experience difficulty walking up and down the stairs, 2% find it hard getting in and out of bed and 8% have difficulty with washing all over. Also, approximately 1 in 10 elderly people suffer from forms of senile dementia. As can be seen, it is simple day-to-day things that most elderly people require assistance with. Their main wish is clear; they simply want to stay in their own homes or in the homes of their family.

Firstly, the problems that existed within community care must be examined, as these were what led to the changes. Community Care is broadly termed as helping people who need care and support to live with dignity and as much independence as possible within the community. Although ‘community’ often means ordinary houses, it can include special forms of housing, or residential or nursing homes. Community Care had been official policy since the 1960’s. However, in the 1980’s a number of criticisms developed regarding the forms of public provision available for older and disabled people. These criticisms included the fact that there were not enough resources being put into community care and too much into institutionalised care. Moreover, the services provided were limited and often did not meet the needs of the individual, in the case of the elderly, wanting to stay at home. Also, the people actually using the services were rarely heard when trying to voice their views and opinions. The service providers were often more interested in their own personal agendas than listening and responding to the users wishes.

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These problems, and more, were the catalyst behind the rapid expansion of public expenditure on private residential care and the government wanted to put a stop to that. The government asked Sir Roy Griffiths to review community care and many of his findings in his 1988 report went onto be included in the 1989 White Paper, ‘Caring for People’. This was the official paper that spelt out the duties of local health authorities to assess people needing social care and/or support. It is based on the assumption that community care is the ‘best’ form of care available. The White ...

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