The challenge of how to pay for adult social care in the most equitable way has reached, and probably passed, crisis point.
And as we hurtle towards the winter months, concerns around bed-blocking and a surge in the number of elderly people being hospitalised are throwing fuel on the fire.
This week too has been dominated by debate around how we fund social care, with health secretary Matt Hancock announcing yet another idea - an “opt-out proposal” modelled on the pensions scheme, which would mean every adult in England was expected to pay into a national fund to cover their care in later life.
Much like the recently suggested ‘Care Isa’, it was poorly received. Schemes of this kind are likely to negatively impact poorer sections of society - those that do not necessarily have enough income to afford voluntary contributions in the first place.
What will happen to those who opt-out? Furthermore, the government, and the taxpayer, are still bearing the insurance risk and with growing numbers of people suffering from dementia in the UK, this risk is growing - rapidly.
And the challenge still stands - It remains an emotional and financial burden for individuals organising care.
According to LaingBuisson’s Care of Older People UK Market Report, people in the South East can expect to pay about £1,053 a week for care home, and 44% of people in these homes pay their own fees. Live-in care, although offering, I believe, a better-quality service, is also a significant cost to families - from around £120 per day.
So how can we, as a society, begin to relieve this burden? I don’t believe that pouring money into a broken model of care can help. Instead we should be taking more progressive, proactive measures which benefit individuals financially and reduce the need for care in the future.
The dementia epidemic
Today, 60% of people receiving home-care services and 70% of people living in care homes are living with dementia. We are witnessing a modern-day epidemic - the rise of a disease which is robbing elderly people of their independence, their memories and basic communication skills.
Our partner the Alzheimer’s Society estimates 46.8 million people globally are currently living with the disease. The numbers affected will double every 20 years, rising to 115.4 million in 2050.
It is a cruel disease which is emotionally draining but equally expensive for patients and families - it is estimated that the average care cost for someone with dementia is around £100k.
However, there is ample evidence that more can be done to prevent this type of care being needed at all. Research published in the medical journal the Lancet suggests that 40% of dementia cases could be prevented through lifestyle interventions and further research released just last week added to the body of evidence which shows that healthy habits can in fact delay the progress of dementia by up to 70%.
If we are able to stop dementia in its tracks, we can radically reduce the need for care and the financial burden that goes along with it.
Incentivising healthy habits
I believe that we should reward those who engage in preventative lifestyle behaviours, by reducing the obligation to pay for care further down the line.
With the rise in technology and ability to understand and analyse data we could easily, and anonymously, track healthy lifestyles, which could later pay dividends when looking for care.
Insurance companies have already started schemes like this. Vitality offers rewards for positive lifestyle changes, linking smart watches which track steps or exercise to benefits, offering money off healthy food, or hotels. Prudential have started using DNA testing, to help people adopt healthier lifestyles.
Imagine if you were able to input data on your physical activity and diet, and for that to increase your eligibility for care support. We might witness a greater number of people taking care of themselves.
This is not a silver bullet solution, but ultimately our own risk for needing care, relates at least in part to “sins” of our past. Whilst this is small succour to those at the end of their lives, for those of us being nudged to sign up for another Isa account, it only seems reasonable that we invest instead in our own most precious asset - our brains.
The benefits of such a measure would reach far beyond simply improving brain health and the impact of dementia, because these healthy habits which improve the mind, would have the same benefits for the body.
This Friday is World Alzheimer’s Day - a day to join together and rally against the threat of this cruel disease. We should be taking this opportunity to look at progressive solutions to both reducing the number of people suffering from dementia, but to look at innovative ways of funding social care.
Prevention and incentivisation will be the key.
Dr Jamie Wilson is a trained psychiatrist, dementia specialist and founder of live-in care platform, hometouch.