The challenge of caring for the old must be met

http://www.guardian.co.uk/commentisfree/2012/nov/25/observer-editorial-improve-care-for-elderly

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The one place where you should not expect to find empathy being rationed is a hospital or care home. Last week, however, a damning report revealed that thousands of older people are treated with scant dignity, compassion or respect and suffer poor and unsafe treatment. The report blamed the failings on a culture where "the unacceptable becomes the norm".

The State of Care is the work of the much criticised watchdog, the Care Quality Commission (CQC), based on 13,000 inspections conducted in 2011. The CQC found that 15% of hospitals and 20% of nursing homes failed to ensure residents had enough food and drink and help to avoid malnutrition. Staff shortages at almost a quarter of nursing homes and 16% of hospitals were putting the quality and safety of care at risk. Insufficient staff was "a major ingredient" of poor care.

In addition, inadequate training and the rising numbers of patients with complicated health conditions, including dementia, also resulted in patients being treated as a set of symptoms, instead of as vulnerable and possibly frightened human beings. Most of us will grow old. As the postwar baby-boomers retire, the fuse of the so-called demographic time bomb is already lit. Yet the challenges of how best we keep an ageing population relatively happy and whole as the decades go by, what constitutes high-quality care and support and who pays for it are still not resolved.

The key lessons are already known. Health and social care must be integrated; prevention and early intervention requires investment and the people who provide care ought to be trained and paid properly, accorded status and given sufficient time to do their job well. What's missing is the political will to ensure their implementation. What is also required is an overhaul of the design and philosophy of residential care so it offers far more than a 1950s boarding school for adult-size children.

Examples of excellent care exist but they are far from commonplace. For instance, Lib-Dem Paul Burstow, the former care minister, is a fan of My Home Life, a social movement begun in 2005, supported by the Joseph Rowntree Foundation and Age UK among others, which promotes the importance of "voice choice and control" for patients – giving residents autonomy and power to shape their own lives – and works to open up homes and make them a more central part of the community.

More than 400,000 older people live in 18,000 care homes, three-quarters of them private. The State of Care warns that funding pressure from reduced economic growth means that care homes and hospitals face more challenging times. The proposal in the far-sighted 2011 report by the economist Andrew Dilnot that suggested a cap on the contributions of individuals to their own cost of care at £35,000 has been kicked into the long grass by the coalition .

Muddle, misery and mediocrity are filling the void, while the price of inaction today is hugely escalating costs, as more and more older people are denied the little bit of help that retains their independence for longer. They, and those who come after them, deserve better.