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Recent community care changes have raised fundamental issues about the changing role of the public, voluntary and informal sectors in the provision of social care to older people. They have also raised issues about the health and social care interface, the extent to which services should be rationed and the respective roles of residential care and care at home.
From Poor Law to community care sets these debates in the context of the historical growth of welfare services from the outbreak of the Second World War through to the establishment of social services departments in 1971. Based on extensive research on primary sources, such as the Public Records Office and interviews with key actors, the book considers the changing perceptions of the needs of elderly people, the extent to which they have been a priority for resources and the possibilities for a policy which combines respect for elderly people with an avoidance of the exploitation of relatives.
This is an updated second edition of The development of welfare services for elderly people, first published by Croom Helm, 1985. It is essential reading for practitioners and policy makers interested in gerontology, policy studies, community care and postgraduate students studying and training in a range of health and social care related professions.
This article begins by looking at past policy assumptions about the importance of home and independence to older people. It is shown that it has long been argued that older people should stay in their own homes as long as possible but that this was not backed up with domiciliary services because of concerns that this would enable families to push caring responsibilities onto the state. The second half of the article looks at present day assumptions on this issue as addressed by the 1990 National Health Service and Community Care Act and compares this to what older people themselves have to say. By drawing on research on 39 older households the importance of home as a place of privacy and self identity is illustrated as is the rich and varied lives of these respondents both inside and outside their homes. It is argued that local authorities as the lead agencies in community care should help to foster such independence and that this requires them to develop a broad vision of community care which covers issues such as transport, leisure and household maintenance.
This article will consider some of the ethical and practical problems associated with the construction of policy recommendations from what are increasingly referred to as implementation studies. Such studies are a form of policy research although there is considerable disagreement over whether it is possible to distinguish an activity called policy making (i.e. the setting up of goals) from an activity called implementation (i.e. the processes required to realise those goals). Whether those who stress that policy making continues well after the formal decisions have been made are right or not, it is clear that many government officials wish to encourage the study of what they perceive as implementation. However, the focus of this article will not be on the expectations of the main research sponsor (whether government or research council) but rather on those of implementing agencies, which allow access without funding the research.
This chapter draws on both historical and contemporary perspectives to highlight the ways in which present government policies are creating a re-medicalisation of later life that is to the detriment of older people. It argues that recent policy developments have ignored the findings from research about how best to respond to the needs of those older people in the community with extensive health and social care problems. The dominant driver of recent policy has been to revert to a medical model in which the major desire of health seems to be to shunt cost onto local authority social services. This chapter takes the recent Green Paper on Independence, well-being and choice: Our vision for the future of social care for adults in England as a case study and shows that what is most striking are the continuities with the past rather than radical improvements.
This chapter explores how future governments in the UK are likely to respond to the challenges of an ageing population especially in terms of the future funding of social care. It sets this challenge within the context of widespread ageism within British Society and the growing tendency to encourage conflict between the generations through a very unfair portrayal of so called ‘baby boomers’ as the selfish generation. It also provides a critique of the extent to which civic engagement or ‘the Big Society’ can reduce the need for the State to play a crucial role in ensuring a high quality of care and support for older people who are near the end of their lives.
Older people in the countryside are vastly under-researched compared to those in urban areas. This innovative volume, the first project-based book in the New Dynamics of Ageing series, offers a unique interdisciplinary perspective on this issue, focusing on older people’s role as assets in rural civic society. It demonstrates how the use of diverse methods from across disciplines aims to increase public engagement with this research. The authors examine the ways in which rural elders are connected to community and place, the contributions they make to family and neighbours, and the organisations and groups to which they belong. Highly topical issues around later life explored through these perspectives include older people’s financial security, leisure, access to services, transport and mobility, civic engagement and digital inclusion – all considered within the rural context in an era of fiscal austerity. In doing so, this book challenges problem-based views of ageing rural populations through considering barriers and facilitators to older people’s inclusion and opportunities for community participation in rural settings. Countryside Connections is a valuable text for students, researchers and practitioners with interests in rural ageing, civic engagement and interdisciplinary methods, theory and practice.
This study reflects a growing recognition of the contribution that studies of the post-war ‘welfare state’ can make to contemporary debates about the restructuring of welfare. Drawing on the community care debates from 1971 to 1993, it illuminates contemporary concerns about such key issues as rationing care, the health and social care divide, the changing role of residential care and the growing emphasis on provider competition.
From community care to market care focuses on the interpretation and development of national policy at local authority level in four contrasting local authorities. The results of the study will make a significant contribution to our understanding of the community care provision of older people.
English
Australia and the UK have historically had very different systems of long-term care for older persons and others. Recent restructuring has led to interesting convergences of those systems - in large part, we argue, because of the limited set of policy levers available to reformers in both countries.
