Preparing For The Worst

Towering achievements cast long shadows, and it is society’s extraordinary success in extending life that explains increasing dementia. As a new report from the London School of Economics explained yesterday, life-blighting loss of memory and mental faculties affects only a minority of older people, but the proportion increases for each successive age bracket, so that nearly one in four of the very oldest are affected.

The population aged over 85 will more than double by 2051, so, barring unforeseen scientific advance, instead of 700,000 people with dementia today there will by then be 1.7 million.

Those with experience of dementia – caused by several conditions besides Alzheimer’s – will understand the moral importance of planning to meet this grim reality. For those directly afflicted, the unremitting erosion of independence can resemble torture; and for families guiding them through this journey without hope, things can be just as bad. For victims and carers alike, the right support can make all the difference, and yet the experience of many is that the system of social care is one in which provision is patchy and entitlements are hard to understand.

Some individual agencies do an excellent job, but others seem more interested in passing the buck to protect their budgets. Services that should alleviate stress can at times work to increase it.

Some progress can be made by simplifying the rules and by rationalising the links between the NHS and social services. But, given the galloping demand which reports like yesterday’s expose, resources are central. In a spending round that will be eye-wateringly tight, campaigners will be most persuasive if they prioritise. Bolstering provision of part-time care for those still at home would be a good place to start. It allows frail individuals to stay independent for longer, and defers the costly move to a residential home.

Yet the danger, identified by the chair of the social care inspection commission last month, is that councils respond to the pressures they face by cutting back on exactly such services. Another priority is a better deal for the carers, who save taxpayers billions a year and yet have never been shown much generosity in return: carer’s allowance is £10 a week less than jobseeker’s allowance.

But the same priority cannot be given to safeguarding the inheritance of families whose relatives have needed professional care. Unless and until provision is got into a far better state, the contribution from the sale of estates cannot be dispensed with, even though more needs to be done to ensure that people do not feel forced to sell their home in their lifetime.

The challenge is vast, so all resources that might tackle it need to be brought to bear.