Ignore the dementia care challenge and pay the price

By 2051, 60,000 people will suffer from dementia. The Assembly must look seriously at the provision of elderly care, says Kathryn Johnston

Like Woody Allen, I’m not afraid of death; I just don’t want to be there when it happens. I want to be living the high life in some tropical paradise, dancing the merengue while drinking a pina colada. Probably you feel the same.

But, in the words of John Lennon, life is what happens to you while you’re busy making other plans. So the funeral is planned, I’ve written my will and signed an advance directive.

But what if I get dementia and the living will kicks in? The Assembly’s Dementia Strategy, published last November, forecasts that 60,000 people in Northern Ireland will have dementia by 2051.

I’ll be ashes by then, but it’s a fair bet that, at some stage, I’ll be one of the 50% of dementia sufferers being looked after in care homes.

And that is an uncomfortable thought when you look at the case of Owenvale Court Care Home in Belfast. Run by St John of God Association, the home is at the centre of an investigation by the Regulation and Quality Improvement Authority (RQIA).

Last month, an elderly woman died following a fire there and the RQIA has identified a range of concerns about the St John of God Association’s running of Owenvale Court. They have moved to take action against the charity and warned the home may be de-registered.

I am helping a friend check out a nursing home for his elderly father, who has vascular dementia. Although he is 87, with atrial fibrillation, pernicious anaemia and a wonky hip, he could live for years – but as his dementia progresses, sooner or later he will have to move into a care home.

We thought that we had found the perfect one. Small, just around the corner from my friend and modern, run by a husband-and-wife team.

Then we read the RQIA reports. On an unannounced inspection at the end of last year, the inspectors found one bedroom “noticeably cold”, with some residents “dishevelled”; two were “thin in appearance”. Not a bit of wonder. One resident told inspectors that, following a previous inspection, they now had a choice of evening meal. So what was the choice on the Saturday night? “A Pot Noodle, or a banana.”

The home charges “Trust rates”. The Northern Health and Social Care Trust rates, for example, range between £426 and £537-a-week. There is often an additional weekly top-up fee of £30-40. And, if you have more than £23,250 in capital, including the value of your home and any savings, you are liable to pay the full costs of your care.

The Assembly needs, as a matter of priority, to examine the funding and running of care homes. We need to know what we will be entitled to when we are older and what they expect us to contribute.

What are the chances of our MLAs seriously engaging in this debate? After all, they can’t even decide on water charges. We are facing the biggest demographic challenge of the 21st century – care of the elderly must be given the priority it demands.

They could start by looking at the Dilnot Commission’s recommendations. One of the Westminster coalition’s first acts was to launch an inquiry into how to stop tens of thousands of people being forced to sell their homes each year to pay for support in old age. The economist Andrew Dilnot was asked to chair the commission.

Last July, he proposed raising the English means test threshold from £23,500 to £100,000 and imposing a cap on the maximum anyone should pay for care in their lifetime at £35,000. The state would then cover any costs above this level.

However, the Treasury is unwilling to provide the additional funding the Dilnot plan requires and plans for legislation were shelved.

No one has come straight out – yet – and explicitly suggested that we adopt the Eskimo solution of putting old people on an ice floe and leaving them to drift away into the sunset, but sometimes you have to wonder.