What do care systems look like around the world?
With improved medical care and scientific funding, the global population is aging rapidly. It is important for elderly people to be well looked after in their later life to keep them happy and comfortable. Care systems differ on a country-by-country basis, with some more reliant on state care than others. Acorn Stairlifts, stockists of straight stairlifts investigates:
In the UK
The most common route for elders to take into care is staggered. This eases the elderly population into accepting care. When individuals are beginning to struggle, perhaps with making meals or getting washed, they can access help from home. This is in the form of specially trained carers who visit those in need at their own homes to provide necessary care.
There are now many homes and flats that have been specially designed for the older generation. These often have a community room where residents can socialise and a warden that is present during the day. The homes are specially designed for those who are less able, with non-slip floors and apparatus to help with getting up from the toilet and in and out of the shower.
When an elderly person needs more care than this, they usually go to a full-time care home. None of the services are free, although some people aged over 65 get help towards the costs and others use their savings. At the moment, people with assets of more than £23,250 have to pay for the full cost of their care (this includes the value of their home).
The system varies across countries in the UK. For example, in Northern Ireland, care in the home is free for people over the age of 75. For over 65s in Scotland, personal care is free if they are assessed as needing help for tasks like washing, dressing and preparing meals.
In the US
The healthcare system in the US is mostly private through people paying for care insurance. There is also a programme called Medicaid that assists with medical costs for those with limited resources — covering nursing home care. This system pays for 61% of nursing-home residents’ care. Elderly care is a key consideration that must be made by many. In the US, 47% of men and 58% of women who are of or above retirement age will experience a need for long-term care in the future.
It's understandably common for seniors to be reluctant to leave their homes. In fact, when surveyed, almost 90% of seniors said that they want to stay in their homes as they age. Care insurance often can assist with this as it pays for home help such as washing and cooking support. Even when elderly people begin to require day-to-day assistance such as getting dressed, only 4% said that they would prefer to move into a relatives’ home over staying in their own surroundings. Despite this low figure, 75% of adult children think about their parents’ abilities to live independently and presumably consider their future options. These children contribute between $7,000 and $14,000 per year to care for an ageing parent.
Seniors do have the option of round the clock care in a nursing home too. 11.2% of women over the age of 85 lived in a nursing home in 2014 and this figure stood at 6.1% for men of the same age group.
In Canada, the number of over 65s (16.9%) is now higher than the number of under 15s (16.3%)! This makes elderly care an important priority for Canadians. When looking at health expenditure as a whole, Canada has invested more funds into drugs rather than hospitals and physicians over the past 30 years and this could count towards their aging population.
Unlike in the US, the health care system in Canada is largely funded through taxing. The capital of Canada, Ottawa promised to spend $6 billion over the next decade in order to address their aging population and help with home-care programmes.
There is a lot of pressure on nurses to provide care in Canada. In fact, the demand for these workers is predicted to rise from just under 64,000 full-time jobs to 142,000 by 2035. Perhaps these stretched resources are the reason why more Canadians are taking on the role of caregiver and offering informal care for their own parents. In fact, 30% of workers with older parents take 450 hours per year of time off work — putting a strain on their own careers and on employers.
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The care system in Italy differs quire drastically to the systems elsewhere. The care of elders is said to be the responsibility of a person’s family and therefore care homes are not as popular as in other countries (less than 2% of the senior population use care home services). In fact, Italian institutions often only intervene if the person has no family to care of them.
It's traditionally left to the women of the household to care for older family members. However, they are now taking up employment and their time is spent working instead — creating a greater reliance on public care facilities. The mentality of family care was evident in 2004 when the majority of Italians thought that it would be beneficial if adult children looked after their older parents when they became reliant. It is likely that this mentality has continued many years later.
Unlike in the UK and US, there is not much of a staggered system. This means that elderly people who are fairly fit live in regular homes that have not been adjusted for needs of the older generation. However, in the 1990s, a greater focus was given to elderly people and their specific needs. This saw the introduction of a new framework which includes home care, day centres and nursing homes and now, over 5% of older Italians use home care services.
Similar to in Canada, the elderly care system is largely public funded. There is also a large amount of informal care that is offered by family members of elderly residents. The general aim amongst Belgians is to keep the older generation in their own homes, comfortably, for as long as possible.
In Belgium, there is a scheme of ‘service flats’ too. This is where elderly people can live within their own space but have access to useful facilities such as home help and cooked meals if they need it. There is also the option of day care and short stay centres and this provides families with some respite from care.
There is also an interesting initiative called ‘kangaroo housing’. This has been around for 30 years and involves older people living together with immigrant families in the same house on separate floors. The immigrant family help the elderly person out if they are ever in need. One project was launched in a Belgian district called Molenbeek where 60% of the population are immigrants and 25% are retired. It can benefit both parties in terms of improving their sense of belonging in the community and overall well-being.
Recent statistics have shown that there will be more than 23 million citizens in Germany over the age of 65 by 2035.
One of the schemes in place in Germany involves their intake of refugees. Between 2015 and 2016, 1.2 million asylum seekers entered Germany, most aged between 18 and 34 years old. A training scheme is in place where refugees are being taught how to care for the elderly. This addresses their aging population and the immigrants who are looking for work.
Another initiative involves cohabiting. When surveyed, 82% of Germans said that they did not want to grow old in a nursing home. Grants that were introduced in January 2013 allow the elderly to live in a community apartment with one another, cohabiting and socialising when they want to. This decreases their likelihood of becoming lonely without placing them in a full-time care home.
There are also places that have many generations under one roof. These multigeneration houses are made up of a kindergarten, a social centre for the elderly and somewhere for young families to drop in for socialising or support. Pensioners can volunteer to read to the children and interact with them through singing and games.
From unique schemes such as kangaroo housing in Belgium to the reliance on private healthcare in the US, it’s easy to see that care systems do differ around the world. And what does the future hold for our older generations? Innovative concepts such as elderly friendly supermarkets and villages are popping up in some places, as countries continue to reach out to older people and try to improve their quality of life.
NHSX releases new data plans, experts call for transparency
Patients in England will get "greater control" over their health and care data according to new proposals set out by the government.
In a new draft strategy called "Data saves lives: reshaping health and social care with data", Health and Social Care Secretary Matt Hancock says that more effective use of data will deliver better patient-focused care. "This strategy seeks to put people in control of their own data, while supporting the NHS in creating a modernised system fit for the 21st century which puts patients and staff in pole position."
Under the new plans people will be able to access their medical records from different parts of the health system through different applications, to access test results, medication lists, procedures and care plans.
The strategy, published by NHSX, the government department that sets policies for the use of technology within the NHS, follows delays to the creation of a central database of patient records amid concerns over data sharing and a lack of transparency, with critics saying that only a small proportion of the public were made aware of the plans and the choice to opt out.
Kevin Curran, senior member of The Institute of Electrical and Electronics Engineers (IEEE) and Professor of Cybersecurity at the University of Ulster, says that moving health records online raises concerns. "The move to an online app does seem like a natural progression, however there is a difference between having computerised records within our healthcare IT infrastructure and having those records reside on a public facing server.
"Having records inhouse limits the range and type of access – it's far more difficult for remote hackers" Curran said. "There are techniques that healthcare organisations can use to reduce the risk of future data breaches. One way is to make it ‘opt in’, so patients have the choice to decide whether their medical information is moved to a public facing service so that they can access it.
"However, those who do not opt in or download the app instead should have their records hosted in a non-public-facing cloud service. This way, if a data breach does occur, those who never used the app, or not wanted to, will not have had their details released."
The new strategy has been welcomed by some, with an emphasis on the need for transparency. Adam Steventon, Director of Data Analytics at the Health Foundation, said: "Health data has played a critical role in the last year – from tracking COVID-19 outbreaks and developing treatments, to getting people booked in for their vaccines. It is critical that the use of data is accelerated if the NHS is to tackle the backlog of care and address the massive health challenges facing the country.
"It is particularly positive that the government has committed to building analytical and data science capability in the NHS and to improving data on social care. To ensure the full potential of data can be realised, the government must ensure transparency on how it will be used and the rights and options people have, as well as engaging with the public and health care professionals to build trust and show people how their data can improve the NHS and save lives."