Time to Care?
‘I haven’t had the time…..’ An excuse that tends to be seen as a lie, even if a white lie. There are 168 hours in a week, full-time work is supposed to take 40 hours or so, sleep maybe 45. Mmm, 83 hours left.
I haven’t had the time to work on ‘Empty Plates Tomorrow’ recently, which probably doesn’t matter to anyone who happens to read this, but it feels a failure to me. Well perhaps I should have had the time. Yesterday I went riding for an hour, today we had lunch in the pub. The issue may not be raw time, but uninterrupted time. I do not have uninterrupted time, except when asleep, and the 3am nightly visit of my father’s domiciliary carers interrupts that, not that I mind because he needs their attention.
Life as a main carer for my parents, both in their 90s, is no doubt similar to that of nearly six million people in the UK, 1.2 million of whom care for an elderly, ill or disabled person for more than 50 hours a week. One in five of the 45-64 age group is, like me, a carer (figures from Key Facts at www.carers.org). Millions of frail and incapacitated people need care, showing that rising longevity is not the same as a longer healthy life. I think the consequences of the rising need for care need to be considered in greater depth.
Public spending has to be slashed because of the UK’s debt mountain. There will be less money to care for the elderly and infirm, and this will increase the need for friends and family to devote time to caring. The alternative is for vulnerable people to go without care, to be forgotten, and to suffer. Strangely enough, as I write this, ‘Election Uncovered’ on Channel 4 is considering this very issue: less public money for care is indisputably possible.
Family and friends who care will have to cut out one or several aspects of their lives. First, discretionary time: fewer hours for holidays, meals out, sports, hobbies, leisure.
Next, caring time cannot also be used for paid work, so carers’ incomes decline. This means lower tax revenues, further damaging public finances. Welfare benefits for non-working carers and for the people they look after could be reduced, giving further force to the downward spiral. For those like me who can work at home a lot, the frequent interruptions mean that each task takes longer and longer to complete. Phone calls and visits from health professionals, the chiropodist, the mobile hairdresser, prescriptions to collect, medical supplies to order, pills to give, meals, drinks, entertainment, company, a care rota and back-up rota to organise, to ensure that a carer is present 24 hours a day, seven days a week. This is not a complaint, just an observation that people who are carers have to cut their other activities.
Why not rely on residential institutions? Standards of care are already woefully low in too many homes (remember the Gerry Robinson TV programmes on deficient dementia care?). Slashed public finances will mean worse care homes, except for the very few individuals who can afford to pay for private, personalised care. The decision whether to send an infirm person into an institution, or to support them at home, may exact a high price – from those admitted into institutional care, if standards are low, or from their carers if they have to stop work, stop pension contributions, and neglect their friends and other members of their family.
People who are recently retired have, for decades, been invaluable as volunteers in community organisations, also as elected councillors and as selected representatives on QUANGOs (definitions vary, but ‘quasi autonomous non governmental organisation’ is a popular one). A bonfire of QUANGOs might not have a detrimental impact on government, but community volunteers and councillors are extremely important to our nation. As more and more of the fit retired, as well as people under retirement age, need to care for ailing family members and friends, the pool of potential volunteers and representatives will shrink.
It may sound bigoted to the guardians of political correctness, but might it be a mistake to protect the NHS from cuts and to prune harder elsewhere to compensate? This policy could prolong the lives of people like me, but if we need long-term care as a result, who would benefit? Should the artificial extension of life be unquestioned as a top priority? It doesn’t appear to be a question that is asked in government, but I reckon that it needs to be both asked and seriously debated.