Opinion: Long-term dread is the bane of old age

Peter Stanford, a writer and broadcaster and sits on various trustee boards

Life and work often mix in strange and conflicting ways. Professionally, I have been spending some time of late looking at how to improve the quality of the carers (or personal assistants, as I'm told I must call them these days) provided to people with spinal cord injuries.

Expert after expert has assured me that standards of care are being driven up, thanks to tighter regulations. Yes, it's been bad, they tell me, but we're on the case. Stop worrying.

I was almost starting to believe them when I visited a treasured old friend - old in the sense of being of long-standing, but also old in years, a stage of life that is becoming an agony for too many in our country.

She has already shrugged off 15 years of blindness to carry on running her business. Now she has the added cross of crumbling bones to bear and, because she lives alone, needs to have a carer on hand 24 hours a day.

Never extravagant, but always hard working, she has enough in the bank to fail the means test for care, so she has to pay for the endless procession of faces that pass through her home week after week. If these individuals are the result of standards being driven up, I hate to think what it was like before. Most don't even have the common sense to know that you don't leave objects lying around on the floor when a blind person is walking about.

The cost so preys on the mind of this exceptional woman that she is losing some of her spark. What will happen when her funds run out, she keeps asking? In Scotland, the state makes much greater provision but is being overwhelmed by the need. In England and Wales, the onus falls on individuals until they are almost bankrupt or worn out by the worry of it all.

In her new book, The Moral State We're In - her study of how this country treats its weakest and most vulnerable citizens - ex-King's Fund supremo Rabbi Dame Julia Neuberger proposes an eminently practical solution to the dilemma.

Research shows that the vast majority of elderly people live for less than two years once they are in the care system. How would it be, she suggests, if they pay for care for a maximum of two years, if they have means, but thereafter the state foots the bill? Pragmatic, yes, in that it does not take away entirely the unfairness of the current system, but it mitigates its worst aspect - the long-term dread that is eating away at my friend.

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