So tightly drawn are local council eligibility criteria that many older people do indeed need to be almost at deaths door (or at risk of passing through it) to be deemed eligible for council commissioned support.  Maybe as a result, care in later life is largely imagined and practiced as an extension of palliative care – managed decline, rather than support for human development: to participate fully in the community should we acquire an impairment of health condition. But if that is true, it poses some questions:

What of all the older people not (yet) eligible for, or deemed suitable for this kind of support, but who nevertheless could lead fuller lives, enhancing their wellbeing and health, if they could draw on some kind of support?  Who offers this?  Who should offer this if it’s beyond the scope of the homecare sector? How are councils meeting their obligations under s2 of the Care Act (prevention)

What of the 75,000 or so working age disabled adults who draw on (publicly funded) home care?  How are their lives and the role of support therein imagined?

Is the homecare sector supporting people well in the later stages of their lives?  Can councils say with confidence that through commissioning such provision – most often life and limb, time and task short visits – that it is meeting its obligations to promote individual wellbeing?  And if this is about end of life, at what point does this become continuing healthcare?

And lastly, does it make sense to imagine ‘social care’ as a single system for every age and stage of adult life, or would it be better to take a life stage approach?

Read more on Making Rights Make Sense.

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