What makes the biggest contribution to keeping older people living independently? Perhaps surprisingly, the answer is not council-funded social care, nor support by unpaid carers, but disability benefits.
According to a new analysis that looks for the first time across a range of different data series, far more older people receive attendance allowance or disability living allowance (DLA) than receive council care. And more receive one of the two non-means-tested benefits than receive informal care and support at home.
The finding throws a fresh spotlight on the value of the two benefits, which cost about £20bn a year but are rarely considered in debate about state support for older people. The Dilnot commission did take them into account in its 2011 review of care funding, which led to reforms in the new Care Act, but said little more than that they should remain in place. Ministers are replacing DLA with the new personal independence payment.
James Lloyd, who has carried out the new analysis for charity Independent Age and thinktank the Strategic Society Centre, where he is director, said: “About half of the older population who have some limitation of day-to-day activities receive disability benefits, which really does show the enormous scale of these benefits and the apparent reliance upon them.”
The analysis brings together data from the census, the Department for Work and Pensions, the Health and Social Care Information Centre and the English Longitudinal Study of Ageing. It suggests that of 4.3 million older people living with limited activities in England in 2011, 2.3 million (54%) received disability benefits. This compares to 570,000 who received some council-funded community services, including 310,000 who received homecare, and just over 2 million who were supported by unpaid carers. Some people had a mix of two or all three different forms of support.
A regional breakdown shows that more than 50% of all people aged 65 or over in the north-east, north-west and West Midlands receive disability benefits, while the proportion in the wealthier south-east is only just over 40%.
The contrast between numbers receiving disability benefits and those getting social care funding is likely to reflect different eligibility criteria, the study suggests. But it may also stem from stigma associated with council support or the complexity of assessment procedures.
The analysis also points to the extent of the shortfall in care and support for older people, looking at the needs of, and provision for, a smaller group of about 2 million who report having difficulty with aspects of their own care, such as bathing or dressing.
Of this group, it is estimated that 70,000 people who report difficulty with three or more such “activities of daily living” do not receive any paid or unpaid care. This is despite the fact that their reported level of impediment would very likely qualify them as having “substantial” needs under the framework used by councils to assess eligibility.
Of those who do receive care and support, either paid or unpaid, 160,000 say it “sometimes” or “hardly ever” meets all their needs.
Simon Bottery, director of policy at Independent Age, said the research highlights “alarming” gaps in care provision. “Councils need to be acting now if the promises of the Care Act are to be fulfilled, but national government also has to ensure there is enough funding to properly implement it.”
Lloyd added: “We will need a revolution in how councils, communities and families support older people who struggle with different aspects of living independently.”
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