Assessment of Older People's Health and Social Care Needs and ...

...."Assessment of Older People'sHealth and Social CareNeeds The Policy ContextOr Eamon O'Shea, Economist, National University of Ireland, Galway----------------------------------This paper considers the policy context within which approaches to the assessment of older people'shealth and social care needs and preferences are being explored at the Conference today. Broadly,good policy has been developed over the past fifteen years with respect to older people, but theissue is that stated policy objectives have not been implemented. There is agreement that, by andlarge, older people want to I!ve at home, that they should be able to do so and that the range ofcommunity care options to support that choice needs to be extended. Implementing policy andreallocating resources so that older people are enabled to live at home is, in my view, a priority forthe next three to five years.Principles for Furlding Long-Stay CareA number of basic principles should underpin the approach to funding the long-stay care of older people.FundingFunding should not determine care requirements; rather care requirements should determinefunding. For example the availability of buildings and nursing homes should not determine the flow offunding in that direction. What is needed is broad-based assessments which, instead of focusingprimarily on the physical dependency or mental state of an older person, consider the whole range ofsocial and economic factors that have an impact on the decision of an older person, in a state ofdependency, to continue living at home.Dependency and Situation of DependencyIt is also critical to make a distinction between the terms 'dependency' and 'situation of dependency'.For example,we talk about 'social dependency' when, more accurately, we should think in terms offactors creating social dependency. Social factors are a cause of dependency and 'social dependency'is not itself a measure, though there is sometimes confusion about this in our approaches toassessment.Conference Proceedings