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

Bias Towards Home Care SolutionsThere should be a built-in bias towards home care solutions while retaining a capacity for financingcare in institutional settings.The Need for EquityThe access of older people to appropriate care should be on the basis of need and should not beimpeded by an inability to payor by geography. However, the reality is that where older people livedoes determine the process surrounding them, in terms of the availability of services, the allocationto care, the measurement of dependency and the assessment of need. This is creating inequity andis a situation that needs to be redressed in terms of the implementation of stated policy objectives.Aspects of the Current EnvironmentThere are a number of known aspects of the current environment which need to be addressed. Theseinclude the following:• in terms of resource allocation, demand is skewed in the direction of the option of residential care• demands 0:1 the exchequer from the Nursing Homes Subvention Scheme have made significantcalls on the available public resources for older people and have skewed resource allocation in thedirection of residential care• there is an absence of an in-built bias in support of community care• there is little by way of innovation and ingenuity towards of community care• family care is viewed as a free resource.Taken together, these aspects point to the need to think about the overall care process and aboutthe development of community and social care approaches in a more eclectic and holistic way thanwe have been doing. We need broad-based assessment of older people's health and social care needsand preferences to help us to do this.:;'-Assessment of Older People's Health and Social Care Needs and Preferences