Economy & Finance

How can we afford to meet the future needs of people with dementia and their carers?

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1. How can we afford to meet the future needs of people with dementia and their carers? Presentation to the Westminster Health Forum Keynote Seminar “Improving outcomes…
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  • 1. How can we afford to meet the future needs of people with dementia and their carers? Presentation to the Westminster Health Forum Keynote Seminar “Improving outcomes in dementia care: integration, personalisation and the Dementia Challenge” 25th November 2014, London Adelina Comas-Herrera Personal Social Services Research Unit (PSSRU) London School of Economics and Political Science a.comas@lse.ac.uk @adelinacohe
  • 2. The future is by definition uncertain… … but one thing we know is that we will need to spend much more on the care of people with dementia than we are spending today. 2
  • 3. How can we afford to meet the future needs of people with dementia and their carers? 1. Find ways of decreasing the future numbers of people affected by dementia 2. Ensure we have adequate care financing mechanisms 3. Make sure that we “spend well” on care
  • 4. 1. Decreasing the future numbers of people affected by dementia • Helping/encouraging people to adopt healthier lifestyles to reduce the risks. • Better management of other chronic health conditions. • Finding a disease-modifying treatment!
  • 5. 2. Ensuring we have adequate financing mechanisms (1) • 2/3 of the £26.3 billion cost of dementia in UK shouldered by carers and people with dementia (Dementia UK 2014, published by the Alzheimer’s Society). • Public expenditure on social care has not been keeping up with increased need* *Between 2005/6 and 2012/13, after standardising for changes in need it has been estimated that net social care expenditure decreased by almost £1.5 billion, as a result of reductions in coverage: Fernandez J-L. Snell T. and Wistow G. (2013). Changes in the Patterns of Social Care Provision in England: 2005/6 to 2012/13. PSSRU Discussion Paper 2867. http://www.pssru.ac.uk/archive/pdf/dp2867.pdf
  • 6. 2. Ensuring we have adequate financing mechanisms (2) • The care cap being implemented in England should help protect individuals and families against catastrophic costs of care… • But it does not bring an additional source of funds to social care, which will continue to depend on (increasingly constrained?) taxation revenue. • If public funding does not keep up with need, people with dementia and unpaid carers will have to pick up an increasingly large share of the costs... Could we find an additional source of funds that guarantees risk-sharing, equity and universal coverage? Perhaps it is time to reconsider social insurance?
  • 7. 3. Making sure we spend well on dementia care (1) • Martin Knapp makes distinction between “good” and “bad” costs of dementia*: • “bad costs: care and treatment due late or missing diagnosis, or unavailability of good quality, or because of an unplanned crisis admission into hospital, or breakdown in community support resulting in earlier admission into a care home than necessary”. • “good costs: Appropriate and effective treatment and care responses to needs of individual and carers, following consultation around their preferences”. http://www.pssru.ac.uk/blogs/blog/what-does-dementia- cost/ by Martin Knapp
  • 8. 3. Making sure we spend well on dementia care (2) • We can use evidence from research to help shift the balance from bad to good costs. • Modelling Dementia outcome and costs project: ESRC/NIHR funded collaborative project. – Systematic review of effective and cost-effective interventions in dementia care – Modelling the impact of widely adopting these interventions on the future outcomes for people with dementia and their carers, and the costs associated with their care. – For more information: http://www.modem-dementia. org.uk/, follow us on twitter at @MODEMproject
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