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Unmet needs of older people being met by informal helpers

On Monday the Care Bill reached report stage. To coincide with this research commissioned by the Care and Support Alliance, of which Royal Voluntary Service is a member, highlighted that in the period 2005/06 to 2012/13, the number of people receiving formal packages of care from their council fell by 320,000. Researchers at the LSE calculated that, given the rising numbers of older and disabled people in the population over that time, 453,000 fewer people were receiving care in 2012/13 than would have done in 2005/06 given a consistent level of eligibility. You can read the full report here.

Today the vast majority of councils are supporting individuals with substantial and critical needs only (86%) meaning that many people are not having everyday personal care and mobility needs met. These needs fall into activities of daily living (ADL) and instrumental activities of daily living (IADL). As the terms suggest ASL is about very basic tasks such as washing, dressing, eating and using the toilet. In contrast IADL are activities although not fundamental to functioning, are important aspects of living independently with some degree of dignity like shopping and leaving the house.

Today’s results from the 2012 Health Survey for England highlight the crucial role that informal help plays in supporting older people. ( The ADL for which help was needed most often by men and women aged 65 and over was using the stairs (21% and 29% respectively). Help was relatively frequently needed in other activities, including having a bath or shower (reported by 15% of men and 19% of women), dressing or undressing (14% of both sexes), getting in and out of bed (10% and 13% respectively) and getting around indoors (9% and 12% respectively).

Among the IADLs, more people said that they needed help with shopping for food (20% of men, 31% of women) or routine housework (20% and 27% respectively) than with getting out of the house or (16% of men and 24% of women).

The shocking finding is that fewer than one in ten reported that they had received help with any of the ADLs in the last month. The proportions who received help with IADLs were higher than for ADLs, but not much. 26% of women received help with shopping for food compared with 14% of men and 19% of women received help to get out the house compared with just 11% of men.

Not surprisingly the need for help and the proportions receiving help increase with age. However, for most activities there was a gap, with more people reporting needing help than reported receiving help. Among those aged 85 and over, 42% of men and 67% of women needed help with shopping for food, while 34% and 57% respectively received help with that activity.

Overall, 44% of men and 55% of women aged 85 and over had some unmet need with at least one ADL, compared with 15% of men and women aged 65-69. Results were similar for IADLs: 26% of men and 28% of women in the oldest age group had unmet need for at least one IADL, compared with 10% of men and 8% of women aged 65-69.

If you believe that the bulk of help is provided for by the authorities then think again. The survey finds that majority of people aged 65 and over that received help in the last month got that from an informal helper, rather than a formal one. For ADLs, 75% of men and 71% of women had informal helpers only, 8% and 13% respectively had formal helpers only. Most informal help is provided by family and close friends to whom no payment is made.

In the survey volunteers are categorised as formal help which shows just how much the state relies on the role of informal help overwhelmingly from families. It is entirely understandable that most families will want to help close relatives where they can but in a significant number of cases that is not possible. With funding under increasing pressure, there is an opportunity for the government to turn to the voluntary sector to support older people with low level care needs. Often something as simple as a weekly visit from a volunteer, a lift to a doctor’s appointment or help with basic tasks such as shopping for food can make a huge difference to that older person and reduce that unmet need.

So as 2013 disappears over the horizon make that New Year’s resolution to join the 15 million people who volunteer regularly to help others live a better life.

Posted by Steve Smith Public Affairs Manager (England) at 00:00 Friday, 20 December 2013.