Caring for the elderly

Peter Tervet, Pilgrim Homes

Founded in 1807 to care for ‘the Lord’s aged pilgrims’, Pilgrim Homes is one of the most experienced providers of care for the elderly. In its long history there have been many changes, but few as far-reaching as those we are seeing today. They result from a huge paradigm shift in government policy that is diverting funding from residential care to ‘care in the community’ programmes aimed at keeping the elderly in their own homes. Pilgrim Homes’ Chief Executive, Peter Tervet, describes what is happening and looks at the role of the church in caring for the elderly. 

As well as the love of God that ‘constrains us’, we are urged by the Scriptures to care for the elderly.  For example, Paul makes it abundantly clear in 1 Timothy 5 that the church has a key role to play in looking after them. Pilgrim Homes has always counted it a privilege to work with the churches to care for those who are of the household of faith (Galatians 6: 10), but now our capacity to care is under tremendous pressure, along with other providers in the UK Over the last 30 months over 1500 homes have closed, with the loss of more than 36,000 residential places. Closures are across the board and include private, council-owned and charities like ours.

Impact of Government regulations

The government is replacing the Registered Homes Act 1984, which currently regulates residential and nursing care, with the New Care Standards Act 2000, and the new regulations and national minimum standards that will be in place from April 2002.  They cover such issues as minimum room sizes, door widths, en suite facilities, and the number of shared rooms allowed.  It also insists on a higher proportion of qualified care staff per home.  Meeting the cost of modifying buildings is daunting enough, but in many cases, after the work been done the home would be restricted to taking fewer residents, which, with increased staff costs, would mean it could not pay its way. Despite protests from many experts the government has declined to make funding available to meet any of the costs involved. On a practical level we know that homes which do not meet the new standards will be closed compulsorily by the government.

Falling numbers of residents

As government policy tightens, we are seeing fewer and more heavily dependent residents. In the past, funding for people needing residential care came from the government. Some time ago that funding was passed, ring fenced, to local authorities. However, the ring fencing has been removed, and now local authorities are only paying for those classed as ‘highly dependent’. Others assessed as ‘low’ or ‘medium’ dependency are cared for in their own homes, with a ‘domiciliary care package’ which covers personal care, unless, of course, they can afford to pay the residential care fees themselves. 

 Experts have pointed out that these care packages can only meet predictable needs, and not the unexpected. There are already reports of carers calling at scheduled times and finding an elderly person collapsed and unable to call for help. Unlike residential care, domiciliary care packages do not provide the security essential for frail elderly people. At Pilgrim Homes we find security a most important reason for coming into our homes along with the desire to continue to live in a Christian environment.

Reduced funding

Although local authorities will only pay for the ‘highly dependent’, who obviously need a lot of care, they are paying less and less for them. It has reached the point now where the average amount paid per resident per hour is £1.65 - well below the actual cost and far below inflation. There seems to be a different rule for council-run homes: a survey published in the Daily Telegraph showed that local authorities pay their own homes much more, in many cases almost twice as much.  

More bricks, less straw.

The pressures on care providers are enormous and the care available for the elderly is being chipped away. Already, some private providers are keeping a high proportion of self-funders and only taking a small number of local authority funded residents. Other residential homes will become places only for the very heavily dependent. Pilgrim Homes exists to take care of elderly Christians and, with God’s provision, has always made up the difference between the incoming fees and the actual costs, but the gap is widening and is a daily cause for concern and prayer. 

 It will certainly be the case that more elderly people will be living in their own homes for much longer and this will mean that the support they receive from families, friends and the church will be increasingly important.        

The role of the church

Practical help often makes a world of difference, both to those in their own homes and those in residential care. Helping them to get to fellowship meetings, doing the things that help them continue to live in their own homes, visiting them for prayer and pastoral care, lending tapes and books (Autumn Gold by Clifford Pond is excellent reading), and taking services in residential homes are just a few examples.  Others are – visiting the housebound, providing meals or invitations to your own home, acting as their representative and handling administrative tasks, and providing transport for all sorts of reasons – for outings, to the shops, or doctors for instance. It goes without saying that Christian families take care of their elderly, (1 Timothy 5: 8) and the church can encourage non-Christians in this attitude, too.

 A key verse for Pilgrim Homes is Matthew 25:40: And the King will answer and say to them, Assuredly I say to you, Inasmuch as you did it to one of the least of these my brethren, you did it to me. (NKJV) The work of Pilgrim Homes has only been possible because of the financial support given by the churches. We are so grateful to the Lord for his provision through his people, and hope they know it is as vital as ever.

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