Once, social care was provided in the family. But thanks to family breakdown, the burden now falls on the state
Sir Simon Jenkins, writing at the Guardian website, provides us with a useful summary of why the question of social care is so difficult for politicians to confront. His headline sums it up: “We all want to live longer. But someone must pay.”
Not surprisingly the article focuses on the question of funding, which seems to be the fundamental question that so many policy issues boil down to; but in the article Sir Simon skirts the real issue, which is this: once social care was not a matter of funding, but was provided in the family. However, nowadays, thanks to family breakdown, and thanks to so many old people consequently living alone, the burden falls on the state.
So, it is the problem that lies behind the problem that we should really tackle, but as no political party in the UK ever wants to talk about the collapse of family life or the social and financial cost of divorce, I do not expect any discussion about that soon. But it is useful to note that when you do away with family structures, you do need something to replace them, because human beings cannot really flourish without the structure of the family.
Where the family fails, then the state must step in. Even though the state can never be as good as the family, it is still better than nothing. But are there alternatives to state-funded care? Well, yes there are.
No one ever wants to go into a nursing home, and most of us dread ending our lives in an institution. The longer residential care can be put off, the better. The longer old people can stay in their own homes, the better. That, I think, is non-controversial. However, it is also true that old people living at home alone can become isolated, and such isolation leads to loneliness. One is more likely to have a sadder life if one is alone, and, I am assuming, a less healthy one too.
To promote the flourishing of old people, the best thing to do from my observation of the matter is to combine community living with independent living. This means encouraging older people to move into residential complexes where each has his or her own front door, but where there are also shared facilities as well. The residents have privacy and their open separate lives, while at the same time not being cut off from a wider community. They can take an interest in each other, and, yes, look after each other. Moreover this form of social care, so in keeping with human nature, would cost nothing, and would free up quite a lot of housing stock, as people downsized to live in such residential complexes. Essentially, the idea is to get old people to look after each other. Given that we have so many old people, and are likely to have more in future, we should look upon them not as a challenge but a resource.
These sort of residential complexes already exist, but we need more of them. Each parish should have one, within easy walking distance of the parish church. After all, the idea is a Christian one, rather like a monastery on the Carthusian model, without of course the austere life and the silence.
One thing that Sir Simon mentions in the article is that children born today have a life expectancy of 104 years. This is true, but only part of the picture. Life expectancy of 104 depends on present trends continuing, and they never do. In 400 AD people living in the Roman Empire, if they survived childhood, could expect to live into their seventies. A hundred years later, this had halved, thanks to the collapse of the Empire, and more particularly to the collapse in standards of hygiene. As those aqueducts and baths became a distant memory, and as the land around Rome turned into a malarial swamp, population numbers collapsed.
Our own life expectancy might well begin to fall in years to come, though for our generation at least, we need to get used to the idea of having a predominantly elderly population – but to see this not as a crisis but as an opportunity to change the way we live.