‘At What Cost? the Impact of UK Long-term Care Funding Policies on Social Work Practice with Older People’: A Literature Review

ABSTRACT

Moving to a care home is a significant and often costly milestone in many older people’s lives, with considerable implications for an individual’s future autonomy, safety, wellbeing and security. Such provision has considerable financial impact both on the economy and on those required to make significant contributions to their own care. Reductions in community-based support and widespread gaps in the sustainable development of alternative options to residential care pose challenges in relation to decision-making for those older people and their carers who wish to make timely plans for good quality provision. The system and process of transfer to care can also be fragmented, bewildering and involve multiple organisations and assessments, often at a time of crisis. Social Workers are key professionals in providing assessment, advocacy and planning with older people and their carers and the challenging neo-liberal policy context suggests the potential for numerous ethical dilemmas for practitioners.

This paper examines themes from recent literature in the field of social work with vulnerable older people, particularly in relation to funding arrangements for residential care, examining how ethical issues in this field of social work practice are. identified and discussed.

This paper presents a narrative review of relevant literature since 2010. It examines and synthesises key themes and considers how ethical issues connected to this field of social work practice are articulated.

KEYWORDS:

• Older people
• gerontology
• social work
• care homes
• funding
• ethics
• choice
• decision-making
• UK policy
• literature review

Notes on contributors

Professor Hafford-Letchfield is a qualified nurse, social worker, manager and educator and is a Senior Teaching Fellow of the Higher Education Academy. She is a Professor of Social Care at Middlesex University. She is also a Research Fellow at Stellenbosch University, South Africa. She has been involved in social work education since 2003, following a long career in practice where she has worked in generic social work, adoption and fostering. She has authored several papers and research reports specialising in pedagogy, adult social care and LGBT issues in social work. Her research interests are in the experiences of marginalised communities in ageing care and equality issues in social work.

Alison Higgs is a Lecturer in Social Work at the Open University. She has several years’ experience in specialist health and social care settings as a social worker. She is now a full-time social work academic, continuing to develop her interests in ethical practice. Her research interests are in distance learning and ethics pedagogy. Alison is a long-standing contributor to the NHS research ethics service in the UK.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Alison Higgs http://orcid.org/0000-0002-8180-7900

Trish Hafford-Letchfield http://orcid.org/0000-0003-0105-0678