Charging and quasi-markets in community care : implications for elderly people with dementia.
Social services authorities in the UK are increasingly involved in charging and fee collection activities with clients in receipt of community care services.
This article explores the implications of these developments for elderly people with dementia.
The starting point of the article is a critique of existing legal and administrative options for handling other people's money, including the difficulties and dilemmas raised for both paid and unpaid carers by the existing arrangements.
This is then related to the failure of charging and fee collection systems which have developed as a result of the community care reforms to address the particular needs of elderly people with dementia.
A case study of policies in one local authority is outlined and this is followed by the presentation of the view of 37 fieldlevel professionals who were interviewed in focus gropups.
The concerns of these respondents included the complexity of the assessment task, conflicts between care managers and finance/revenue staff, the difficulty of defining and responding to financial abuse, and dilemmas over the extent to which relatives and carers should be trusted.
The final section of the article considers the implications of a move to, quasi-markets in social care for elderly people with dementia, particularly in terms of their vulnerability to financial exploitation.
Mots-clés Pascal : Démence, Prévalence, Démence sénile, Vieillard, Autonomie, Dépendance, Travail social, Relation familiale, Système santé, Royaume Uni
Mots-clés Pascal anglais : Dementia, Prevalence, Senile dementia, Elderly, Autonomy, Dependence, Social work, Familial relation, Health system, United Kingdom
Notice produite par :
ENSP - Ecole nationale de la santé publique (devenue EHESP)
Cote : 96/09 V
Code Inist : 002B30A01B. Création : 199701.