Disability and care needs in the older population

Background

Care services are available through Local Authorities and cash disability benefits are provided by the national social security system. Individuals may be entitled to one, both or neither source of help. Each element of the system operates its own assessments of an older person’s care needs, and they differ in how account is taken of whether the person has a partner.

People who receive care via a Local Authority pay means-tested charges for their care, except in Scotland where there is a non means-tested public subsidy towards the cost of care. Other than an element paid via the means-tested Pension Credit, entitlement to disability benefits is not affected by an older person’s income or financial assets.

Care provided via Local Authorities is in the form of services or a ‘personal budget’ which has to be spent in ways which address the recipient’s care needs. Recipients of disability benefits are free to spend them as they wish. These differences mean that, irrespective of their financial value, the support from the two separate parts of the system may alleviate the adverse effects of disability on wellbeing in different ways and to different extents.

Some have suggested that public funds channelled through disability benefits should be redirected to the care system, but widespread debate on the funding of care and support for older people continues.

Project aims

The research project aims to provide robust, independent empirical evidence to sharpen policy judgements on reform of care services and disability benefits for older disabled people.

Using advanced statistical methods, the research team’s objectives are to:

• understand the impacts of public support including the effect of disability on wellbeing; whether care services and disability benefits have a significant alleviating effect; the effects of cash benefits compared with care services
• assess the responsiveness of public support to changes in older people’s care needs including examining the existence and consequences of any delays between the onset or increase in severity of disability and the receipt of benefit or services
• provide evidence on the likely impacts of potential policy reforms; seeing if there is a strong case for a change in the balance of cash benefits and care services within the system of support for older disabled people in terms of improvements in their wellbeing and in use of public resources
• assess the role of different configurations of disability within the households of older people; looking at couples where one or both have a disability and how that relates to the receipt of benefits/care services

The team expects to make a significant contribution to the body of objective and independent evidence on the likely impacts of reform of care services and disability benefits for older disabled people. Ultimately they expect this to improve the public debate and sharpen policy judgments in this area.

Methods

By making use of advanced methods which are innovative in this field, and exploiting opportunities provided by new data on receipt of and payment for care services that are being collected for the first time in two of these surveys, the team expects to establish:

• the extent to which the well-being of an older person is affected by the disability of his/her partner or other members of the household, and the likely consequences for their wellbeing of taking account of a partner’s disability in determining entitlement to publicly-funded care services and disability benefits
• whether equivalent-value care services and disability benefits mitigate the impact of disability on wellbeing to the same or differing extents
• the responsiveness of the current systems of care and disability benefits to changes in older people’s needs for care and whether any delays in the system affect their wellbeing
• the likely effect on the wellbeing of different groups of disabled older people of potential changes in the balance of public funding for care services and disability benefits