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Who will take good care of Mum and Dad?: As the population ages, services to help find residential care will flourish. Nicholas Roe meets a woman who started her own agency

Nicholas Roe
Tuesday 06 July 1993 23:02 BST
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FOR anyone with an elderly parent, Eve Horan's dilemma sounds like a nightmare bounced into real life. The divorcee, who lives in London, was deeply involved in a personal crisis with a grown-up daughter in hospital. She was trying to hold down a full-time job as a picture-researcher while talking to doctors, being a good parent . . . Then she received a telephone call to say that her own mother - frail and elderly and living miles away on the South coast - was threatened with homelessness.

There had been a blazing row at the sheltered accommodation where she had lived for years. The old lady had given in her notice in a rage and now the owners were refusing to let her reconsider. 'I had to go shooting off down to Brighton to find something for her,' says Mrs Horan. 'I had a matter of weeks, perhaps days. I didn't know where to start.'

She called on Carematch Services, a one-woman concern which acts, according to its literature, as 'independent care brokers'. The business provides a link between people who offer support for the elderly and those who need it.

Liz Ross, who runs the service, was a manager with East Sussex County Council Social Services Department for 18 years, then glimpsed the potential gap in the market when seeking a temporary home for her own mother. 'I went to see one nursing home suggested by a hospital,' she says. 'But beyond that I didn't do any research. I felt very guilty that I was not doing a proper job because I hadn't the time to devote to it.'

Local authorities provide lists of approved homes, but these often run into hundreds and the raw material can be overwhelming. Staff are also forbidden by law from giving too firm a steer towards one home over another. Ms Ross decided to offer specific guidance - matching clients to homes, including information on funding and legalities - in an area centred on Brighton and Hove. She is still technically employed by the council, but remains on unpaid leave while launching her new venture.

Mrs Horan found her through the Brighton branch of Age Concern and plied her with the inevitable questions. What was available for her mother, now? How much would it cost (this can range from about pounds 285 to pounds 500 a week)? Would it be suitable? How could she be sure? Ms Ross interviewed Mrs Horan's mother and assessed what kind of personality she was. She then consulted material on rest and nursing homes, built up by visiting more than 200 and filling in detailed questionnaires on each of them.

These files are the key. Beyond the basics of staffing levels - and what references are taken up on employees - and what a proprietor's overall attitude to his or her home may be, lie finer points: are the old people expected to mix? Is the place peaceful? Must they obey rules? Are there shops nearby? 'One lady had been thinking of moving her mother from a flat on a busy road to a home with a lovely view of the country,' says Ms Ross. 'But looking out of the window at the traffic going past was important to her mother.'

Mrs Horan was given a short-list of three homes promising the sort of balance between care and informality that her mother appeared to need. She visited them and found that at least two seemed suitable. She picked one and when it became clear that her mother had indeed settled happily, the initial pounds 20 consultation fee was repaid by Ms Ross, who took a commission from the home itself.

Mrs Horan is clear about what she gained. 'If you have someone like Liz Ross who does your legwork, and who you can just ring up for help, it is a godsend.'

There are a growing number of private agencies that help place the elderly in residential care, particularly in London. Ms Ross is unusual in that she also gives advice on home care. In other words, she may encourage an old person not to go into residential accommodation.

Here she ventures on to ground where social services are often weak, largely because home care is a cottage industry that is hard to monitor. For a basic fee of pounds 45 (which can vary, depending on how much work is involved), she will match an elderly person to a range of home services: from a simple meals-at-home facility to a package involving shopping, cleaning and getting someone up and dressed.

Again, she has collected her information the hard way, by answering advertisements, knocking on doors and asking questions. She has visited all the companies she recommends and takes up references from two clients before including any on her list.

Some will argue that a private agency duplicating a public service is unnecessary or a lazy way of helping your parents. But people are getting busier, and public help is limited. As Jim Graham, assistant director of East Sussex County Council social services department, admits: 'It may be perceived that we don't give such a personalised and time-intensive service to that kind of request.'

More specifically, there are funding limits to public help for the elderly which leave a section of pensioners uncatered for. Details vary from area to area, but basically if old people have savings of more than pounds 8,000 the local authority may simply leave their relatives to arrange help.

Eve Horan says: 'Extended families have gone out of the window and people like me have to work.' This is the point. Her nightmare could be anybody's, and will increasingly become so. Age Concern says that there are 10.5 million pensioners in the UK - more than 18 per cent of the population. By the year 2034 there will be 14 million, and as local authorities increasingly 'target' their aid, more and more children may find themselves called upon to help.

But honouring a parent takes time, and yesterday's children have inherited a different world from the one their own parents knew. Wives work. People move away. Young children faced with poor job prospects become more dependent on home rather than less so. Private agencies such as Liz Ross's are likely to grow, partly because the figures say they will, but also because there is simply less time available in people's lives for the oldest commitment of all.

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