Introduction
This chapter considers the difference that voluntary sector organisations can make to the lived environments of older people in long-term institutional care. It does so through an analysis of care homes provided by the UK Jewish voluntary sector. It discusses how these institutions can create a greater sense of home than is possible in many private facilities because of the involvement of local communities and volunteers and the sense of ownership, safety and belonging of residents and families. Nonetheless, given increasing regulatory requirements and the financial realities of providing services in a highly competitive long-term care market, the chapter considers what extra dimensions the voluntary sector can still offer to highly vulnerable older people.
The UK Jewish community is used as a case study for two reasons. Firstly, the community can be said to be at the vanguard of British demographic trends. Both nationally and across the Organisation for Economic Co-operation and Development (OECD), not only is the proportion of older people relative to those of younger age increasing, but they are also living longer. While some 16% of the overall UK population is aged 65 or over, 23% of UK Jews are in this age cohort. The proportion of Jews aged 75 or over is also twice that of the UK as a whole (14% as compared with 7%). British Jewish women have a life expectancy that is two years longer than the UK average, and for men the figure is four years (Miller et al, 1996; Schmool and Cohen, 1998). In this sense, the Jewish population in Britain can be seen as ‘demographic pioneers’ (Valins, 2002).
Secondly, the community has a long history of voluntarism and, specifically, of providing long-term residential and nursing care home provision for older people. Indeed, some of the major Jewish social service agencies and care institutions date back to Victorian times (Alderman, 1992). Although the community (like many others) is finding it increasingly difficult to recruit volunteers, it also has reserves of social capital that can provide human and financial support in ways that other ethnic communities may find far harder to develop (see Patel, 1999). Hence, if the Jewish community is unable to make a real difference to the lives of its frail older people, then the prognosis for other voluntary sector ethnic or faith-based communities seeking to establish such provision would be even poorer.