04/11/2012 The Wales Report

Come this week, with it in Washington for a special edition of

Wales Report on the eve of the presidential election. The result

will have an impact worldwide and we will have a report on the impact

on Wales. We will report from the ancestral home of Mrs Rumney. Stay

Welcome to Washington DC for this special edition of Wales Report.

The focus on the last few days has been on the focus of the

devastation of Superstorm Sandy. But now the race is very close and

both candidates are focusing on one thing. The state of the economy.

How do you create growth and jobs? Obama and Romney have two different

visions. I have been talking to one influential Welshman in Washington

and asking him for his view about what is at stake in this campaign.

There is such a sense of expectation here in Washington, but

why should people care in Wales? is tremendously important, not

least because of the uncertainty in Europe and the austerity programme.

I think a strong and America with a clear sense of purpose over

inconsistent time period has an enormous impact on the world

economy and the economy of Wales and Europe in general. You are an

avid follower of American politics. Is there Ricky it difference of

vision between the two candidates? An enormous difference. Romney is

relying in all of his propaganda on the idea that if you cut taxes at

the top level you create investment and therefore jobs. He talks about

creating 12 million jobs over four years. That will happen on the

basis of Obama's achievement in saving the US economy from decline.

If Obama is re-elected, there is an opportunity to continue with the

kinds of imaginative investment that saved the US motor industry

and got the banking sector back on a strong footing, although a lot of

people have misgivings about many aspects of what the bankers have

done and what they have not been rare -- reprimanded for doing.

Obama has a much more ground it message and personal view. I am

trying to be objective. You clearly think he is on the right track in

terms of economics. I am wondering why it is the race has become so

tight and why he is having a big fight on his hands to win a second

term? Two things have happened. During the early stages of the

campaign, he had a clear lead and then there was an extraordinary

debate when Obama seemed to be half asleep. Somebody play and the

altitude in Colorado and the fact he is very busy. He didn't rise to

the occasion. Romney got a big bounce out of that. That now at

ease, I think, declining. What we are seeing is Obama edging ahead.

The storm last which created an opportunity for him to be seen

working with the Republican Governor of New Jersey. He went on

television a few days ago to say how excellent he thought Obama's

response to that terrible disaster was. There are many things that

resulted from Matt but it helped him recover his position a bit

because he could be seen as the chief executive working across

political boundaries. That was gary macro talking to me earlier. One of

the defining issues of the first term has been the reform of health

care. It has prompted a wider debate about the role of the state

in providing for the vulnerable and elderly. It is an interesting

parallel with a debate back home in Wales about the way we care for the

elderly. The Older People's Commissioner considers that older

people are being forced into care too soon and one doctor warns of

Old age does not come alone. It presents new physical as well as

mental challenges, often at a time when people have been a will,

sometimes lonely and often vulnerable. Some find themselves

forced out of their own home and on a merry-go-round of care homes and

hospitals, and able to care for themselves. Well, it is where they

could put you but because most hospitals want the birds, don't

they? You go there and then they want the beds where so you goes

someone else. I have done the circuit. All of them. Derek "Del

Boy" Needs, as he had is known, has spent 12 months in and out of

hospital and care homes in Swansea while undergoing treatment for

advanced died BT's. You have a treat and then it is hard to do so

they say, go on a diet. I have tried a few but always went back.

I'd lost my leg and my toes on my right leg. During his prolonged

stay in hospital, his partner of 23 years with who he had lived died,

as did his brother. His life unravelled before his eyes. To make

matters worse, he had few relatives still living in Wales to take care

of him and the ultimate blow came when he discovered that he could

not return to his cottage because it couldn't accommodate his

wheelchair. With your rent,... it wasn't for the Red Cross a who

found him sheltered accommodation, Derek would almost certainly have

ended up in a care home, just another statistic in a long line of

victims of the Perfect Storm of unforeseen circumstances. In less

than 20 years, it is estimated that there will be more than one million

people on in Wales over the age of 65. This will put enormous

financial pressure on local authorities, health and social

services and, not least, on individuals faced with life-

changing decisions. Sarah Rochira is on something of a mission to

change that situation and curb the number of elderly going into care

homes unnecessarily. She is particularly concerned about the

lack of information available to the elderly to enable them to stay

in their own homes. It was only a fluke conversation I had with a

councillor that I got the information I needed. As luck would

have it, I have the stair lift put in and the shower put in. It still

took about two years to get it all going, but I am so, so grateful.

But without that conversation, I would know nothing at all and would

have probably ended up selling the House. One thing that concerns me

is the variation in advise people get. It can depend on whom you know

and way you live and that is wrong. There is huge variation across

Wales. There is good practice, but we need to see it become standard

practice. Wales has more elderly people than anywhere else in the UK.

An increasingly more and more of the elderly are going into care

homes. In some cases, that move can cost them their lives. In the case

of old people, we know many psychological traumas are

associated with a massive spike in mortality. Dr David Leopold says

the system keeps some elderly people in hospital for too long

during which time their mental and physical health declines. Perhaps

more worrying is the doctor's opinion of the decision to send

someone into a care home from hospital is not always made at the

patient's bedside. The final decision is rarely made by the

doctor. You would be surprised by that, I think. The concept that

decisions are made by the bed side, which most of us would expect and

wish, is wrong. For many of us, indeed most of us, if we are honest,

the prospect of ending up in a care home is something we prefer not to

think about. His signals something quite profound and difficult in our

lives - the moment we decide to relinquish our independence and

place ourselves in the House -- hands of others to care for Russ.

For some there is no choice and a good care home provides a kind of

sanctuary. I had to think hard. I had carers in, but then I was left

alone and I had to cope. I had to walk with a walking stick so I had

only one hand. I had steps inside my house as well. I had a chairlift

to go upstairs, but I couldn't cope. This home bucks any perception of

care homes as dumping grounds for the elderly. Here, there is a

deliberate policy to provide a stimulus and to encourage

involvement in the kind of activities which may look mundane.

In reality, they provide residents with a link back to a life once

lead in their own homes. We never called them Welsh cakes. It is a

lovely place here. How did you come to be here? I couldn't look after

myself in the House and I didn't want to go to my son's to live.

Why? I don't want to be a burden. Often it is a selfless Joyce, but

no matter how good the care home, the preferred option would be to

stay in their own homes, even if it means they take a chance of what

remains of their lives. overwhelming number of people would

say I would rather take the risk of dying sooner. I'm of a nature MIA...

I would rather spend that time in my own surroundings with familiar

things. With 23,000 elderly people already in care homes in Wales and

growing elderly population, the older people's champion is in no

doubt about the challenges now facing all of us. I have been

consistently Clear as commissioner that I don't want to be the voice

of others. I want to give the voice back to them so they can control

their lives and the decisions they need to make. I know the Welsh

government shares my aspirations and might challenge to -- his to

move that took delivery so that old people have some choice over where

they lived. A few days before I left Washington, I put the salient

points to mark macro who chairs the social services committee. You know

what the problem is according to the older people's Commissioner for

Wales, that far too many people end up in care when they do not need to.

The Health Committee's inquiry largely bears that out, although it

is important to recognise that the number of older people going into

residential care in Wales has fallen substantially over the last

10 years, and if present policies continue, a reduction of 10% will

happen in the next five years. The fall is happening because local

authorities are much better than they once were in providing

services for people in their own homes. People who previously would

have needed residential care can stay for longer in the place they

would prefer. One of the points made by the Commissioner is there

is, if you like, a breakdown of communication meaning that the

patterns of care are not what they should be. How do you see those

patterns of communication? There are two points in the process.

Early in the process, sometimes when people are waiting by

adaptation some things in their homes but can continue to manage in

their homes, they are not as good as they should be. But almost all

admissions to residential care don't happen in those circumstances,

they happen in a crisis. When something that has been holding

someone's circumstances together fails, goes wrong, somebody else

falls ill, whatever, and in a crisis you get an admission. Our

focus and that of the Commission is looking at ways in which we can act

differently in a crisis to stop an appropriate care admissions. When

you say act differently, give me a practical example of how things

might be different? In the past, large numbers of people have ended

up in residential care straight from a hospital bed. They have a

fall at home, something happens, they go into hospital and people,

often for the best of motives, worrying about someone's ability to

manage and thinking they need to be looked after and so on, decide

residential care is the option. Many local authorities in Wales,

Carmarthenshire would be a good example, now insist there is a six

week period following people coming out of hospital in which they get

what is called we able month, a concerted attempt to try to rebuild

people's abilities, putting a new package around them, so they can

manage at home. But not every county does that. Not in a

consistent way. Almost everybody has something like it, but not

everyone does it and the focus and concerted way that the best

authorities manage. There is no point asking people to cope at home

if they don't have the facilities and help necessary. Would you agree

there are certainly plenty of examples of people ending up at

home and actually finding they are not given the help they need?

residential care home I have visited during Aaron Querrey, I

have met people who have said, I am here as a matter of choice. Not

because it was the last resort or the worst thing that could have

happened to me, I didn't want to be at home. And the only thing I saw

was somebody for 50 minutes in the morning and did evening and I spent

the whole of the rest of the day worrying what would happen if I

fell, I would prefer to be here with people around when I meet them.

You are right, being at home in all circumstances is not a panacea for

everybody, but where it is done well, most people would prefer it.

There is a call for another voice, that the elderly in hospitals come

looking for what kind of future they face, we need a voice to

represent them which does not exist at the moment? Is that convincing?

I'm convinced by parts, not all. I'm absolutely convinced there is a

need for a voice of those people who want to speak up for a older

people and make sure their views and wishes are heard more

powerfully in the system. The system does not allow for that in

the way it should. Do we need a new professional, an advocate, to do

that? I'm not so sure. There are lots of people in the system,

family friends, for example, very keen to have a stronger voice.

There are care staff, social workers who place people in care

homes, lots of people in the system already who should be speaking up

for older people, but the system is not as good as it needs to be in

allowing that to happen. A final point, are you confident that the

quality of the system and how it supports elderly people is going to

improve in years to come, despite the fact there are enormous

budgetary constraints and huge financial pressures? There will be

a lot of people watching this he will find it difficult to believe

we can deliver a better system with far fewer resources. Paying for

care in the future is a huge issue. It is an issue that has to be

resolved not just at the Welsh level but UK level. We have had

lots of evidence in our inquiry about the Dome of report and the

urgent need for the UK Government to act on it. Until we sort out the

fundamental question about paying for care in the future, anybody who

has looked at the system will be anxious about how we will manage.

Thank you. That was Mark Drakeford talking to

me a few days ago. We have already heard from one

Welsh voice in America, but I have been to a corner of the states

where Welsh voices are far more familiar. The state of Ohio is one

of the swing states in this election, every vote will count,

including in the village of Oak Hill, a village settled by Welsh

people in the first half of the 19th century. I have been to talk

to one of the leading lights in the Welsh community there.

Elizabeth, you've been here since 1974, and this is the very southern

tip for most of Ohio. That's right. Oak Hill. What is your link with

Oak Hill? I had relatives that emigrated here in the 1800s. Are my

grandmother's side of the family. How many of them? There were two

branches of the family, the Morgans and Daviess. Here we have pretty

spectacular proof of Welsh heritage in America, what do you call it?

The Welsh American Heritage Museum. It is the only one in the States?

It is remarkable. It is like stepping back 200 years. Yes.

take a seat. From 1840, then in 1971 it is converted into a

heritage museum? In between times, the Baptist denomination took over

the church and the Congregational church closed. I think they kept it

going until the late 1960s. And the church was going to be sold. So a

group of interested people who wanted to prove that -- to preserve

the Welshness got together and bought the Church in 1971. It is

lovely, and there is nothing quite like it anywhere, as far as I am

aware. You have amassed a lot of treasures? Yes. How much work was

that? We asked people to donate things of Welsh interest to the

museum. Sometimes when people pass What it for you is the big value of

this place? What does it contribute? It reminds everybody

off the Welsh heritage and the beginnings of the people who worked

hard when they came to Oak Hill. Most came because they were

escaping or fleeing terrible hardship? Yes. But they found

pretty tough conditions here? The first generation worked very

hard. It was their children who reaped the benefits. What does the

sense of Welshness in Oakland today? -- what is the sense of? Is

its strong? Not as strong as when I first came here. When I came it was

at its peak at that time. The younger people don't have much

interest, it is very hard to attract them to many Welsh events

or come to the Museum. Do you miss Wells after 28 years? Yes, over the

years I have made frequent trips back home, twice a year. Do you

think you would ever go back to settle in Wales at any stage, or is

this home? This is home now. My children and grandchildren are here.

We're over here now. SPEAKS IN WELSH. 24 speaking to us. -- thank

you for speaking to us. The Welsh Heritage Museum in Oak

Hill, Ohio. There is a rich Welsh heritage and lots of the USA.

Indeed, there is an unexpected Welsh flavour to the presidential

campaign, given the ancestral story of Mrs Romney, whose family has

links with Nantyffyllon. We sent the former Plaid Cymru MP Adam

Price, who has just been studying It is hard to avoid the razzmatazz

of an American presidential election. Even at home here in

Wales. Ann Romney's father was born in the street behind me. Proud of

the Welsh working classes, she even visited the area and burned those

famous Welsh cakes live on Good Morning America. It was to prove

her Anglo credentials, quipped one commentator! Maybe he was thinking

of Alfred the Great?! This campaign has been the longest and certainly

most expensive in history. It has also been the most disappointing.

Both parties ended up with a candidate that did not fire up the

debates, the Democrats with a president who never really

delivered on a promise of hope and change. And the Republicans with a

moderate bat tilted right to win the nomination, then tilted right

back again to try to win the White Who'd have thought that this most

boring of campaigns would have ended in such a nail-biting finish?

This is the closest presidential race involving an incumbent since

1916. The Democrat Woodrow Wilson won that time around. Within a year,

the United States had entered the First World War, decisively sipping

their -- tipping the balance in favour of the Allies.

No one is suggesting there is as much at stake for us this time

around, but the reverberations will still be felt here in streets like

this. Europe may not be at war, but it faces a severe economic crisis.

President Obama is the last of the Keynesians in a world addicted to

austerity. Will a Romney victory condemn us to economic oblivion?

That matters in Wales. Of the 40 billion also manufactured goods

that UK exports to North America every year, about 4 billion are

made here in Wales. And it will be the economy that decides the

election for the average American voter. One by one, states that

Obama won in 2008 are slipping beyond his reach, leaving the rust

belt of struggling manufacturing areas as the real battleground in

this election. It sometimes feels as if the candidates are running

not for the presidency of the United States but for the

governorship of Ohio, a state with strong Welsh connections. It may

even be that a few thousand Welsh American boats, descendants of

people from valleys like this, may end up determining the fate of

Barack Obama. One thing is for certain, this

election is too close to call. I will make one prediction, though -

whoever wins, they will be loathed by the other side but unloved by

their own. This inauguration, when it comes in January, always on a

cold winter's day, will be just a bit colder this day. And in the age

of antipathy not just of the President but of politics itself.

A Welsh take on the presidential contest. They will be counting the

votes on Tuesday night and the result could affect us all. A quick

reminder of the contact details, you can e-mail us at