Tag Archives: Older people

Wealth of the Web: Broadening Horizons Online

Last week Age UK London launched our new report “Wealth of the Web” written by Ben Donovan, calling for more support to help older people get online and take advantage of the digital world: http://www.ageuk.org.uk/london/

The fact that, for example, 78% of people over 75 in London are not online at a time when more and more Government services (central and local) are becoming “digital by default” is making a lot of people sit up and take notice, and it feels as if this is an issue whose time has come. Our launch event was attended by representatives from eg. the Cabinet Office and Government Digital Service, Ofcom and a major bank as well as the Greater London Authority. Since then we’ve been invited onto the Government’s Digital Inclusion Stakeholder Group along with Microsoft, BT, Everything Everywhere … OK, more meetings I know but there does seem to be a head of steam getting up  to do something about digital inclusion, with Lottery funding on its way.

So far I’ve emphasised getting people online to access services, but we’ve realised as we’ve gone along that what will really get people wanting to go digital is starting from people’s interests: keeping up with family and friends, a hobby … This has been really clear from the digital inclusion/engagement projects we’ve run so far.

Our launch was at an event run by Positive Ageing in London, the London regional forum on ageing which is one of a network of forums in every English region working with the DWP (and of course, with the Mayor and other London regional bodies): http://pailondon.org.uk/ Before the report launch, we put on an interactive workshop where just over 50 older people gave their ideas on what gets people interested in the digital world, and the barriers to getting online.

The workshop was facilitated by David Wilcox and Drew Mackie, and David has reported on it in his blog: http://socialreporter.com/?p=2803 One challenge for service providers coming out of all this is  that until recently it was assumed that “computer classes” would involve learning to use either desktop computers or laptops, but now many people expect to use tablets, smartphones or other devices.

Age UK London hosted a Q&A on the topic of digital inclusion for older people from their Twitter handle @ageuklondon on Tuesday 28 January at 12.00pm. The complete Q&A can be viewed on Storify.

We very much hope to work with a lot of partners to support more older people getting online, if you’re interested in this it would be great to hear from you and we’ll come back to it in the blog!

Ticking boxes is on the way out in the NHS… but there is a need to think wider and deeper to change it.

The idea of giving the million most frail older people a named GP to look after them was trailed last week by the Health Secretary and on the face of it seems like a good idea – the aim is to get away from a box ticking mentality and to focus more on the needs of the older person.

My worry here is with some practical problems – not least that older people themselves can be quite stubborn when it comes to their GP and might not take kindly to this idea if it involves the local practice changing their contact. GPs also report that older people come to see them over trivial matters when all they really want is some company – having a named GP might actually make this significantly worse, if older people believe they now have a real right to see the named person.

I’m also wondering what will happen within GP surgeries? Will the named GP actually become a dumping ground for all the patients no-one else wants? And what is the betting that this will be the newly qualified doctor rather than the managing partner? And let’s not forget that most GP surgeries operate on a tight timetable of appointments – I’m not sure this idea will help that time-scale and will probably put more pressure on it.

However, I’m quibbling here and the emphasis on needs rather than box-ticking is a very positive move.

But is it enough?

Er, no.

There are some real basic cultural problems with the NHS that mean the turning of this particular supertanker may take longer than any of us may have left to live. The main one is the medical focus of the NHS…

Medical focus of the NHS? Isn’t that what it’s there for? Well yes, but the problem here is that NHS care is far too blinkered when it comes to other treatments and interventions that may help a patient.

And I can see where this comes from – doctors and nurses train hard for many years and experience things every day that most of us would lose our lunch over, so they are right to be protective of their expertise and dedication. And they are also pushed for time – GPs have 5 minutes to see a patient and five minutes to write up the notes? Does this seriously give them a chance to really engage with a patient?

Given the time available, they have to see a condition and then prescribe a pill or some tests, without maybe looking at the whole person and what else is going on in the patient’s life. What about the patient’s finances? Or the falling out they’ve had with their only living relative? Or the fact that they are 87 and also a full-time carer? I think this is what Jeremy Hunt is getting at with the line about returning to the “old fashioned family doctor”, but it actually needs to start with the doctors themselves.

Doctors need to have it ingrained into their daily practice that social care solutions can dramatically improve patient health, and that the combination of health and social care solutions can bring benefits to patients greater than the sum of the individual parts. Here in Bexley, tentative steps are being made in this direction, with the Council and CCG working together on an integrated care pathway for hospital discharge. It is early days, but the fact that it is happening and that both health and social care professionals are committed to it means that patients here will benefit.

We don’t want doctors to become social workers, but how do we get them to appreciate the social care side of improving a patient’s life?

My solution? Every GP and nurse should have a social care module as part of their training, that they have to pass in the same way that they would with medication and anatomy.

If anyone wants help writing this course, give me a call.

Time may change me…

Ageing brings change but doesn’t mean we do not want to do new things, nor that we might not develop new goals and dreams. AARP, where I am currently volunteering, has put together an initiative called ‘life reimagined’. The project aims to help turn people’s goals and dreams into real possibilities through online and offline programmes, experiences, resources and services that help people adapt to their new life phase and live their best lives. It got me thinking about the nature of ageing and change.

Having recently married and moved to the USA I am in the land of new. New husband, new country, new friends; even buying a pint of milk here can be a challenge! Yes I miss my family and friends and occasionally get fed up with navigating new situations – don’t even get me started on my first post office visit! But it’s fun too.

A colleague at AARP was telling me this week that her last child had just left home and she was now an ‘empty nester’. We commiserated together. For different reasons we are both experiencing the fears and excitement of change.    

As we go through life and grow older change is inevitable. It brings many new things; new roles as parents, as grandparents, as students and then workers (and back again) as volunteers, as husbands, partners and wives, as immigrants and emigrants.

Not all change is unwelcome, sometimes it comes because we are fulfilling old dreams or developing whole new goals. Even bereavement, difficult as it is, can be the start of new and positive times. Yes, some people are at home and alone and yes we need to reach out to them – but others are running marathons or skydiving; learning to play the piano or teaching children to read. My colleague above for example, was looking forward to joining a singing group as well as missing her children.

When my grandmother was widowed at 81 she packed her things and moved in with my parents without looking back. Many people assumed it would be to slowly end her days. On the contrary, many afternoons find her playing puzzles with her favourite great-grandson and now she is planning to redecorate her flat (at the top of the house). Now 94, she may have written a will and planned her funeral  but she is also picking out fabrics and watching a fourth generation grow up.

Life is all about change. Isn’t it time to see that as a good thing?

For more information on the Life Reimagined project go here: http://lifereimagined.aarp.org/

We all want to live in an Age Friendly World

I have just moved to Washington DC, and have been volunteering with the American Association of Retired Persons (AARP) – in their international department.  AARP is probably best described as the USA’s equivalent of Age UK.   It is the world’s largest membership organization, with nearly 40m members.  In my short time here, I’ve already seen that many of the same challenges exist here as in the UK, as well as seen some interesting new solutions.

By 2050 the number of people aged 60 and over worldwide will have doubled, from 11 to 22%.  In the developed world it is projected that by then 64% of the world will live in cities or urban areas.  In the developing world this will be closer to 85%.  Cities will need to be places where we can grow older, healthily and happily.

AARP runs a network of Age Friendly Cities in the USA.  The network is a great opportunity to unleash the energy of local communities and to rally policymakers and businesses to act in the interests of older people and their families.  There are currently 15 communities in the Network, including cities, towns and counties.  Combined, the network reaches nearly 20 million people.  The AARP network links to the World Health Organisation’s (WHO) Global Network of Age Friendly cities.

At the heart of the Age Friendly concept are local people, organisations and government actively involved to bring about changes they think will improve their lives, from more benches in parks to changes in local planning policies to involve older people.  It involves assessing communities 8 ‘domains’ or areas of community life; outdoor spaces and buildings, transportation, housing, social participation, respect and social inclusion, civic participation and employment, communication and information, and community support and health services.  The community then makes an action plan and decides how they are going to decide if it has worked.

New York City is one of the early adopters of the concept.  A big, diverse city, it has many similarities to London – it has also put aging at the front of its agenda in recent years, its work on changing New York, one district at a time is a really interesting way of encouraging local action.  Age UKs in London, Older People’s Forums and many others are doing much of this work already.  The advantage that Age Friendly can bring is; shared learning – across the globe, recognition, and a way to bring the myriad of successes already being achieved under one simple goal – to make your city Age Friendly and a great place to grow old.

Do you think this is something that would work in London?

Co-operation in Care

This is a guest blog by Ed Mayo, Secretary General of Co-operatives UK

Age UK London would like to thank Ed for writing this blog post for us.

It is in the nature of people to care… and to know when not to care.

Many of the most important and fulfilling parts of our lives – such as parenting, neighbourliness and favours – fit within the description of care, even if they are not typically understood as economic activity.

When people are motivated by a need which inspires care, whether unpaid or paid, such as a care worker or nursing, there can be a richness in the motivation, because it is needs driven and sustaining of people and society.

It is in the nature of institutions that care can be a slot machine.

The welfare state plays a vital role in peoples’ lives and can be a life saver, a safety net or a transformer.

As one person explained to a friend of mine, Richard – “There are things that, if I didn’t experience them here at the day centre, I wouldn’t have ever done them in my life. Before, I never got out. I was a right scaredy-cat. Now, I’ve tried so many different things, I think “Yes, I can do it”. So that’s what it’s done for me’

But the welfare state can also lose a caring touch in random acts of thoughtlessness, pervasive bureaucracy or the demeaning nature of being assessed as in need. Talk to any parent over the years who has had to get one of their children ‘statemented’.

The language that is used to describe and plan care services mirror that confusion.

Richard, who I mentioned before, was doing research on people who use social care services. He wanted to explore the different ‘labels’ they have – citizen, consumer, client, customer, user, member of the public – all labels with slightly different connotations.

He showed the list of terms to one person and asked ‘How do you think the service providers see you?’ The man looked genuinely confused, and then replied ‘They just call me John’

The words that professionals use to talk about health and social care today, including that great ugly noun, personalisation, are no more than bits of Lego. Terms can be assembled, fit together and sound good, but they don’t capture the fundamentals of care. They don’t answer the question ‘why care?’.

At root we need to understand care as about meeting human needs and creating human dignity.

This needs to be good work. Fritjof Capra puts this as ‘we can’t be empowered by work that destroys the environment around us or creates systems of inequality. No matter how our work is organised, it cannot fully empower us unless we believe in its purpose’.

This is not how the care system, or the wider economy, works.

• In paid work, people are often being rewarded in terms of money and status when they are behaving destructively.

• Those who care at home or in the family that are unpaid suffer low status, poor conditions and often stress and personal costs.

• The burden of this work continues to fall disproportionately on women, whether they are out of or in the labour market.

• The entry of venture capital into the care of children and vulnerable people shapes the culture of providers towards an instrumental model of care, where service is means to an end in the form of a return on capital.

The co-operative model is now well-known and, thanks to the efforts of pioneers in the field, is increasingly looked to as an alternative, potentially better approach.

A co-operative is a business, owned by its members and there for no reason other than to serve their needs.

If the language is confusing, then yes, we can say that co-operatives are a form of social enterprise – something that is run commercially but with people in mind. What is distinct about co-ops is that the people in mind are not passive beneficiaries. They have a say. They have responsibility.

The Foster Care Co-operative, for example, gives a voice to foster carers. It can match pay and good working conditions, though not exceed them, but it adds a precious commodity – dignity.

The challenges of running a business focused on health and care, particularly in the context of local authority financing, are well known. The most impressive examples I know are long-standing health co-operatives and mutuals that in fact pre-date the NHS, such as Simplyhealth and Benenden, which has recently opened its services to all.

But when you talk to co-operatives like this, they stress that what makes the real difference is values and culture.

We are surprisingly unreflective as a nation about the institutions that serve us, surprisingly complacent about turning the care of vulnerable people into a market. To create an economy that cares for people in need, we should take a better road – the road to co-operation.

 

It’s a myth that older people ‘block jobs’

older professionalsI was inspired to write this post by Jim Clements, who at 66 years of age, decided to return to work with a security firm after growing bored with retirement.

Thirty four years later he is still at that firm and, at the age of 100, became the subject of a number of articles where he was reported as being one of Britain’s longest serving office temps .

The news stories were interesting in their own right, but it was the public’s response that piqued my curiosity further.

“Very happy for him but it would be better if the firm took on a young person in his place”, wrote one contributor.

“Come on Jim, move over and enjoy your retirement and lets [sic] get some school leavers on the ladder rung of work!!!!”, wrote another -   enigmatically self-aliased ‘TT’.

While the majority of comments referred to Jim as an inspiration and wished him all the best, these were just two of many similar comments reinforcing the accusation that older people ‘block jobs’ for the young.

This idea is not novel to the media, as only recently, the Daily Mail ran an article with the headline: ‘Greying’ workforce is squeezing younger generation out of jobs after over-50s see 90% rise in employment’.

Lord Bichard

So what is the alternative solution for proponents of this discontented viewpoint? And how does this stand up when pitted against reported comments made by Lord Bichard in October 2012, when he said:

“We’re prepared to say to people if you’re not looking for work, you don’t get a benefit. If you’re old and you’re not contributing in some way, maybe there should be some penalty attached to that… Are we using all the incentives at our disposal to encourage older people not just to be a negative burden on the state but actually be a positive part of society?”

The ‘no win’ scenario of older people ‘blocking jobs’ or being a ‘negative burden’ on family and the state, is not only a perpetuation of a divisive ideology instilled across generations – it is also a distraction from the fact that older people, like anyone else  acquire  considerable, variable and multi-faceted capabilities which enable them to make valuable contributions. All that remains for them to be able to carry on, is for society to let this to happen.

The image of the ‘selfish older person’ job-blocking or being a burden, spectacularly fails to capture this perspective and  serves to reinforce misconceptions and discrimination.

The vast majority of older people have been contributing throughout their lives and, whether, like Jim, they continue to be in employment or not, they continue to be a ‘positive part of society’ in many great ways.

The economic climate is something we all have to face, but older people have a range of experience, knowledge and skills to contribute in an employed capacity in the workplace or in an unemployed capacity through providing family-support, volunteering, supporting viability of community services and much more besides.

Recent research undertaken by Age UK London, which aimed to capture older Londoners views, highlighted just this point.

The following provides some examples of a prevalent theme:

“I am appalled at the way ‘older people’ [are] portrayed by the media and others as the cause for the problems and insecurities of society. It causes one to feel as if you should just disappear; everything would be alright. Most older people are still fit and active and is [sic] contributing a lot by volunteering and also allowing the young people to work by looking after grandchildren and even great grandchildren.”

“I find the way older people are portrayed in the media as very distressful [sic],, with people being described as being a drain on the economy and depriving younger people of jobs, increasing their taxes etc. A great many older people help their families and their communities, with financial support and childcare support and are active volunteers in their local community.”

I worked from the age of 15 till I retired at 67. I paid full contributions and a private pension so I am not entitled to claim anything. I still pay a large amount of tax. All I hear is the older people are living longer and are a burden which cost the state. I have well paid my way.”

So, I think all credit is due to Jim Clements for giving his time and effort to a cause that is a source of enjoyment for him and value to others.  Credit is also due to so many other older people who continue to contribute in a multitude of ways, but who will never be recognised by the mainstream press.

Finally, and for the particular  consideration of those who  feel that older people deprive them of  opportunities to work -  it is worth noting that Jim is a former engineer for the MoD who is currently happy to go to work as an ‘office temp’. Perhaps there is a message in that somewhere…

 

Dignity in care?

We recently held an event for Older People’s Forums in London to try to equip them to press for dignity in their local NHS and social care services http://www.ageuk.org.uk/london/news–campaigns/dignity-in-the-capital/ What really struck me during the day was that everyone agrees what the problems are, but they still keep on happening. Some of the ones which came up in workshop discussions were:

Hospitals: rushed discharges with no advance notice or care plan, sometimes at weekends or even at night; lack of pain relief;lack of basic skills or basic communication by staff; decisions about older patients being made without consulting them.

It’s clear that key NHS staff recognise all the problems and want to drive positive change, but how to make that happen at ward level?

Care homes: lack of skills or training in working with people with dementia or who can’t express themselves; lack of activity and stimulation; staff either not treating people as individuals or not having time to.

Care at home: too many different carers in one day; the gender of carers specified being different to that delivered; carers’ times being too rigid – because travel is never factored in; carers have bad attitudes and practices – some don’t even give older people water or know how to change the sheets on a bed; carers don’t turn up.

I know that more money doesn’t automatically mean more compassion. But some of these are the same issues that have been pointed out over and over again in relation to social care funding and spending cuts. Might there be a more direct link between funding and quality of service in social care than in hospitals?

We were aiming to focus on constructive solutions, and the 90 older people participating came up with a lot of ideas. We have provided a written toolkit intended to help people challenge undignified treatment (which is available to download on the link above) and we plan to keep following this up with people who were at the event and to keep raising the issues!

An Englishman’s home is rented

I wonder if, like me, you were fascinated to see the roll out of news, blogs and opinions as the statistics from the 2011 census came out.  It’s hard not to process it through our own experience, our own families and friends.

I live in Hackney, which I found out yesterday, had the lowest level of home ownership in the UK.  I’m lucky enough to own my home, but I scrambled onto the ladder 12 years ago by the skin of my teeth. More people turn 65 in 2012 than ever before, a leap of 30% in a single year.  My mother is one of them, and she joins the ranks of one in six .  But the spike in the Baby boom is yet to come, when I turn 65 (and of course I’m not saying exactly when that will be) I will be one in four.

Hackney stands out, but in general the number of rented households has more than doubled over the past ten years to 3.6m.  The number of households in which the property was owned outright also increased, though not as sharply (0.8m).

I mention these separate statistics because there is a relationship which will have an impact on demographics to come.  It is generally the older generation that owns their home outright.  Who are the lucky ones?  Is it the older people, in their own homes?  Not always.  Many of those are holding on to an asset which they cannot afford to heat.  Or they expect to use it to pay for their care.  ‘Cash poor, asset rich’ is how it is often called.  The younger generation might have more  cash but it is being spent on spiralling rents.

I believe governments, individuals, communities and organisations need to look at these figures and learn, and start getting a bit creative, and think about what we can do in the next ten years, and the ten after that.

A recent creative initiative, supported by the design council, http://www.roomfortea.com/ came up with a really creative way of bringing old and young to address their housing needs and assets. The move to community led housing, through community land trusts, a campaign supported by London Citizens, http://www.citizensuk.org/2010/10/momentum-builds-for-uks-first-community-land-trust/ is another example of thinking anew.

Do you have any idea, solutions or your own responses to the census?

Natalie Turner

 

Older pedestrians’ safety

Official figures show that older people are very much over-represented among pedestrians killed on London roads. This came out at a meeting I was at recently between Transport for London (TfL) and charities and campaign groups, looking at how to improve pedestrians’ safety.

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Hair of the dog?

The Panorama programme on older people and alcoholism last night highlights a growing headache for society, but Panorama’s solution is more likely to make things worse.

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