Conversations about community support for older people

 

 

 


BACKGROUND

Outside the Box is working with other people to change the ways communities include and support older people.

There are examples of older people getting good support and feeling a valued member of their community. But it doesn’t happen this way for everyone.

We have been asking people to tell us what a community looks and feels like when it does work well for older people. In this, we include all older people, including those who have health problems such as dementia and who need extra support.

The notes here are what people have told us so far.

• Thank you to everyone who has contributed so far.

• Please keep sending us your views and experiences.

• Please tell us about ways you have found or are working on that will help ensure the good things happen.
Update: early November

Thanks to all the people who are telling us about their conversations and responding to the first notes.

We have added notes on new topics which people are discussing:
• Poverty and managing money
• Keeping warm and fuel poverty
• Living in rural areas
• Keeping in touch with other people and coping with loneliness
Comments on the earlier notes

It’s good this conversation is happening.

There are viewpoints here that I hadn’t thought of. Very interesting. Thank you.

We need to remember that life is not like this for many older people today. There are still too many older people who are lonely and isolated and not getting the support they need.

Having a good conversation

These are points we’ve learned on ways to make these constructive conversations that enable people to raise deeper issues.

• They can be short or longer conversations. You can learn a lot in 10 minutes when you listen.
• Focussing on the experience of one person can open up a good understanding of what life is like for people in that situation.
• Go for a walk together. See what a place and a community is like from that person’s perspective.
• Get everyone to think about what a good life means for them, including younger people and people who provider services.
• Keep the questions very open.
• Don’t ask about what people think of services – the usual approach to consultation. That has the presumption that services are all or most of the answer.
• If you are in a professional role, don’t feel you always have to contribute an answer.

WHAT PEOPLE ARE TELLING US

What does a good life mean for you?

• Being valued, and having nice things in our lives that make us feel valued
• Independence, choice, sense of belonging, security
• Learning, growth
• Feeling safe
• Knowing your neighbours
• Good physical, social and emotional health, and a balance of all 3
• Have people around me
• Keeping up my interests
• Access to good support services when we need them
• Control of your own life
• Getting out of the house
• Being part of your community, not just living in it
• Using the experience from your life to benefit yourself and others
• Interacting with family, friends, work colleagues – people in our lives who matter to us

“It’s having a good cup of coffee and nice biscuits or cakes. Not the cheap stuff that says ‘you don’t matter’.”

“When you do know what is available you have choices and feel reassured.”
Comments on the earlier notes

Good reminder that older people want the same things as anyone else.

The point about the balance of physical, social and emotional health is well made. See the Equalities Committees report on Age and Social Isolation.
Scottish Parliament Equalities Committee report, published 29/10/15


People’s own attitudes and outlook

• Plan for a good quality of life
• Involve people
• How we respond to bereavement and loss in our lives
• Positive reinforcement
• Networks –holding on to the old ones and finding new ones
• Motivation
• Self-belief
• Using our skills
• Others believing in me
• Giving and receiving

“Having hopes, dreams and aspirations.”

“It’s how we see the world. That’s the starting point. It is people claiming the right to be positive and make a contribution, however old or frail we are.”

“We all know people who have become isolated and spiralled into depression, with no goals in their life.”

“I know there are risks. I’m 90, I’ve had a good life and I know I’ll die fairly soon. I want my remaining life to be happy and busy, not wrapped in cotton wool.
Comments on the earlier notes

People’s own attitudes are important. You can see the glass as half empty or half full. You can decide to do something about it or feel that everything that happens is inevitable. That’s been the most important lesson in my life and it has got me through hard times as well as the good ones.


Planning for a positive retirement

• Recognising that it often is a big scary step
• Looking after our emotional health and wellbeing
• Being positive about how we think of ourselves: going from professional to retirement and finding ways to keep the sense of our experience and skills
• Having responsibilities, such as voluntary work
• Confidence to network
• Finding out what is out there – such as getting some retirement magazines, local newspapers, websites
• Look at options before your retirement
• Go on a pre-retirement course
• Find retirement networks
• Having interests and friends who share them
• Avoiding illness and downward spirals – be aware of the risks that can come with retirement and plan in ways to reduce them.

“See this as time to enjoy your interests and hobbies. And if you don’t have any, it is time to get some. Try lots of things and you’ll find what is right for you, and meet interesting people along the way.”

“Be open to the opportunities that will come along.”


Other people’s attitudes

• People in the community having a positive approach to older people
• Getting the balance between wanting to protect people and taking away their independence
• Families feeling able to let people live their lives and no longer being overprotective
• Communities that look out for each other because they care. That includes looking out for families, young people and other people who need some extras support as well as for older people
• Acceptance of risk for older people
• People feeling able to offer help to someone if they see we might need it, because that is a caring and a polite thing to do
• A bit of tolerance for people who need extra time in shops, banks and the like, because our eyesight or mobility or memory is not so good as it used to be
• People thinking about what life is like for older people.


How other people give support, or not

We heard about conversations around how and when older people get support from neighbours and other people in their community.

• Some people have very good experiences of this. They think that most people are good and will help. There are some people in the world who are dishonest or would try to harm people in other ways. The important thing is to learn how to watch out for that and be sensible.

• Other people felt that it was important to have services with people – paid or volunteers – who had been checked for criminal records etc, as that gave more protection to vulnerable people.

• Most people had found that the best way to stay safe was to have a lot of people in your life, who would notice and act if anything was amiss from any source, including family and workers.

• There were discussions about whether this presumption of older people being vulnerable was itself the cause of problems and was driving other people away.

• Some people thought that the balance had moved too far and that other people were becoming anxious about offering to help and older person, in case people thought they were doing it for bad reasons. Several people compared it to a fear of offering to help a child who was distressed, in case people thought you were abusing the child.

• Other people described how getting support from care services, or having a serious health problems, led to friends and neighbours doing less because they felt that only professionals could support the person now.

These conversations happened soon after the national news items about the death of a lady with dementia who had travelled away from her home area and had got lost. We wondered how many people would go up to an older person who seemed distressed or lost and ask if she was ok and if they could help. Or would most people think this was someone else’s responsibility?
“It can be hard for workers to know if ordinary services are safe for older people when they don’t have safeguards like a registration system.”

“It’s asking different questions, such as ‘How do we make support from neighbours safe?’”

Comments on the earlier notes

This really made me think. It is so sad and so wrong that this is happening. At first I thought surely people would help if an older person was distressed, but then I realised many people probably wouldn’t.

Dementia-friendly communities must be the way forward.


Physical environment

• Seating: benches in parks, town centres and shopping areas, and inside buildings
• Toilet facilities – open and enough of them in places like town centres and shopping centres
• Even surfaces/ramps
• Gentle steps that are not too steep
• Dementia-friendly environments, such as clear colours to help people recognise where they are, labels on doors or clear panels
• Surfaces that won’t hurt people when they fall, such as the ones used in children’s playgrounds, in places where older people often are
• Long enough to cross the road at traffic lights

Comments on the earlier notes

A big YES to all of these points. And they would make life so much easier for parents with small children too.


Housing

• Having a range of housing choices, so people can keep or find the housing that is right for them
• Cheaper retirement villages and flats
• Accessing relevant information, e.g. the type we are developing through the Falkirk moving assistance project
• Transport links make a difference here – good public transport can give people the option of staying where they are
• Being near facilities such as parks and local shops
• Staying in touch with the friends and neighbours you know even if you do move
• Advice to make your home safe, eg from Fire Service and Community Police
• Help and adaptions such as grab rails, easy access bathrooms, easy to use equipment in the kitchen, to help people by independent for longer
• Safe space outside – such as easier steps and safe surfaces
• Using technology to make our homes safer. An example could be motion-sensor lighting that comes on when you get up at night.


Good transport

• Regular and accessible
• Routes that are helpful
• Affordable
• Dial-a-ride services in each local area
• Understanding that this is essential to enable people to get to appointments and have access to all the other services
Comments on the earlier notes

Better public transport is the change that would make the biggest difference for people living in rural communities. This is contributing to so many people – of all ages – being isolated, having mental health problem, and having a poor quality of life.


Ordinary services that are there for everyone

• Libraries staying open – in town and the mobile one
• Post offices and banks in local areas
• Leisure facilities and more
• Cash machines that are easy to use when your eyesight and hands are not so good as they were
• Ordinary services that are understanding when you need a bit more time or other support
• Shops that sell small amounts, such as one chop and a few potatoes, not just big family-sized packets
• Food packaging that people can read and open when their eyesight and hand mobility are not so good
• Cafes that don’t have loud background music all the time – such as a quiet morning or day

Refuse collections

We are hearing a lot about bins. A community that includes and values older people is one that has thought about how older people – including those who live alone and have mobility and sight problems – manage to get the bins out.

These are some of the problems people are facing.

• The colours of the recycling bins are hard to distinguish when your eyesight is not good. It would help if there was a stronger contrast.
• It is hard to remember what goes out which week.
• People are afraid of the consequences if they put the wrong bin out or do it on the wrong day.
• The bins are bigger now to reduce the number of collections. So they are heavier and harder to pull.
• It is even harder to manage when you have sticks or a walking frame or use a wheelchair.
• Many care services do not see putting out bins as part of support workers’ roles.
• Even those that do face problems when the support worker visit is too long before the time you are allowed to put the bins on the kerbside, or too late next day for the time when the bins have to be off the pavement.
• You are expected to get family to do this for you. But that is a problem for some people.
• Asking neighbours can feel like admitting you can’t cope with managing your own home, so many people don’t ask for help.

“My son does it when he can, but it’s a 40 mile round trip and his shift pattern means he misses some weeks.”

“A new neighbour has offered to do this for my mum, which is great. He’d seen her struggling for months, but hadn’t been sure if it was ok to ask if he could help.”

People said they understood about the policies of recycling and reducing costs, which are good ideas. But in many places the arrangements have not taken account of how they will affect many older people.

Comments on the earlier notes

YES to the points about the bins as well. It is a nightmare for my parents.

It’s a relief to know it isn’t just me who struggles with the bins!


Information that works for older people

Plain, simple
• Age appropriate – for people in their 50s and for people in their 90s
• Accessible – not just online
• Easy to read
• Need to know where it is – easy to find

“Work with business in the community that are being helpful, such as Tesco helping with information about local community resources in Scottish Borders.”

Technology and Digital inclusion

• The services that older people use having good wi-fi, such as care homes, sheltered housing, places we use for day time support or social activities
• Easy to use equipment
• Help and advice on getting started with the internet and technology that is relevant to us
• Sharing ideas on ways to use technology to make life easier and safer

Comments on the earlier notes
More information

See the Hints and Tips on digital inclusion, with suggestions from older people on what makes this easier:

Older People & Digital Inclusion


Using technology to keep in touch with older people who are more vulnerable

There were several conversations about how GPS technology could be used to keep people safe when they were away from their homes or at home.

The main suggestion was having a wristband or similar to enable an older person to get out and about in their community but still alert family (or another person they chose) if they wandered too far.

• Some people thought that there were great opportunities here, and it was just another step on form the personal alarms that many older people use at home in case they fall

• It could take pressure off families by reassuring them.

• Other people felt this approach had too many negative associations with tracking criminals.

• Some people felt it was an invasion of privacy, and that relatives or workers might abuse it.

• Others felt that this was not a problem if the person agreed to it, and that it was a good trade-off for the increased independence it gave.

• Part of the problem was how the current devices looked – large, obvious and not attractive. If more people – and not just older people – used them the technology might improve and they could become much nicer to wear.


Not feeling harassed

• Effective ways to stop cold calling from charities, energy companies and the like – by phone and junk mail
• Protection from scammers
• Public services and services such as fuel companies and insurance companies being thoughtful about the letters they send – not frightening or confusing people
Comments on the earlier notes

I feel official bodies don’t take this seriously enough. My mum got an electricity bill for over £2,000. It was their mistake. But she was in a total panic.


Enough resources for community groups

• Funding programmes that make older people and our activities a priority (as well as other people, but not ignoring us).
• Continuity for community groups. Not expecting us to always be doing something new.
• Not having funding withdrawn with no time to make other plans.
• Being part of networks, so each group does not have to discuss with the local authority or other funders on their own.
• Priorities for funding that value keeping people well and preventing future problems for them.”

“My positive future has older people taking responsibility for saying how good our groups are and why we should be supported. Challenging the idea of giving money to poor old people who can’t do things for themselves. It also has people responding and giving us what we need.”

Comments on the earlier notes

Community groups do so much in telling older people about fuel payments, ways to reduce heating costs and the like. That’s another reason why cutting funding to them has so many bad consequences.


Health and social care services that work well

• Joined up services
• Flexible
• Person centred
• Accessible
• Timely and efficient
• Equipment to stay at home i.e. grab rails, wet floor shower rooms
• Support to keep you at home when you want that
• Support to get you home from hospital quickly – picking up medication, warming the house, help with hot meals for the first few days, and so on
• Support to help you to be part of your community, stay in touch with friends and the activities that matter to you.
Comments on the earlier notes


Poverty and managing money

• A society that works for older people would not have older people living in poverty, or worrying about this
• Younger people would understand that many day-to-day costs are higher when you are old
• People would not have to choose between keeping warm and having enough to eat
• We would be able to afford all the things that let people keep in touch with friends and family: phones, computers and broadband, taxis if you cannot manage to get out otherwise
Bank accounts and other money matters would work for older people
• They would remember that not everyone is in work and that there are other types of income
• They would be more flexible when people are dealing with difficulties such as when someone becomes frail or has memory problems
• People would have encouragement to plan out their financial affairs, to minimise difficulties. Banks and other financial institutions would see this as part of giving a good service

“Being able to get your shopping on-line and delivered to you is great. But you need a credit card, and it is hard to get that if you have never used credit before and can’t give employment details.”


Keeping warm and fuel poverty

• A supportive community is one where people’s income is enough to cover their heating costs
• This would happen through the year – winter is worse for everyone, but there are always some people who need more warmth for health reasons
• The schemes to help people save energy through better insulation and the like are a good help, so a positive step is making sure people have the information and support to take advantage
• Looking ahead, it is about designing houses that are easy to keep warm
• New technology could help older people here, such as motion sensors that put lights on and heat rooms when you come in and also turn down when you leave

“Keeping warm is something that many older people worry about a lot. There is more to this than just having a winder fuel payment.”

“Community groups do so much in telling older people about fuel payments, ways to reduce heating costs and the like. That’s another reason why cutting funding to them has so many bad consequences.”

More information

There is information and advice on fuel poverty at Energy Action Scotland: www.eas.org.uk


Living in rural areas

• Having communities that work well for older people is even more important for rural areas, which often have higher proportions of older people
• Local services matter a lot – libraries, post offices, banks, chemists, food shops
• Older people are and can be part of the solution to keeping these services going for everyone
• Innovative ways of delivering health and care services, that work for people in rural areas, instead of just copying what works in a city


Keeping in touch with other people and coping with loneliness

• A society and a community that understands about both being lonely and being alone – how they are linked but not the same
• Lots of ways for older people to keep in touch with their friends and people who share their interests – meeting up, phone calls, internet and social media – with encouragement and practical help when needed to do these things
• Enough income to get out and stay part of the things you enjoy
• Help with finding friends when you have had a difficult period, such as being ill or for carers – befriending services and other types of support
• Care services, and projects that provide company, being flexible enough to make sure they do not inadvertently drive away other people
• People in the area being friendly
• Places for people to meet and keep up with what is going on – ordinary places like cafes as well as lunch groups, older people’s clubs and so on
• Encouragement with planning ahead, similar to the retirement planning, as we continue to get older, so people are finding new interests and friends as they lose old ones
• Help with coping with loneliness and being on your own, so people know what they can do
• Good support for people’s mental wellbeing, and treating people’s depression promptly when this happens
More information

See the Equalities Committees report on Age and Social Isolation:

http://www.scottish.parliament.uk/parliamentarybusiness/CurrentCommittees/93385.aspx

Wisdom in Practice Discussion papers on Social inclusion and older people

http://www.wisdominpractice.org.uk/social-inclusion-older-people-being-part-of-their-communities/