This blog was contributed by Clive Newton, Age UK’s National Development Manager – Care and Communities.
Five years on from the publication of Putting People First and Transforming Social Care, it’s time to take stock. Have older people entered the promised land of choice and control? Are they receiving personalised services, tailored to their individual needs and preferences? Did the £520m Social Care Reform Grant deliver the intended transformation in the way care and support is designed and delivered?
Unfortunately, from the point of view of most older people with care and support needs, the answer to all these questions is a resounding ‘no’. There hasn’t been a ‘strategic shift to prevention and earlier intervention’. The system remains crisis-driven, with ever-tightening eligibility criteria. Self-funders receive little or no support. And even those older people who are eligible for a personal budget rarely experience any real sense of choice and control. What went wrong? Continue reading “Is personalisation failing older people?”
This guest blog was contributed by Occupational Therapist, Chrissy Bishop.
As an occupational therapist working in intermediate care, a common predicament occurring in health care environments is the constant battle with prejudices and age discrimination, consequently in meeting the needs of people over age 85: the ‘oldest old’ (or as some refer to this age group, the ‘frail elderly’).
When planning discharge and care for an over-85 client, a fundamental dilemma of the multi-disciplinary team is establishing rehabilitation needs. This means making an informed decision and estimating how they will manage at home, and assessing their ability to regain independence in activities of daily living.
Unfortunately, it is not uncommon for unintentional age discrimination to occur, fundamentally related to the capability of the oldest old of engaging in a rehabilitative treatment plan to maximise their level of independence in their preferred home environment.
In retrospect, why does this age discrimination still occur? We need to challenge our assumptions about people.
Rehabilitation teams need to continually ask questions such as:
Exactly what is the reasoning for your 100 year old patient who has recently fallen to go into a care home?
Would you consider this change of home environment for a “faller” in their 60s or 70s?
Do you consider loneliness when discharging the oldest old back home?
Is your patient educated on the effects of the medications they take, and has anyone looked at possible medication interactions?
This guest blog was contributed by Julia Unwin, Chief Executive of the Joseph Rowntree Foundation. This forms part of our Expert Series which highlights the work of those influencing, designing, commissioning and delivering services for people in later life.
This decade is one of transition – transition as we adapt to our economic circumstances, transition as we try to reduce the impact of climate change, and
transition as we conserve resources of all kinds. But it is also a time of transition in terms of demography.
We are an ageing society. This is a cause for great celebration, and one of the triumphs of our time. But it does also represent a transition, as we get used to the fact that we are indeed all ageing and this has implications for us personally, and for policy-makers. We can bury our heads in the sand and pretend this is not really happening. We can hide behind jokes about getting older, behave as if ‘it won’t happen to us’ and allow policy-makers to ignore this major challenge to the ways in which we organise ourselves. We can collude with the view that once we are no longer economically active, we are no longer worthy of consideration. That way we will never have a sensible settlement for meeting the real costs of long term care. We will never resolve a better way for providing pensions. We will continue to think that more of the same will provide answers, even though we know it won’t. And we will continue to treat residential care as a dread destination, rather than a place of opportunity and growth.
The alternative is to embrace this change, and recognise the great prize of a longer life, seize the opportunities that it offers and stop being scared. To do this we need to hear from people who are themselves older, understand their very different experiences, and start to think much more honestly, and much more creatively, about the ways in which we want to shape a good old age, both for ourselves as individuals and as society. An ageing society can be one that values difference, and recognises the very rich and different contribution that we will all be able to make. An ageing society can be one that uses all the skills, experience and talents of all of us as we age. It would recognise that older age is not only about loss, there are rewards and excitement too. It would therefore be a society that is better for all of us. It would be one in which frailty is no longer equated with powerlessness, dependence no longer seen as weakness.
If we start to see growing old as an important and natural transition in our own lives, we will also be able to build a society that makes this transition in a just, considered and creative way. Such a society will be able to respond to the changing needs of all parts of its population, without hiding behind lazy stereotypes and prejudice. It will structure policies and practice that meet the needs of real people, not just imagined nightmares.
In a good society, ageing will be seen as an inevitable and important part of life’s journey. Older people themselves will shape, design and provide the services they want. Policy-makers, practitioners and older people together will develop activities and services that meet our very different needs. Services and activities for older people will be at the heart of communities meeting the needs of all generations, shaped by the needs, aspirations and desires of older people but meeting all our needs. Intergenerational activity benefits us all. It allows us to share scarce resources, but also share the joys, and the pains of ageing. Our changing demography provides us with a golden opportunity to re-shape dramatically our attitudes to ageing, and to engage in that great transition with creativity and with courage. Failing to take that opportunity means that the lives of all of us will be considerably poorer.
The Joseph Rowntree Foundation’s ‘A Better Life’ programme aims to hear from older people about what they want and value in life, and help bring their words and images to a wider range of people.