Older people deserve better

The word 'deserve' disturbs me and implies that whoever ‘deserves’ has had to have done something to earn whatever is on offer. This actually implies an inequality for some people. Those people might be you, me, your sister, brother, mother or father. I have always been interested in how the use of language to describe people and practices does tend to influence attitude.

So I want to concentrate on the fact that we need to remove that word 'Deserve' and focus on rights for all people, recognising the humanity in us all.

It is amazing and indeed shameful that older people felt the urgent need in Wales to actually produce an explanation of what Human Rights meant to them.

But we must understand why we still have to use the word ‘Deserve’ when we consider older people's care and support. I think this is because there is still evidence out there of failed care, omissions of services and public inquiries into abuse.

My contention is that we are continually being pushed into lobbying for better services for older people, and using terms such as ‘Deserve’ indicates that society and public services still do not understand ageing or adequately recognise the real cost and benefit to supporting older people to maintain their health and wellbeing.

Similarly prejudicial remarks have long been recognised as inappropriate when applied to, for example, gender or ethnicity. So it seems that older people are still the last frontier and we are still having to use this term to get what older people actually need to enable them to experience a higher quality later life.

The attitudes that fester the lobbying for better services I have just mentioned affect assessments of need and packages of support. The customary diagnostic rigour which, for instance, healthcare professionals have been trained to apply as standard, can sometimes be mysteriously replaced for older people as patients by ageist therapeutic emptiness. In other words, nothing substantial to help them maintain their health. Professional values and training still overly prioritise the acute, the rare, the high-tech and the cure, and need to change to reflect the reality of modern health and social care practice which now is beginning to embrace, in partnership, the work undertaken within housing services for older people.

If we are providing a public service based on need and preventing ill health, and also implementing action on health and wellbeing as equally important, then we must give adequate and full assessments to all the people who actually turn up in the system, rather than for those whom we would find more personally engaging, or those ‘consumers’ who shout loudest.

It's great that the housing sector is championing a change in the approach to support for the older person and I am proud to be a part of that. However, there needs to be much more commitment all through the health system and action undertaken now which recognises the work that we, the housing champions for older people, have done to promote the rights of older people to continue to live independently and to experience a good later life.

Lets get to a situation in Wales where we never have to use the term ‘Deserve’ any more.

Lorraine Morgan
Board Member, Care & Repair Cymru

Positive ageing - bucking the trend?

This week is Positive Ageing Week, which also includes Older People’s Day today, (1 October). The narrative around ageing and particularly around the substantial increase in the number of older people in the coming decades is often focused on the challenges of increasing demand for services and the fact that, across public services, we aren’t ready to accommodate this need.

At Care & Repair’s recent Annual Conference, a consultant from Powys Teaching Health Board (Prof. Bim Bhowmick) spoke about caring for older people with more acute needs in the community. One of his main points, which really resonated with me, was in saying that an increase in the older population doesn’t have to mean greater demand… more need… pressure on hospital services. He’d been leading on a consultant led “virtual ward” service aimed at keeping older people out of hospital. Through this he demonstrated a few things, namely:

• Consultant-led community services for older people will reduce attendance at A&E and instances of delayed transfer of care.
• Services configured to intervene at the time, before someone is admitted to hospital for further checks etc., is by far the most important time to intervene. 
• Ensuring that there's an understanding of what can be provided in the community by NHS staff and other stakeholders is key for General Practitioners. 
• The home is often an appropriate place to provide interventions for people with acute needs. 
• If we make these changes on an all-Wales level, we can realise a future where even though there’s a large population of older people, better service focus along with changes in lifestyle and behaviour can combine to offset the type of demand being predicted at present. 

The way we understand housing in the context of positive ageing is also very important. All too often this is a bit one dimensional – along the lines of poor housing leads to poor health. Clearly this is a really important part of understanding the impact housing can have, and the implications of poor housing. But an over-focus on the physical environment may lead us to overlook much of what it means to age positively. Housing certainly underpins this, but (for example) opportunities to socialise, learn new skills, inform and participate in local and national debate, spend more time with family, work or volunteer and travel the world can all have a huge bearing on how 'positively' we age. 

For the housing sector, it’s about understanding how we can best support this shift in emphasis and if there’s capacity to provide staff, share expertise or facilitate patient, carer or family engagement in building a shared understanding of how we support people in truly holistic way. 

Matthew Kennedy
Policy Officer: Care, Support and Health

Living Longer, Ageing Well?

The fact that we have an ageing population has been well established and is rightly something we should be celebrating and embracing fully. The often uneasy elephant in the room is the simple truth that services aren’t geared up to serve an ageing population in the same way as they do at the moment. 

Information is readily available which reflects the increasing life expectancies people can expect to experience in the coming decades and beyond. Relating to Healthy Life Expectancy, the Office for National Statistics reports that boys born in Wales between 2008 and 2010, who are expected to live to the age of 77.5, are estimated to spend 63 years in good health. Similarly, girls born in Wales between 2008 and 2012 can expect to live 63 of their estimated 81.7 years of life in good health. So this should make up a key part of our thinking now as well as considering the impacts on future generations living well in to their 80s and 90s.

We’re left with a situation whereby an increasing amount of people will require care services of some sort. It is vital that we seize the opportunity (as many are already doing) to really listen to older people and work collaboratively to provide services that can serve a number of their central needs from health and housing to education and transport.

Working with this holistic mentality to provision will go some way towards creating the opportunity for the latter years of a person’s lifetime to be some of the most rewarding, fulfilling and enriching.  

Matt Kennedy
Policy Officer: Care, Support and Community Health
CHC Group