“I didn’t have children to look after me”

This is often the one of the first responses we get when we talk about ageing without children. We need to make it clear that we don’t think that’s why people have children; I mean really does anyone anywhere know someone who had children purely so they could be looked after in their old age?

However, the reality is that one in for people aged in their 40/50s are caring for their parents. Overall there are 7 million family carers in the UK and three in five people will become carers; 12% of people in the UK care caring for an older relative. Adult children are providing vast quantities of care to their parents as they age. Most of what they do goes unnoticed and unappreciated by the state. Government policy talks about the need to support family carers but the reality is, that support is patchy at best, nonexistent at worst.

No one has children in order to care for them in their old age but the reality is that a lot of people do end up and will end up relying on their children for support when they are old because health and social care services are underfunded and over stretched. The decimation of social care funding in particular has had a devastating effect; 90% of local authorities now only provide care to people with critical and substantial leaving people with moderate and low needs to rely on others. Government policy operates on the tacit assumption that older people will have children and that those children will take on a lot, if not all, of the care and support their parents need.

Of course, older people don’t want to rely on their children for care; I expect pretty much every bodies parents have said to them at some stage “I don’t want you to look after me”. Older people would much rather spend quality time with their children than have them cleaning the house, doing their shopping or giving them a shower. However, if that help isn’t being provided any other way and will simply not get done then inevitably those care and support tasks will fall to people’s chidren. We need services that don’t expect families to fill the gap; services that recognise 2 million people will age without children.

We believe that a world that understands that 20-25% of people will age without children and responds accordingly will be a better world for ALL older people, both for those with children and those without.

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The Decline System – challenging the narrative on ageing by Dr Mervyn Eastman

This is a guest blog from Mervyn Eastman Change AGEnts Network UK, CoDirector and Society Secretary. He wrote it originally for Age Action Alliance but they declined to publish it so I have posted it here with Mervyn’s Consent. Follow him on twitter at @MervChangeAGEnt

The Decline System

When the Government responded to Lord Filkin’s House of Lords Committee’s Report ‘ Ready For Ageing’ he slammed it as “ weak and failing to give leadership on the biggest social change facing our society “. The Government’s reaction showed yet again their incredible lack of informed debate and perpetrating the aging demographic as a crisis rather than being beneficial. No wonder the good Lord Filkin was so hacked off!
On the 8th of July I become officially an “ old age pensioner “ and given I am an early Boomer ( b 1945-1954 ), I will be one of millions who will, in ten to fifteen years time drain the poor public purse because our health and social care needs. Having denied our children their rightful legacy by spending all their inheritance, we will be storming Adult Social Care offices across this green and pleasant land clutching our Personalization budgets storming Adult Social Care offices across this green and pleasant land demanding replacement plasma screens.

This narrative has to be challenged and confronted, as in the words of Margaret Gullette * it is an “erosion of seniority and respect for ageing; that stops and reverses the manipulation of the cult of youth and the present narrative of fatalism about old age and obscures those forces that undermine our understanding of age and the fullest possible experience of life itself”. Gullette talks about ‘ the Decline System’- one of doom and one of gloom and which demonizes ageing and increasingly threatens the very fabric of our social and economic cohesion – my paraphrasing for dramatic effect. What’s the use of Blogging without any drama?

What are those threats from the entire decline system which she articulates as “the innocent absorption of cultural signals, youthful age anxiety, middle-ageism –which infiltrates our society from top to bottom”?
 Psychological well being
 Healthy brain functioning
 Public health
 Midlife job growth
 Full employment and the economic contribution of Older people
 Intergenerational Harmony
 The pursuit of happiness and the fullest possible experience of life itself

So as I hit this life course milestone of perceived “dotage”, what do I personally think is required from me? Firstly, confronting in every which way the pervasive Decline System on which much public policy and practice is based; adding my time and energy alongside the host of individuals and small locally run organisations out there striving to write a new narrative which challenges the current ageing construct. I come across them all the time, but often our influence is limited for lack of celebrity or political patronage, thus muting our collective voices, (an indictment on both civic and civil society).

Secondly, contributing to an enlightened and evidence based approach that confronts and transforms the ‘social epidemic’ of the decline system which has been my mission and passion personally and professionally for over forty years.

Again quoting my newly discovered cultural critic, “inviting us to step closer to our ageing bodies and souls and then remind us that we cannot step into another’s life course; can never wrap ourselves in their experience of ageing “

If we are to redefine ageing we surely must also face our own attitudes to that ageing. I hope to enjoy whatever later years are left me to experience new adventures and realize new ambitions but I realise I may have to face a period of poor acute or chronic ill health, but I do not want to be defined at 65 years as a potential burden when I’m in my late 70’s 80’s 90’s. I am me, not you, and I cannot define your own aging experience. I do not, as I draw my State Pension in a few months time want to be turned into a demographic ‘time bomb’ about to explode all over my local Co-op store !
Forgive the rant but unless we collectively re-write the mind-set of decline, thus promoting new paradigms of ageing and growing older we will simply remain invisible at best and derided at worse . Let Gullette have the last word “ Attitudes get enacted in laws and acted out through relationships. Context is everything.”

*Quotes taken from Gullette M, “Agewise”, The University of Chicago Press ( 2013)

Mervyn Eastman, Change AGEnts Network UK, CoDirector and Society Secretary

Losing hope over social care

This is the most pessimistic blog I’ve ever written; it contains no ideas, no solutions, not even really that much anger just a ton of weary despair.

Today the ADaSS has released findings of a survey which show that the total budget put aside for means-tested social care by councils in 2014-15 stands at £13.68bn which represents a drop in cash terms of £266m from last year and a real terms cut of 12% since 2010 once inflation is taken into account.

At the same time demand for support has risen by 14% since 2010, meaning councils have had to make savings of 26%. LGA estimate the funding gap for social care will be 1.9 billion by March 16

The Governments response is depressingly predictable “‘Councils are ultimately responsible for deciding how to spend their budgets but we agree that we all need to work differently’ said a person from DH, she added the Better Care Fund would help

In other words, 1. blame local authorities and fail to mention that most have had their budgets reduce by 30-40% and 2. point at the Better Care Fund as the panacea to solve all social care ills.

Equally predictable and depressing is the complete lack of public outcry about the frankly shameful level and standard of social care in this country . I know The Guardian shouldn’t necessarily be taken as a barometer of the public view but just look at the number of comments any article about the NHS gets (easily hundreds) and then the number ones on social care get (tens if you’re lucky). It’s hard not to draw the conclusion that the general public don’t understand or care about social care. It’s all about the NHS.

As far as I can see, the Government sees no votes in social care because the public displays little or no interest in it. Unless it starts to affect voting patterns, I can’t see any Government prepared to have the conversation with the public that needs to be had about social care funding or to put the money into it that’s required. It’s a vicious circle.

As for me, after 20 odd years of trying to work with a social care system that seems to be crumbling to dust leaving the most vulnerable and the poorest with next to no care or support, I don’t know what to do. It seems impossible to change a social care system when society just frankly just doesn’t seem to give a ^$$(£$^ about it. I have huge admiration for people like @whoseshoes @legalaware @ermintrude @markneary1 and @georgejulian who battle on and on, yelling about the injustice, poor practice and appalling standards of care experienced by people on a daily basis, and who have come up with solutions to make things better. I wish I could be more like them, maybe one day I will, but at the moment  improving social care seems a hopeless task.

 

 

How do we increase public understanding of social care?

 

A few months ago I wrote a blog about a world where people cared as much about social care as they do about the NHS. Since then I’ve periodically returned in my thoughts as to how we could make that happen.

Two recent things have really brought home to me how crucial it is we find a way of doing this. The first was the response to the Kings Fund Barker Commission. The report itself examines the future of both health and social care funding but inevitably what was reported by the media were the suggestions made around the possibility of some NHS services being charged for and the social care aspect was largely ignored. The second was last week’s Protecting Our Parents  on BBC2 where the bewilderment and anger of people at the care people received at home was widely expressed on twitter and elsewhere.

In my original blog I suggested 5 main reasons why people didn’t care about social care

  1. People haven’t a clue what it actually is or how it works.
  2. It’s hidden away. They don’t see social care happening. Most of it happens in people’s own homes or in buildings euphemistically labelled “resource centres”. They don’t come into contact with it unless they actually need it.
  3. They don’t understand how it’s funded or what it costs to deliver.
  4. Users of social care are amongst the most disempowered people in country. There has been progress over the years through user led organisations and personalisation to rectify this but service users views are still routinely downgraded, ignored or just set aside as “too difficult”
  5. People don’t want to think about getting old and frail or what it’s like to have a disability or sensory impairment. There is huge ageism in our society and a dismaying rise in disablism. It has to be said though; most people don’t want to think about getting cancer either but that doesn’t stop millions being raised from the public from cancer research.

I should add that I think one of the other key problems is that it suits Governments of all political hues to kick social care firmly into the Local Government field and point accusing fingers at them when cuts happen. It’s not us they say, WE think social care should of course be properly funded but it’s an issue for local government you see, conveniently ignoring the unprecedented and savage cuts made to local authority budgets. Generally speaking local politicians respond to what local people complain about and what most people complain about are pot holes, pavements, rubbish collection and parking. Social care is rarely high up the list of most people’s agendas.

One of the problems we have is that when there is public discussion in the media around social care it focuses solely on number 3, how it should be funded accompanied by sad faced pictures of people saying how their mum had to sell the family home to pay for care. In my mind, the often poorly researched and inaccurate articles about social care funding that do exist in the main stream press only make the situation worse. It seems to me that any debate around funding is doomed to fail. How can the public possibly think about how social care should be funded if they don’t really have a clear idea what is is, who it’s for, how you get it, where it happens etc The others times that social care appears in the media, it is generally being criticised for providing crap services (15 minute visits), encouraging a race to the bottom (low pay, poor conditions) or being roundly abused for either interfering in things that don’t concern it or for not doing enough when people needed it.

So, how do we not only increase public understanding of social care but get them too care about it as well? (Possibly even see it as important as the NHS) NB I should say I’m talking about adult social care. There is a definite need to do something similar around children’s services but it’s an area I have very little knowledge about and wouldn’t presume to make suggestions

These are my ideas but I’d love to hear what thoughts other people have

1. Recognise that most of the wider public will be starting from a knowledge base of zero and so any campaign to raise the profile of social care must start with where the public are at, not where we’d like them to be. Market research and drawing on what we do know about public views is key

2.  Agree a small number of simple key messages about social care that can be repeated again and again and again

3   Heavily involve people receiving social care in telling their stories and the difference that having social care has made to their lives

4. Get some well known faces to front the campaign because often that’s the only way to get media coverage

5. Have a national social care day. Yes I know I know there are already a plethora of days for everything – but there’s not one for social care and it least gives a focus and a target

6. Develop a programme to work in schools and work places to help people understand what social care is

7. Encourage community venues that are delivering social care to become more open to the public and engage more with the community and proactively local strategies that encourage and support this.

It feels to me that if social care doesn’t find a way of fighting its corner, it will become increasingly starved of funds and eventually be subsumed into the NHS and while the NHS is brilliant at many things, I don’t believe social care is one of them.

Remember the case of Gloria Foster who starved to death last year??

This was the appalling incident where Gloria Foster of Banstead in Surrey starved to death after being left without medication, food or water for 9 days after the UK border agency raided the care agency employed to provide home care and shut it down. Maybe if you work like I do in health and social care you do. If you’re a member of the general public I’d be amazed if you did. It was covered by The Guardian, a bit in the Daily Mail and Telegraph and a small story on the BBC. Certainly not the front page tabloid headlines that would have occurred had a child been left to starve to death in similar circumstances.

Today yet another in a very long line of reports has been published pointing out that the Government has no idea of the true impact that social care cuts are having on vulnerable older people. The warning about cuts to social care and the subsequent impact on the lives of older people, their carers, families and other services have become like a broken record of late. It has been said over and over and over again and yet absolutely nothing changes.

On Monday I was at the Redefining Ageing conference put on by Age UK London. There was a real sense of anger and frustration at the lack of action about the problems facing older people. Mary Sinfield chair of the Older Peoples References Group for the New Dynamics of Ageing said she had counted over 50 reports highlighting again and again the inadequacy of care and services, each with long lists of recommendations, most of which had never been implemented. She also made the following stark point to the people in the room “no one is going to fight your battles for you. You have to get out there yourself and do it”

There is a lot of rhetoric in the media about how older people (by which they really mean the so called baby boomer generation) have stolen the country’s wealth, pulled up the ladder behind them and given a few years, will be costing the NHS and social care a fortune. An ageing population is constantly described as a negative thing; a burden, a challenge, a problem.

My personal view is that it is very hard to find issues around which older people coalesce particularly while the powers that be use 50 as the benchmark for when “later life” begins. The idea that you can take people of 50, of 70 and of 90 and expect them all to have the same views, issues and aspirations about services because they’ve been plonked in a box marked “later life” to me is laughable. However, I do believe ageism is the one issue older people can come together around because its ageism that underpins a lot of attitudes, policy and practice in this country. To be old generally is to be invisible; to not matter; to be seen as unimportant and past it.

So long as older people are still seen, if they are seen at all, as a burden or a problem to society rather than just individual people then they will remain without power. There will be more reports, more deaths and nothing will change.

It’s likely 1 in 4 people born in the 70s will not have children – not that you’d know it from discussions on ageing

In this country, care for older people rests mostly on the backs of family carers. 70% of carers are supporting someone aged over 65. Half of these will live with the person and the majority are of working age, mostly in their 50s suggesting that they are the children of the people they are caring for. They are a hugely under appreciated over exploited resource.

I think the way that family carers are treated are appalling; their efforts taken for granted, the expectation that they will undertake any and all tasks from giving injections to changing incontinence pads all without the help and training given to paid carers, and that they will do all this for a paltry amount of money £59.75 a week IF they even qualify for it.

Frankly without them the health and social care system would collapse completely – but here’s the thing. 1 in 5 women born in the 1960s don’t have any children and ONS statistics predicts this will rise to 1 in 4 for women like myself born in the 1970s (I did try to look for statistics for people as opposed to women born in these eras but naturally in a sexist world, childlessness is seen as a women’s issue not a peoples issue)

yesterday I was the redefining ageing conference put on by Age Uk London. It was a very good event (more on this in a later blog) but I was struck by how there was no reference at all to the large numbers of people who will age without children. I have spent 20 years working in the field of ageing and have never heard it mentioned. Instead speakers talk of children and grandchildren using anecdotes about grandchildrens funny comments to connect with the audience, because everyone has children or grandchildren don’t they?

Now this isn’t to have a go at people for doing this. I laughed along with other people and its wonderful to hear people have such great familial relationships and of course more people have children than don’t, but the childless or child free depending how they define themselves are going to be a big cohort in 20 years time. Why is this NEVER talked about?? why at conferences on ageing are people still continuing to assume that people will have families to support them, when its likely that 20-25% of them will not. Ignoring this issue seems to me utterly bizarre. The potential impact on services is huge; all the tasks family carers routinely carry out unnoticed and unappreciated by the state such as making appointments, running mum or dad to the hospital, making sure they take their medication, getting the shopping in, cooking meals and making older people still feel connected to the world, who will do this for me and for my friends also without children?

I didn’t choose not to have children but that doesn’t matter; what matters is that for me and tens of thousands like me, the state cannot rely on our children to look after us when we get old. There will be more of us because we’ll live a long time. where is the forecasting on this issue? has anyone at DH even thought about it?? and why the bloody hell do we NEVER talk about it??

manAGEing through Sport – a brief outline

Since I first tweeted about manAGEing through Sport, I have been overwhelmed with how many people have contacted me wishing me well and offering help. Other organisations like the men’s health forum, older men’s wellbeing network, sporting memories, independent age and local age UKs have also given helpful advice, guidance and support. I’ve also been asked by quite a few people for more information so I’ve put this brief piece together which outlines where thinking is so far, with the caveat we’re about to start testing our assumptions with older men.

What does manAGEing through sport want to do?

manAGEing through sport wants to reduce loneliness and isolation in older men by bringing them together in groups to watch sport. 

How will it work?

The groups will meet at venues of their choosing to watch sport. The venues could be pubs, social clubs, sports clubs, people’s homes, whatever they prefer. The groups will be facilitated to ensure practical details such as transport, food, booking seats, spaces can be organised for the group.

The idea is that the groups will be facilitated by older men as research suggests older men like men only spaces to talk and socialise but we’re testing this view at the moment.

 Who is it aimed at?

Older men who either live alone or feel socially isolated; for example an older man may live with one of his children but feel isolated from his peers.

Why older men?

There is a wealth of data that shows older men have shorter lives and a less healthy old age.

Will it be free?

No, there will be a charge though a lot of work needs to be done on the financial model. manAGEing through sport will need to be self sustaining; too many good third sector projects cease when the grants run out, we do not want this to happen to manAGEing through sport.

Where is manAGEing through Sport at in terms of development?

Very early stages, we don’t yet exist as a legal entity. We have the overall concept and are currently testing our assumptions by getting the views of older men about how they would like manAGEing through Sport to work in practice. We are also applying for start up funding and a small committee is meeting looking at the various legal structures available to social enterprises.