By John Woolham, Guy Daly & Liz Hughes.
Many older people are enjoying life. That is what the authors found from their research. But a significant number are not. The reasons are many and varied and the summaries of those reasons give indications of what might be done to improve the quality of life.
A study of 1,500 people over 65, with an average age of 71, by academics at Coventry University on behalf of Coventry City Council and other local agencies including Coventry NHS PCT and AgeUK Coventry, has highlighted a divide between the majority – who are healthy, happy, and keen to be independent and left to themselves – and the rest, who feel burdened by caring responsibilities, ill health or disability.
The research provides some significant insights into delivering services for older members of communities, and how needs are changing. Focussing on four broad thematic areas – health and well-being, choice and control, economic and educational participation and social and community participation, the research team’s report included a number of interesting findings
Health and well-being
Large numbers of people wanted to change their current lifestyle by losing (or gaining) weight, taking more exercise and improving their diet – but very few people mentioned reducing their intake of alcohol or cigarettes. Being able to look after themselves, or self-care, didn’t seem to be a problem for most people who took part in the survey. Where it was difficult for people to look after themselves, the majority reported that they got the help they needed for this. A fifth of those who answered the question – 252 people – said they cared for someone else. Those cared for by this group were mostly other adults. People who were in a caring role provided, on average, 55 hours of care per week, and 25% of carers were providing over 100 hours of care a week.
Most people reported that they were enjoying life. There was a strong relationship between whether people reported that they were enjoying life or not, and many factors – such as being a carer, being retired, being troubled by loneliness, not feeling productive, being troubled by living with illness or disability, and not having enough money to live on. People said that reduced crime levels in their area, having more money to live on, and having more information about local services and activities would most improve their quality of life.
Recommendations to address the issues raised relating to changes to lifestyles to improve health included the appointment of a Healthy Lifestyles Co-ordinator with a responsibility for implementation of a programme of initiatives. More advice on existing, affordable gardening services would be useful along with the creation of a local, basic, gardening enterprise for people who can no longer do this activity, and mobilising the skills and energy of other local groups – social enterprises and voluntary agencies.
Choice and control
Researchers explored the preferences people had for local services and the use they made of local amenities. One of question included in the survey was whether, if people needed care and support, they’d prefer to receive payments to be able to spend on meeting their needs, or to have someone who knew what their needs were and arrange care and support on their behalf. The survey found that slightly more people preferred the idea of someone else arranging their care and support than having a budget of their own. The numbers of people who said they’d prefer to manage their own budget decreased with age. This finding is a challenging one as the Government sees the growth in use of personal budgets as the best way of empowering people who need social care, and personalising care and support.
Over two thirds of people said they’d prefer to stay in their own home and receive care from there, rather than move to somewhere else, such as sheltered housing or a care home. One in ten of those who took part in the survey had not previously heard of NHS Direct. The majority of those who took part in the survey felt that local civic amenities such as libraries and community centres were very important, but at the same time, were not well used. For example, although 84% of people described libraries as important, only 21% said they used them daily or weekly. The study also found that many older people needed better information to enable them to make informed choices, for example, in choosing local builders or other tradesmen.
The research team recommended improvements in local services by developing a broad range of options to deliver personalised support, and to offer people choices to enable them to use their Personal Budgets and Direct Payments effectively. Preventing, or delaying, the need to move (though care, support, provision of assistive technology or home adaptations) were also seen as continuing to be a very important objective of local services. The authors also envisaged an important role for local voluntary sector agencies in helping older people obtain services and to provide information to prevent them falling victim to unscrupulous tradesmen.
Economic and educational participation
Just over a third of those who took part in the survey said they didn’t have money worries. A similar proportion felt they could manage if they budgeted carefully. Many did not seem financially secure: a fifth worried about their finances in the future and 7% said they did not have enough to live on. 13% felt they needed advice about money, and would mainly seek this through friends and family, or voluntary organisations such as the Citizen’s Advice Bureau or Age Concern.
Less than half of those who took part in the survey said they were involved in a range of learning or leisure activities listed in the questionnaire. Amongst those who were taking part, the most popular activities were art and craft, exercise, vocational training (e.g. computing) and foreign languages. Barriers to taking part in these activities included poor mobility, not wanting to go out and about at nigh, lack of good transport, and the cost of the activities.
The researchers acknowledged limits to what councils and other local statutory agencies can do to help older people living on low incomes, but there is probably a much greater role for private sector organisations in offering . discounts or concessions to people of pensionable age for goods and services. Discounted cinemas and theatre tickets , is one obvious example.. The provision of readily available transport was something that people also said would remove a significant obstacle to participation, particularly evening classes taking part in the winter months. The authors speculated about whether this might be something that could be organised informally by tutors: either seeking volunteer drivers from amongst students or establishing a ‘taxi-club’ to share rides to and from sessions or events.
Social and community participation
Being on a bus route, good relationships with neighbours, and accessible shops were the things regarded as most important about the local neighbourhoods in which people lived. When asked to describe in their own words the most important features of their local neighbourhood, people tended to focus on aspects of their physical environment rather than the quality of social relationships and neighbourliness.
Many older people did not use, or rarely used, modern technologies of communication. A quarter said they rarely or never used a mobile phone, and almost half rarely or never used the internet. The older people were, the less likely they were to use these technologies. Only 10% of people said they were using assistive technologies such as pendant alarms to keep them safe or to support their independence.
Loneliness seemed to be a very significant issue for a large minority of people who took part in the survey. Improved access to everyday leisure and educational activities, and ‘skill sharing’ schemes which have been developed in one or two parts of the country, where younger people may be able to teach older generations about how to best use mobile telephones, computers etc, in exchange for advice from older people about practical skills such as budgeting, cooking, decorating etc were seen as potentially helpful in alleviating loneliness.
John Woolham, Guy Daly & Liz Hughes, Faculty of Health & Life Sciences, Coventry University. A full summary of the findings and recommendations of the study can be made available on request.