ACTIVE, HEALTHY, SUCCESSFUL AGEING ?

http://www.theatlantic.com/business/archive/2015/04/unequal-until-the-end/389910/

Browsing vaguely in the early morning, I came across this article. It is about the US but the article looks at ageing from a different angle than the proselytising  “successful ageing”, “active ageing”, “healthy ageing” well-intentioned, money wasting, programmes that so infuriate me.

I will quote only a few lines from the article but Abramson’s book (The End Game .How Inequality Shapes Our Final Years. Corey M. Abramson. Harvard University Press) may be useful to the people engaged in social policy, and fund-raising endeavours.

For the affluent, old age has its challenges. For the impoverished, it’s only harder.

Perhaps the presence of shared challenges in later life explains why we’ve glossed over inequality’s effects among the elderly …  

Social circumstances affect not only how long we live, but how healthy we are when we become seniors.

Some of the elderly I encountered in my study aged with immense wealth, social support, and education. Others did so in poverty and isolation. The wealthiest people in my study had aged in or retired to communities with voluminous senior programs, while many of the poor became increasingly isolated as they struggled with piecemeal social services.

The ideal of “successful aging,” emblazoned in the collective consciousness by glossy magazine pictures of smiling senior couples watching sunsets from a beach, is more attainable for some of us than others. The reality is old age is not the end of inequality, but its end game.

I often argue that the choice given to old people between retirement/care homes and ending their lives on their own in their own homes is a false one. The rich old Americans must know what is good for them… Campaigning for a ‘healthy’ life for the old must include the demand for funds to establish structures to facilitate social life for the frail, the disabled, the financially deprived…

 

 

 

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Active Ageing and Disability

I am angry, I am very angry.

‘Active Ageing’ is the buzz expression these days. Mention the magic words and short-term projects will be funded, academic research will be supported and women who want a contemplative and quiet life will feel guilty.

I believe that the expression was introduced by the WHO about people over 60 years of age and has been taken up by the EU and other organisations. What are the ageist assumptions that underpin the Active Ageing concept? I do not know about men, or other countries and I talk from an 80 years old Londoner’s point of view. I know that fit and healthy old women do not sit doing nothing all day. Some are still paid for their work, the majority work for no pay: they look after their grandchildren, they are carers for parents or partners, they volunteer for hundreds of charities, hospitals, hospices, schools, churches, synagogues, mosques, they take courses or lead courses. They write, they sing, they paint.
They tend their gardens and allotments and care for the environment and campaign for peace and justice. And some have earned the right to choose not to be ‘productive’. Fit and healthy women do not need help in being ‘active’. I sometimes think that they would benefit from help in slowing down.

In the field of education I am angry because Adult Education courses where old and young adults learned together have been severely curtailed for lack of funds and new courses are funded specially for the ‘old’ to be active – very often without provisions for the disabled old.

Quoted in Age-Friendly-London Report: “Older people are living with disabilities and longstanding illnesses for a greater proportion of their life, although this varies with social class, ethnicity, gender and location. At age 65 men are now expected to live with disability for 7.9 years, women 9.9 years (ONS 2014a).” I am angry because the Active Ageing campaign does not address this fact and seems to me to concentrate on the fit and healthy.

There are no courses on living with impaired hearing or vision. There are no courses in adapting to creeping disabilities. There are no courses in adapting to the changing relationship in couples when one becomes disabled. There are no courses on how to talk to your doctor and learn about the medication prescribed. I only know of one course on living with a chronic illness. And apart from the growth of independently organised Death Cafes I know of no courses about death.

Active Ageing? Yes, of course. Give the old the means and they will need no help to be active. State-of-the-art hearing aids for the hard of hearing that is one of the causes of isolation. Mobility scooters for all who want one. Local Community Centres with good transport and facilities for the disabled that will provide daily social contacts.

I am angry because the problem of isolation and mental deterioration is not solved by a befriender visiting once a week even if there are caring relatives who can visit sporadically Sheltered accommodation, care homes, nursing homes are of an appalling standard unless you are extremely rich.

Yes Active Ageing: Fund community hubs, adult education, local activities, adequate transport, meeting spaces, age-mixed housing areas with cultural activities. We are social animals and need daily human contact however superficial.

Live isolated in own home – this is what people say they want

Is it coincidence or what happened to a friend and a relative of mine more common than the general population imagines?

The two women, very different in all ways, over 80 both of them thought of themselves as coping living on their own. O loved her comfortable flat. Very independent she belonged to a few social groups, had many friends and family and at no time considered changing the situation. M on the other hand lives in badly managed sheltered accommodation after many moves, has no friends and only an elderly relative  as social contact.

O was found by a neighbour, unconscious. Nobody knew got to know how long she had been lying on her bed unable to contact anybody.  After a few weeks in hospital, she died. M was also found  nearly  unconscious and bruised on the floor where she had been lying for two days and nights.  The ambulance took over an hour to arrive and she was admitted to hospital. After 10 days as an inpatient she was declared medically fit and discharged with the promise of home care help as soon as she arrived home. She was still very confused, weak and unable to function. The relative was not informed of the situation, and not given any contact numbers.  The carers did not arrive that day, evening, or the next day. It transpired that she was discharged before a care plan was put in place by the council.

I am writing this because I felt strongly that the general policy of keeping old people in their own home as long as possible ,’that is what they wish’, may in the long run be more destructive and costly that establishing good care homes. I have written about this in previous posts (search in this blog ‘Enrich your future, and  Protecting our parents) . Our culture is an individualistic one. The isolation figures are worrying and lead to the above incidents. Yet excellent care homes cater for rich people. We need to think outside the box, read Being Mortal by Atul Gawande, investigate OWCH. Ageing is a feminist issue and there is hope that the revival of feminist groups (london 70s sisters)   will yield similar projects.

http://www.theguardian.com/society/2015/feb/16/co-housing-people-things-common-live-together-older-people

London Feminist Conference 2014

In spite of a very busy time I felt I  had to attend the Feminism in London conference. I managed it, arriving late and leaving early but the few hours spent in the exhilarating atmosphere made it worthwhile. To be in a crowd with so many women – specially the young ones  revived my feminist identity and commitment. I appreciated meeting old friends from past campaigns and the art stimulated my imagination.

However I felt a bit sad. In the multitude of stalls, old women were not represented. There were no workshops on the crisis in care or the plight of caseworkers, on ageing, ageism, on the relationship between disability and ageing. I do think that ageing is a feminist issue. To date, while academia and even the media are shining their spotlight on age, there is no public old feminist voice. But academic papers on the culture of old age does not seem to permeate the general consciousness and the media’s misrepresentation of old women in images and language attract no interest.  It is not that there was a lack of old activists at this conference.  Splashes of white hair were seen from the back of the lecture hall and among the workshop facilitators. Individuals were present but not the groups. What I mean is old women’s activism was invisible.

The OFN Older Feminist Network, the oldest group (1982) of old women to get together as feminist old women were not there. OWCH the Older Women Cohousing  group were not there.These women challenge the false choice between the isolation of growing old in one’s own home and the anonymous uninspiring retirement home. The new 70s sisters network were not there.  Only G.O.D. Growing Old Disgracefully advertised their existence with their banner on the wall of the stairwell.

I appreciated enormously Gail Dines plenary speech. In her words  ‘Feminism is not for each individual, it only works as a collective movement. We’re all in this together’.

 

 

Greater London Forum for Older People. Question time

The GLF (Greater London Forum for Older People) supported by AGE uk organises a yearly Question Time at the House of Commons. This year the speakers were:

Segun Oladokun – Head of Inspection Adult social Care, Care Quality Commission and Professor Martin Green OBE – Chief Executive Care England

Paul Burstow MP chaired. 

While the sessions the previous two years (see links below) made me angry, this time I came home deeply depressed. When my partner asked me what was the point of these sessions, I was at a loss to say anything.

Segun Oladokun would have been insulting had he not mentioned the lack of trust we have in the caring agencies but instead of giving us facts and figures about the situation  he talked to us about the purpose of the CQC and the change of approach to their practice.   His last words were that the services were variable. A member from the floor commented that indeed there are very good homes if you have the money but there are no resources to fund good care for all. One contribution summarised the situation. The government delegated the social care services to local authorities and the local authorities handed the responsibilities to lowest bidders care agencies.  The contributions from the floor were testimonies of appalling conditions rather than questions. At no point were we given facts and figures about the state of the quality of care present at the moment.  At no point was the question of local authorities’ resources raised, and at no time was  the government blamed for an austerity programme that penalises the vulnerable.

Martin Green Chief Executive Care England. He started his speech by accusing the local authorities of lacking creativity. He carried on later with the argument that there is inequality between the treatment of old people and the treatment of children/people with learning difficulties. The question to be asked he says : “Are old people treated the same as children?” and that we as members of the GLF should fight for equality of treatment. He invoked society’s ageism for the fact that old people with dementia are neglected. To me his judgement is flawed. The question is not the equality of treatment within a ring fenced limited budget between two sections of the population who have no voice  but enough resources and finances in this budget to fulfil the needs of both groups. Mr. Green OBE seems to have discovered ‘ageism’ and urges us to combat it. Did he not realise that his argument itself is ageist by its very nature of comparing groups on the basis of age rather than needs? If he considers that the needs of children/people with learning difficulties are well met, shouldn’t he fight for an adequate  budget that would permit old people’s care to be as good?

It is the second Question Time where we, the audience of old people, all involved in voluntary activities, all busy working on the ground  are harangued by officials. We are told to agitate, to ask for our rights. But we have no power. The people who could make a difference, are people like the speakers we are invited to question. They should be our representatives, they are the ones who should hold the government, the care corporations, the share holders to account.

http://oldwomaninfeaturefilms.wordpress.com/2012/11/09/films-and-demographic-changes/

This site : social care in the home november 15/11/ 2011

 

ALL ALONE IN A CARE HOME

June 8th 2014.  From astra OFN member since the 80s.

It’s the wrong time and the wrong place where I am living now. Since 1974 , I’d been settled in a small upstairs flat opposite woods. I’d never moved away till recently. Both a social worker and an occupational therapist agreed that my beloved flat is no longer safe for me. It is the steep flight of stairs and the slippery bath and more recently my inability to stand unaided after a fall that finally convinced them that my flat was no longer suitable for myself, an 86 years old with a history of falls, both indoors and out, over more than a dozen years.

This settled the matter of what my local council could or should do with me so it was that I found myself in a care home first, and then a second care home, each one populated by people who are deaf or demented, sometimes both. Mealtimes are silent except for the TV in the corner or the carers urging the residents to eat not sleep at the table. Unfortunately there is no one with whom I can have a conversations with so I draw or read or wait.

Currently I’m on a waiting list for a flat in a nearby sheltered housing estate. This is teaching me patience. If nothing else.

PROTECTING OUR PARENTS episode 2

Episode 2 of ‘Protecting our Parents’ was called ‘Who Decides’. Yet another distressing programme that asks the wrong question. In Kathleen’s own words : “the system is all wrong”. Kathleen is the strong-willed bed-bound 80 years old woman who is a problem for the NHS and Social Services . She wants to die at home and not a care home but needs 24hrs care.  She also says: ‘The carers do their best but they are not here when you need them…make me feel like I am a nuisance …if I need help I need help. The carers are all right but they have no time …They should be paid properly.  I do not think it is fair that have to pay for private care.” But the psychiatrist declares that  her decision-making is impaired.

How can such an absurd situation arise? Urgent hospital admissions followed by discharges to the same inadequate situation. Hundreds of calls to the emergency ambulance, just to lift distressed Katherine up the bed. Official guidelines and personal wishes set in stone. Teams of well-meaning people and experts with their hands tied because of financial constraints and the conflicting interests of the diverse agencies involved.   The pretence that the whole problem is not a question of money.

Where was the son in this situation? Was nobody capable of thinking outside the box and find a solution for this woman to be comfortable in bed and prevent her from phoning emergency services costing over £57000 over a few months? A technical solution that would prevent her from sliding down the bed ? But do these hundred of calls to the emergency services express a deep sense of insecurity since the husband cannot lift her up the bed anymore?  what does this insistence of staying home with no quality of life and at all costs mean? The terror of the thought of the care home?   Did this isolated, symbiotic couple see other people apart from the rushed carers? Was there no other way to finance the extra help that Kathleen needed?

On a positive note and in the absence of family members,  it was good to see that the community social worker did work as an advocate for the couple against the medical experts’ assessment of Kathleen as being incapable of making decisions.