INDEPENDENCE is not in itself an ideal to be sought; humans are born to be interdependent and flourish through their relationships with others. Knowing that there are other people around, especially if they are consistently present, generates security and confidence, both physically and emotionally. Autonomy is not the same as independence, and the more elements of control that people have over their lives, the more content and confident they are likely to be.
As people age, they are not necessarily (in fact rarely) better off in their “own” home, whether they are single or a couple. This is a belief to which the ageing will cling until they have experienced an alternative, but, sadly, are being continually encouraged to hold on to. Thus, basically unsuitable premises are tinkered with to add various mobility and other aids as the person living there becomes increasingly isolated and lonely, and often fearful as well.
By 2036, the number of people aged over 85 in the UK will increase by 113.9 per cent (ONS 2016). Current government policy favours care at home and short-term support to maintain the “independence” of older people, who themselves tend to prefer Independent Living Services.
Nevertheless, the need for care-home places is predicted to rise from 433,000 (in 2014) to 460,000 in 2020. Part of the impetus comes from the lack of places which currently delays, and will continue to delay, hospital discharge. The Local Government Association predicts that, by 2035, the specialist care-home places needed for older people will have risen by 400,000.
CLEARLY, there is a need not only for greater provision, but also for a new vision, if people are to fulfil their human potential for meaningful and rewarding life into old age. Interpreting the vision of “family” for the 21st century presents wonderful opportunities to rethink the place of older people in society, restoring rich relationships between them and between generations.
Already there are glimpses of this potential to be seen. Channel 4’s Old People’s Home for 4-Year-Olds, broadcast last year, set out to measure the impact of bringing the two age-groups together with a day-care arrangement for the children set in a retirement home, and revealed that the impact of the children on those in their late eighties was very significant: after six weeks, the majority of metrics (such as cognition, mood, and physical abilities) had improved markedly, and none of the elderly were depressed, including two who had been diagnosed with severe depression.
In Deventer, Holland, students are living with older people in the Humanitas care home, exchanging the noise and cost of student halls for a wider range of ages in return for providing some assistance and two-way companionship. A report published in January by United for all Ages, a think tank, explores the concept in depth, and observes that such models are starting to be used more, and in the UK, in very recent times.
For example, over the summer of 2017 the Cambridge Housing Society (CHS) set up a small-scale pilot Intergenerational Housing Project to provide accommodation for postgraduate students in one of its sheltered schemes at reduced rents, in return for volunteering and spending time with elderly residents.
Three postgraduates were selected and spent time on activities with residents, including befriending, running errands, preparing meals, film nights, and trips, and administrative activities such as meetings and student training in data protection, dementia awareness, and so on.
At the other end of the age spectrum, some older people are taking arrangements into their own hands. For example, the Older Women’s Co-housing Group, comprising 26 older women from 51 to 88, has created the project New Ground in High Barnet, London. This is a community of individual apartments designed to provide a combination of privacy and mutual support, and based on the premise that everyone is willing to know and be known so that each can be respected and valued.
ONE of the notable aspects of both these “social experiments” is that they are based on similar observations: that facilitating formation of relationships that mirror family bonds is critical to well-being, and that older people must be given an active part to play in the society in which they live, within (but pushing at) the bounds of their ability.
“Care” is not about being done to, but about being helped to participate in the fullness of life.
This is an edited extract from Developing a Relational Model of Care for Older People, by James Woodward and Jenny Kartupelis, published by Jessica Kingsley at £17.99.