Category Archives: Older people

My campaign to change attitudes, one event at a time

We have just ‘celebrated’ World Mental Health day (10 October). I, and many like me, hope that as each year passes so does the stigma and discrimination of mental health. Stigma impacts like a disease – if left untreated, the result is devastating.

Attitudes are certainly changing around mental health, although slowly. As pointed out by Time to Change, the mental health campaign I’m involved in, perceptions are changing. The National Attitudes to Mental Illness survey shows that since 2011, an estimated two million people – or 4.8% of the population – have improved attitudes towards people with a mental illness.
In addition, the data suggests that more people are acknowledging they know someone with a mental health problem (64% in 2013 compared with 58% in 2009). However nearly half (49%) of respondents said they would feel uncomfortable talking to an employer about their own mental health.

Anti stigma work has taken up a large part of my life in psychiatric nursing. And, although it sometimes feels like two steps forward and one back (as the research quoted above hints), the long and winding journey is worth the taking and the rewards are for the benefit of everyone.

I have seen the impact of stigma. I have also felt it. I have seen the destruction it causes people who experience mental illness and their loved ones. This is the motivation for my work.

The recent news about the impact of isolation underlines the need for more work along these lines. Both young people and older folk are affected by severe loneliness.

These issues provided the context for a talk I organised in my childhood village in July, and which I blogged about on these pages.

My talk was about the stigma of mental health and aimed to promote Time To Change. I wanted to raise awareness of the insidious impact of stigma and its long-term damage, and explore how we can all make a difference to the lives of others through our daily interactions. I wanted my message to reach across the village and, more personally, make a mark in the place where I spent my childhood years.

For me going back to my former home, which I left almost 40 years ago, was quite an emotional occasion. It had been the culmination of a life long ambition, a seed borne in childhood that had finally flowered. In the dark corners of my mind has sat the repressed thoughts from childhood of my father’s mental health issues, and the attitudes of others at the time to this.

Assembled in the room of around 50 people were faces from my childhood, alongside faces of the present. An eclectic range of people and experiences, young and old. Friends and family sat beside strangers. I will always be very grateful for the efforts they made to attend and help me to achieve my ambition.

Social contact and interaction is a powerful weapon in challenging ignorance and the myths surrounding mental health. Breaking down the invisible barriers we put up and accepting people as people, rather than defining them by their mental health condition is critical. The two-hour event was informal and interactive thereby providing the ‘safe’ space for those who wished to be open and share their personal experiences, or the experiences of others they hold close.

I started with a mythbusting quiz about mental health to highlight the misconceptions that exist, then spoke about my work in mental health nursing, my anti-stigma initiatives, and also my own experience of depression. I covered my work in the media with the TV soap Emmerdale, advising on the award winning depression storyline of one of the main characters, Zak Dingle.

I stressed it was my hope to encourage the viewers to empathise with Zak’s plight, to see him as being vulnerable and a victim of his circumstances rather than a danger to others, and criminalized

To contrast with this I also explained my advisory role with the character Darrell Makepeace in BBC Radio 4 The Archers. This character had not been received positively by listeners because the producer had decided to criminalise this character. Despite this, I stressed this at the very least ensured people were talking about mental health.

It was a success. I was at pains to ensure it went well because it meant so much to me. I have delivered many talks and presentations previously to large and small audiences but this one was more personal.

Since that summer’s evening I have spoken to people to gauge how things went. Did it make a difference? Has it changed their views? Inspired them? Where do we go from here? The responses have enthused me.

I intend to arrange a follow up event to build on this and plant another seed for the future. A seed for the young people, some who, sadly, will inevitably grow up with the same experiences I had.

Hopefully there will be some changes in attitudes resulting from that evening. It might seem to many just a single, small event, but if it can change just a handful of attitudes and encourage people to talk about mental health, it will be a success. Change drips slowly, but it will come all the same. One day.

Specialist dementia care for black and ethnic minority families

“They should not suffer in silence”, says Amina Begum, a full time carer for her mother, of why we need more culturally specific dementia services for black and South Asian communities.

Speaking to me for a Guardian piece published today ahead of World Alzheimer’s Day on Sunday, Amina spoke about the contrast in support between when her father had Alzheimer’s (he died seven years ago) and today, as she cares for her mother, Jahanara, who has vascular dementia.

Amina is lucky; there is strong targeted support in Tower Hamlets for the area’s Somali, Chinese and Bengali communities. But while there are pockets of great practice, such as the Alzheimer’s Society’s monthly “dementia cafes” that Amina and her mother attend, such specialist care is not widespread. This is despite the fact that African-Caribbean and South Asian UK communities are at greater risk of developing dementia than the indigenous white population.

Amina Begum, a full time carer for her mother who has dementia (photo: Alzheimer's Society)
Amina Begum, a full time carer for her mother who has dementia (photo: Alzheimer’s Society)

Amina told me that as she hears her mother swaps childhood stories with her peers at the Sylheti-speaking dementia cafe, she sees another side to her 65-year-old parent. Jahanara is at ease and animated instead of being confused and frustrated. The pair are among around 200 regulars at the social club for the area’s Bengali community based at the East London Mosque. Continue reading the full piece here.

*Amina and her two daughters are taking part in the fundraising Memory Walk on Saturday 28 September which aims to raise money for research into dementia.

Telling the untold stories of austerity


Women in Croxteth, Liverpool, discuss the impact of cuts on communities, part of the research for the new book, Austerity Bites

Do you know what austerity really means?

Here’s a definition from the Collins Dictionary, as quoted in Mary O’Hara’s commanding new book on the subject, Austerity Bites: “…difficult economic conditions created by government measures to reduce the budget deficit, especially by reducing public expenditure: a period of austerity/austerity measures.”

But that literal definition, and the words of politicians using the rhetoric of austerity to mask the harsh impact of public spending cuts, conveys nothing of the human cost of the unprecedented reform of the welfare state.

Austerity Bites redresses that imbalance. I don’t usually do reviews on this site, but this timely book demands attention.

Reading this book means you join the award-winning journalist O’Hara in her “journey to the sharp end of cuts in the UK”. Based on a 12-month trip around the country meeting diverse people affected by cuts as reforms were introduced in 2012 and 2013, O’Hara gives a platform to untold stories of hardship.

O’Hara’s book suggests, “austerity” has become an acceptable rhetoric, one that glosses over the harsh impact of welfare reform – as in “cuts hurt but in the age of austerity, what else can we do?” The creeping normalisation of food poverty and food banks, as explored in this book, is shameful.

While an intricate explanation is given of the political and economic context, it is the lives of those whose voices are rarely given a platform – the homeless, the disabled, the young among them – that are the focus here.

Crisscrossing the country, the picture is one of political classes living in a “bubble” untouched by the harsh reality of life on the front line of Austerity UK; a massive chasm between the people suffering from the impact of cuts and abolition of vital benefits and the people making the decisions to abolish that support.

People talk of “breaking point”, “existing not living”, their “desperate situation”; the book does much to explode the myth of benefit Britain. A fairly comprehensive catalogue of unfairness is chronicled in Austerity Bites – the disabled, for example, are shown to be bearing the brunt of cuts, the vulnerable are made more vulnerable and the poorer become poorer.

As one man, Dec, who O’Hara meets on a Luton estate tells the author: “Do I deserve better? Do other people deserve better? I think they do.”

Unsettling, but vital, reading, this book lays bare the real, true story of austerity.

Ageing and art: tackling isolation among older people

Photographer-led workshop, part of the Meet me at the Albany project
Photographer-led workshop, part of the Meet me at the Albany project

One in six of us – that’s 10 million people in the UK – are over 65 years old. By 2050, this number will have nearly doubled to around 19 million, or one in four, according to government figures.

In a recent Age UK survey, more 77% of respondents said they are looking forward to living longer but 91% said something needs to be done to help us all lead a better later life. The survey of 1,480 adults also suggested that most of us (83% of those questioned) believe negative perceptions of later life must change.

The onus is largely on health and social care organisations – hospitals and care homes – to improve the treatment of older people (not least as cuts decimate support for the most vulnerable). But communities themselves and some innovative local projects are also doing much to tackle social isolation and change attitudes.

One unusual scheme in London is doing just that. I know the Albany arts centre in south east London through the work of the fantastic charity Heart n Soul, one of almost 30 groups that use the venue as a base (read more about Heart n Soul in this previous post).

The centre is now hosting a creative day club for the over 60s – the kind of stereotype-smashing thing that sticks two knitting needles up at anyone who dares assume day care for older people is about flower arranging and endless cups of tea.

Proving that older people can be just as innovative, artistically edgy and downright clown-like as their younger counterparts, the Meet me at the Albany project involves everything from circus skill tasters, to neo soul music performances and spoken word sessions with “poet from the pub” Simon Mole and fellow leading wordsmith Malika Booker.

The image above is from a recent workshop with photographer Manuel Vason, an artist who sees his practice as a constant battle against the impossibility of reaching ‘presence’. Think cutting edge rather than Kodak moment.

The project is produced by the Albany and participatory arts company Entelechy Arts, which has worked for more than two decades with people in care, younger people and those with learning difficulties and complex disabilities. It is also a direct response to the issue of loneliness among our ageing population and has been created with the support of Lewisham council’s adult social care staff “to ensure the effective dovetailing of the programme with targeted provision for those with greatest need”.

As well as creative workshops and performances from established artists, participants can have a home cooked hot meal and drinks. Sessions take place every Tuesday at a cost of £6 (all materials are included in the price and there is no charge for personal assistants and carers). The scheme is targeted – rather wonderfully I thought – at “anyone over 60 who’d like another place to call home”.

At 80, Velda is the sole carer for her husband Henderson who recently had a severe stroke. She is fully signed up to the Albany ethos: “[It’s]…good to leave your home, to get away from your four walls and come together, use your imagination and do things that are worthwhile rather than just housework. I enjoy making new friends – people you never knew before. [My husband has]… known me for 51 years and he never knew I could draw.”

Just last week Age UK launched its Love later life campaign encouraging people to think differently about getting older, and demonstrate that older people have a valued role in society (see clip below).

The campaign urges us all to think that it’s never too late to try something new. Down at the Albany, Velda and her peers are ahead of the game.


“Ageing is not an illness”: Age UK’s new television advert

Seeing dementia through a different lens

Ashwani and Didi laughing, from Love, Loss and Laughter by Cathy Greenblat
Ashwani and Didi laughing, from Love, Loss and Laughter by Cathy Greenblat

I was entranced by some of Cathy Greenblat’s photographs of people with Alzheimer’s, which I came across when researching a recent piece about dementia.

Dementia is a major global challenge – health experts describe it as the next global pandemic. One in three of us will develop it – 135 million people by 2050, according to Alzheimer’s Disease International (ADI), and its annual worldwide health and social-care cost is around £400bn.

Yet Greenblat’s work goes behind the headlines to present the human aspect of the disease.

The images in the book Love, Loss and Laughter present a rare view of the illness, shattering the stereotypical image of people as personality-free empty shells, discarded and forgotten by society.

Marie-Therese at a party (photo: Cathy Greenblat)
Marie-Therese at a party (photo: Cathy Greenblat)

Greenblat’s thought-provoking project to document the lives of people with Alzheimer’s is endorsed by ADI and has taken her all over the world for over a decade (it was published in 2011).

An academic and photographer whose grandparents and mother all developed Alzheimer’s, the sociologist’s work combines a large scale vision and research expertise with a very personal focus on human relationships and societal attitudes. Many of her photographs reveal the characters behind the disease, presenting people with Alzheimer’s in a social or familial context and among friends and carers.

The hundred or so photographs taken in care homes, private houses, clinics and day centres all over the world show how it is possible for people with dementia and their families and carers to experience some joy as they lose their cognitive functions (the “love” and “laughter” in the “loss”). The images show how people can maintain both independence and quality of life.

It is worth pointing out, however, the images do not shirk from touching on the frustration, anxiety and isolation – particularly at the end of life – which Alzheimer’s brings.

As Greenblat, Professor Emerita of Sociology at Rutgers University, writes in the book, “people with dementia retain vital capacities”. She reinforces the notion that our attitudes to dementia must change if the experience of those with the illness is to improve; her book quotes Michael Verde, president of American dementia organisation Memory Bridge, who says People with dementia don’t disappear unless we disappear from them”. It is possible, as Verde has said, “to change what is referred to as ‘the long goodbye’ into ‘a long hello’”.

The photographer tells me that people are often surprised to hear that the subjects of her pictures have the disease, she says: “I’m often struck by the responses of viewers of my photos at exhibits who ask with some astonishment, ‘But does this person really have Alzheimer’s?” They have only seen images that show people who are sad, dispirited, disconnected, and it takes them time to accept that that is not the necessary condition.

“People who are treated as hopeless lose hope; people who are treated as being unable to do things lose confidence. We don’t treat a sense of hopelessness or lack of confidence with medication: we do it by helping them to feel needed, cared about, being stimulated, communicating differently with them.”

Greenblat will be in Australia in late February to photograph more care settings and explore how to create “joy filled residential communities for people with dementia”. She hope this will result in a multimedia project with interviews, photographs and videos. Some more of her work is included in the gallery below:

• I asked Cathy a few more questions about her work, here’s what she said:

“Perceptions of Alzheimer’s are changing in the time since I’ve been photographing.One of the big changes is that there is so much more talk about Alzheimer’s, in the press, in books of all sorts, on the internet in the form of webinars and connections that are global.

Of importance is the greater participation in the dialogue by people living with dementia – people with diagnoses and people who are their care partners. This is no longer just the medical community telling us about what they know, but sharing of experience…Not everyone is listening to these new voices, but those who do have learned that there are ways to continue a quality life for much longer than has generally been believed.

How has my academic background helped me in my work? Probably the most important thing is that I came to this work with a knowledge of doing research… I knew how to go into new situations and places and learn from people about their lives. Now I was adding a camera to my “tool kit”, as I believe that seeing is so important in changing one’s mind… I speak in an early chapter in the book about ‘Changing people’s minds about people’s changing brains’ – that’s what I have been doing. And I think that is crucial.

I thoroughly believe that we need to distinguish between the physiological changes as we become ill, and the primary symptoms brought about by that. But there are many secondary symptoms such as apathy, aggression, social isolation, that are not caused by the disease but by the way people are treated and come to see themselves .

People who are treated as hopeless lose hope; people who are treated as being unable to do things lose confidence. We don’t treat a sense of hopelessness or lack of confidence with medication: we do it by helping them to feel needed, cared about, being stimulated, communicating differently with them… It is what the photos illustrate. This is not a new perspective… it has been discussed by scholars around the world, but the addition of visual evidence in photos that clearly are not posed has given them wider acceptance.

Many people “run away” from dementia. Surely some people run away from family members or friends who begin acting strangely and are difficult to deal with because they are don’t want to deal with the problem. We all know of siblings who fight about the care to be given to a parent, leaving the responsibility on someone else’s shoulders. They say they are too busy, they had poorer relations before, they have other responsibilities..

But many people are not selfish and ill informed – rather, they are frightened, they don’t know what to do they don’t know what they can do, they believe that there is nothing that can be done until a cure is found. That is simply not true. There is so much we know how to do now to engage people in continuing stimulating activities. There is so much to be gained through creating partnerships with professionals and other groups that provide day care activities, memory centers, art and music therapy, etc.

We need to help people know that there is a great deal to do and inspire them to find resources near their homes or on the internet. Many friends and family want to be engaged and helpful but they don’t know how to do that. There are excellent books, pamphlets from the Alzheimer’s associations and other groups. This can not only help the person who is ill, but it makes the friends and family feel more empowered… They can learn what to say and how to act in ways that let the person feel they are understood, which in turn reduces the aggression which so often is the result of feeling they can’t clearly express their needs and desires.”

• You can watch some films on Love, Loss and Laughter here and here or visit the website to find out more about upcoming events related to the book and photography project. You can also follow Cathy on Twitter @CathyGreenblat

We need to prepare for the next global pandemic

It is a disease one in three of us will develop – 135 million people will have it by 2050 and its worldwide health and social-care cost in 2010 was estimated at £400bn…yet no one is ready for the worldwide pandemic that is dementia.

My Guardian interview with leading microbiologist Peter Piot today, coinciding with the G8 Summit on dementia, underlines why international action is vital. Piot, who spent four decades investigating the world’s deadliest diseases and whose pioneering work made HIV/Aids a global priority, is in no doubt that dementia is now the world’s greatest social, economic and moral challenge.

“There’s not enough awareness of how bad the problem is,” warns Piot, a global health expert and director of the London School of Hygiene and Tropical Medicine. Like most of us who know someone who has had or is living with dementia (my grandfather had it), Piot’s father-in-law had the illness, so he knows first hand of the denial and stigma it brings: “It is the most neglected of all the neglected health problems and it’s a hidden problem because people are at home – they’re already written off by society”.You can read the rest of my piece is here.

When Piot argues that the discrimination faced by people with dementia is tantamount to a “human rights violation” and more than just a medical problem, I couldn’t agree more.

Funding and focus on research is essential, but this has to be accompanied by a change in attitudes – and the latter will be an uphill struggle for a society fails to have older people on its radar, regardless of whether or not they have dementia.

Older people power: society and product design need to wise up

Gordon Morris, Age UK Enterprises
Gordon Morris, Age UK Enterprises

Society often fails to realise that people aged 65 and over currently represent a sixth of the UK population responsible for £120 billion worth of spending power a year – over 18% of total spending in the UK. And the number of people aged 65 and over is projected to rise by nearly 50% in the next 20 years to over 16 million (figures from the Office for National Statistics).

As Britain adapts to an ageing population, the marketplace for assisted living aids and adaptions such as stairlifts, adapted bathrooms, wheelchairs, mobility scooters and pendant alarms will become a dominant area of spending. Market forces will encourage producers and distributors to sharpen up their communications to older people but it would be a very positive development if we were to address this now rather than later.

The government’s 3 million lives initiative, announced last year with the aim of improving access to telecare and telehealth, is an important step towards transforming service delivery for people with long term conditions, and/or social care needs, by utilising telehealth and telecare within health and social care services. Telecare and telehealth relate to the use of technology-related devices, from high-tech equipment to simple sensors, that help people maintain their independence and boost their safety. And during a recent debate on the Care Bill in the House of Lords the government announced that it intends to maintain existing entitlements for older people regarding aids, minor adaptations and intermediate care.

These developments are warmly welcomed. However recent research by Age UK Enterprises, the commercial arm of the charity, found that there is still a way to go in ensuring that knowledge about these developments is passed to those who most need them. The survey revealed that 20% of over 65s feel there is a lack of information available about independence aids for the home.

The low consumer awareness amongst people aged 50-70 of the very products which can aid independent living at an older age can be addressed. But there are also social perceptions that we need to tackle too. A key finding from the research conducted by the Health Design & Technology Institute (HDTI) at Coventry University in partnership with Age UK and campaigning charity Grandparents Plus, is that while some in later life would benefit from independence aids, many older people do not want to be stigmatised or singled out as being in need of “assisted” products or “equipment”.

Age UK Enterprises is interested in this as we provide personal alarms (one of many aids that help older people remain independent within their own home). It is imperative that the utmost is done to prevent falls and accidents within the home and these aids are a step in the right direction to ensure the protection of this demographic (NHS figures show that around 30% of adults over 65 and living at home will experience at least one fall a year and this rises to 50% of adults over 80 who are at home or in care).

So we need to collectively tackle these issues by thinking comprehensively. From their inception and design these products need to help avoid stigmatising older people by ensuring good, attractive, non-medical design. Their availability needs to be considered too.

Out Age UK Engage Business Network aims to share knowledge and insight about what the ageing process means for business best practice. It encourages better design of mainstream products and services to meet the needs of our ageing populationThe Network is seeing more and more businesses waking up to the idea of making services and products easier to engage with and inclusive; not just subsets of their product range aimed at the older market but their entire offering. If done well, this will naturally make brands accessible to all customers, including people in later life.

We must help older people realise how much support is available to them. There are solutions available to help improve their independence, as well as their confidence in the support available to them. This support network is substantial and includes everyone from charities and businesses, through to local authorities and the government, and each element has its part to play in raising awareness of independence aids.

* Gordon Morris is managing director of Age UK Enterprises. Age UK’s ‘Adapting your home’ guide includes information about the aids that can enable older people to stay independent in their own homes for longer; for a free copy call Age UK Advice free on 0800 169 6565 or visit www.ageuk.org.uk to download a copy.

An invisible population: older people with autism

A resident of Hinnerup Kollegiet, a Danish community of older people with autism (pic: Hinnerup Kollegiet)
A resident of Hinnerup Kollegiet, a Danish community of older people with autism (pic: Hinnerup Kollegiet)

Timothy Baron was among the first children in the UK to be diagnosed with autism just over 50 years ago. Timothy was in need of specialist education but autistic children then had no right to schooling, so his father, Michael, opened his own school, the movement became the Society for Autistic Children – now the National Autistic Society (NAS).

That was the 1960s; today, Timothy, who lives in residential care, is nearing 60. The first generation of children to be diagnosed with autism is now moving into older age. Ageing with autism brings not only the particular challenges of the condition – communication, social interaction or sensory issues – but the social, physical and mental health issues often experienced in old age.

Policymakers are aware of the impact on society of the ageing population, but the same focus has not been given to people with learning disabilities and autism.

Read the rest of my piece about the need for more work on autism and growing older in the Guardian’s social care pages.

Older, wiser..and off the radar?

How old does a woman have to be to be categorized as “older”? 50? 70? And if we push females deemed to be “older women”, in “late adulthood” or in “advanced years” into the same group, what common concerns do they share, if any? More importantly, does anyone outside of that demographic notice or care about ageing women? And if they do – what’s being done about the issues they’re concerned about?

While Britain as an ageing society is a constant source of political and public debate, the specific issue of women and ageing isn’t afforded the focus it should, given that women tend to live longer than men. The 2011 census suggests there are about 11 million women over the age of 50 years, about 4 million of which are over 70 years. By 2035 there will be 4 million more females aged 65+ than under 16s.

Like most people, my personal experience – and I speak from the start of my fourth decade – is that the older you get, the younger so-called “older people” seem. As you age, your perceptions of old and young clearly shift. I don’t, for example, class my friends in their 50s as “old” and my own 81-year-old mother-in-law defies stereotypes and expected patterns of behaviour with her far flung travels to South America and her energetic role as a breeder of rare sheep.

The youth/age picture becomes confused still when you think that childhood apparently ends at 12, younger girls are presented (and sometimes present themselves) as much older while older women – think Madonna, Helen Mirren – are variously praised or mocked. And more often than not, the kind of articles I’m thinking of include a particular kind of faux-praise for a woman’s age-defying antics and appearances…you know what I mean – the pieces that comment on a woman’s “confidence” (ie delusion) in “flaunting” (as in “she’s too old to dress/act like that”) her “mature” (read: “wrinkly, untoned”) figure.

A provocative series of essays published today, coinciding with International Women’s Day, highlights policy issues about ageing women, underlining how the contribution to and role of older women in society is overlooked.

The think tank the International Centre for Longevity (ILC-UK) publication Has the sisterhood forgotten older women? contains 38 essays – everything from personal recollections about the role of women in family and society, to thoughts on intimacy and relationships, the invisibility of older women in international development and opinions about the low media profile of older women (see the words of an older female MP on how she is treated by political parties in relation to media work).

The authors include politicians, policy makers, academics and campaigners such as Jane Ashcroft, chief executive of housing and care group Anchor, Sheila Gilmore MP, Michelle Mitchell, chief executive of Age UK, Heléna Herklots from Carers UK and Marina Yannakoudakis MEP.

As well as discussions about how far women in their 50s 60s 70s think of themselves as “old” (answer: they don’t), the collection of writing stresses the dilemma facing older women – while longevity is to be celebrated “there is a risk that women, who often live longer than men, do so at the risk of being caught in the metaphorical mouse trap: alive but with little quality of life”.

The ILC-UK has also today announced it is establishing an Older Women’s Policy and Research Action Alliance to create “a roadmap for future research and policy priorities”. The organisation hopes today’s compedium will spark a new debate on women in an ageing society.

The issue of the challenge for ageing women in care is a particularly strong theme in today’s collection of essays. In the UK, women account for two thirds of community care users over the age of 65, and three quarters of people in residential care.

Baroness Sally Greengross, chief executive of the ILC-UK added: “Women must engage in the debate on social care funding if we are to get a solution which works for all. It is also essential that the caring contributions of older women are not ignored. Future care reform must take account of and not disincentivise the informal care contribution of older women.”

Here are just three edited highlights from among the pieces in today’s publication:

Oh, I didn’t see you there!
Jane Ashcroft, chief executive, Anchor
:
“For several years I have been irritated by the propensity of print journalists to tell us the age of any woman in the news, regardless of any relevance to the story, while rarely applying the same approach to men. Why is age a defining characteristic of women?

In 2010, research conducted on behalf of Anchor, the housing and care provider which I lead, analysed one week of TV programmes on the 5 major UK channels (Older Faces Audit, March 2010, Anchor). We found a dramatic under-representation of older people, and especially older women. Across all channels, people over 50 were under–represented. Despite making up 34% of the UK population, representation on the major channels was as low as 12%, with only BBC2 achieving a realistic level of 38%. And amongst TV presenters appearing in the week under review, only 1 in 5 was an older woman.

This supports my view that ageing in men is often seen more positively than in women – many older men are described as wise and experienced, whereas the expression “don’t be such an old woman” is used to convey entirely negative characteristics.

This picture is so different from the reality that I see in my everyday life, that it is tempting to wonder if I live in a parallel universe! Of my 9,000 or so colleagues in Anchor, over 500 are continuing to enjoy their work well past the official “retirement age”.

Behind the scenes, many older women are leading change in communities, organisations and families, contributing their resources and multitude of skills, and leading interesting and rewarding lives. Some older women, like older men, are facing loneliness, loss and poor health. As a society, and for ourselves, don’t we need to recognise every older woman as an individual, and to enable us to do that we need to improve visibility – instead of “oh, I didn’t see you there” can we say “ah, I’ve been looking for you”?

Older women and care: are they invisible to the sisterhood?
Michelle Mitchell, Age UK:

“Despite care having been on the feminist agenda for years, the issue of it in later life has remained shrouded from our viewpoint, as millions struggle in quiet crisis. Yet nowhere are the compound challenges of class, gender and age more evident and nowhere are older women more in need of a voice.”

Older women carers – invisible and ignored?
Heléna Herklots, chief executive, Carers UK:

“Many older women carers grew up during a time when women’s contribution to society was far less recognised than it is today. They now live in a society which too often ignores their contribution as older women carers. We need to challenge this; guard against any prejudices and assumptions we may ourselves have; and work to ensure that older women carers are recognised, respected, and valued – no longer invisible and ignored.”

*Download ILC-UK’s Has the sisterhood forgotten older women? here

Why I always had time for George: older people and mental health

I’m walking across the grounds of the psychiatric hospital on a very wet winter evening and a patient, let’s call him George, steps out from behind a bush to talk to me. He needs to tell me something that he feels is important and can’t wait.

We both stand for quite a while talking (he’s a staunch socialist and wants to talk politics) and both get soaked to the skin. I think to myself that it’s more respectful to hear what he wants to say then hurry on and seek shelter. As we eventually walk back to the ward together, he is calmer, seemingly content to have got his feelings off his chest.

This scene took place more than 20 years ago (I mention it in my book, Sticks and Stones) but I believe now what I thought then, that my exchange with George is what real empathy is all about. It’s what being non-judgmental is about, what being human is about, what being a nurse is about.

I have nursed enough people during my time as a mental health nurse to understand that life is a bit of a lottery. I have seen the elderly lose their dignity in nursing homes and in hospitals. This is not always through dementia. This could be depression or psychosis, or other debilitating illnesses depriving them of their confidence, self worth, and esteem.

But as the recent figures about suicide rates rising among the elderly show, mental health issues may be overlooked in older people as society mistakenly presumes dementia is the only condition older people experience. Another assumption is that depression is a normal part of ageing, because the elderly have more of a sense of their own mortality.

I hope that whatever befalls me in my old age I am shown the same respect and compassion as I believe I have shown others. There’s often a failure of respect not just because of deliberate neglect or a lack of compassion, but through ignorance – through not treating people as individuals or not meeting their emotional needs.

So how do we prevent this? Essentially it is around searching for the person behind the illness and stepping back for a second and thinking “how would I like to be treated if this was me?” or “would I like to be looked after in this environment?”

Of course I’m not arguing against the completion of care plans, but I do worry that the increasing onus on form-filling and box-ticking can deny care staff more time to spend with those they support. A care professional might be spending hours on admin, or typing up a care plan – but how does the person in their care know this is part of them being cared for? They’d rather have our face-to-face time I’m sure.

Person-centred care, as the name suggests, is meant to put the client at the heart of the care planning process. This care is collaborative and negotiated with the client (theoretically). However, often when someone is acutely psychotic and lacks all insight, nurses then become the advocate and the care must be planned depending on what is required to get the person well again. As for personalisation and personal budgets, the take up is sadly not as high as it should be; people worry about risk management and general funding pressures that can put people off.

Compared to when I was in a clinical setting, today’s care world involves a far more litigation and risk-averse culture which takes staff away from the client. At the time I knew George, I could spend longer in one to one sessions with clients, so could my colleagues, but more often than not, today’s staff are only allocated a set amount of time each shift to spend in one to one, face to face therapeutic sessions on the wards.

Staff cutbacks on the wards and in the community will also reduce the time staff can spend with clients in face to face interventions. However staff should still show empathy and be non judgmental in all approaches, because this is the essence of their roles.

Clearly, organisations promoting older people’s issues have a role to play in raising awareness and educating. We stigmatise the elderly as much as we stigmatise the young people, so we need more positive promotion of what the elderly can offer society. Countries like China and Japan, for example, revere the elderly and yet in this country I think some people view them as an afterthought, a burden.

The hospital where I met George has long since been converted into a block of expensive flats while the man himself, already in his 80s when we had that long rainy chat, will have passed away many years ago. But the memory of that evening stays with me as a reminder of the underlying principle of care as I see it; listening to, respecting and having the individual – not “the system” – as your main focus.