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By Debbie le Quesne

Archive for August 2012

Making friends and building connections with the elderly

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It’s Friday and the weekend beckons. I always find the days immediately after Bank Holidays a little odd as I struggle to get back into the rhythm of work after three days off.

I posted a piece a couple of days ago about new approaches to dealing with isolation issues with the elderly and I confess to thinking the problem had the potential to get worse, rather than better as financial restraints grip our economy.

Thoughts of loneliness in old age, the elderly whom I know personally facing that very same problem and what we could all do to make things a little better had refused to leave my head.

I desperately wanted some cheery antidote to ease me into the weekend break and help re-establish ‘normality’, whatever that is in the West Midlands Care Association world. Then, unexpectedly, I stumble on this . . .

In a casual trawl of the social care headlines I find that tea parties, organised by younger people for older ‘friends’, are popping up under the radar.

At 22 Bobby has a brilliant social life with his partner Matt in west London, but he makes no bones about the fact that he “can’t stand anyone between the ages of 16 and 55,” says The Guardian on line.

With their housemate Lucy, they started giving tea parties for Contact the Elderly in their Hounslow flat in 2011 as a new year’s resolution.

They host one every month on a Sunday, which is a particularly lonely day of the week for its members who are all over 75 and live with little or no social support.

The article says that Bobby wants to protect his older friends from the isolation he likens to “a form of torture for prisoners of war” but he deeply values their conversations too.

Love it!

“Older people have such great stories to tell and so much life experience to pass on. They’re just so funny,” he is quoted as saying.

Helping older people earn money from this wisdom and experience is what drives Rich Brown, the 30-year-old commercial director of another London-based business, The Amazings.

“What we found was that there were lots of people aged 50-plus who, rather than we provide services to them, were able to provide services themselves. The idea was to turn that amazing wisdom into something that will pay that person money,” he says in the newspaper’s piece.

This is creative genius.

In a diverse, modern society, pressured by increasing workloads for the employed and social dislocation for many unemployed, it’s easy to lose sight of ‘external’ needs. When they do come into focus, however, the big question is ‘where do we go from here?’

How can we galvanise that moment of sudden awareness and create action?

How too, can we build societies where it is entirely normal for young and old to live and learn together?

Honestly, I haven’t a clue. But I’m encouraged by my new knowledge that Bobby, Matt and Lucy, along with The Amazings, have found an extraordinary way to help that could never have been anticipated.

Enjoy the weekend.

Written by debbielq

August 31, 2012 at 8:08 am

Posted in Uncategorized

Nursing crisis closes care home

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The Mail Online today fired a warning shot at the government in an article which says critical shortages of staff will put plans to modernise the NHS at risk unless the Chancellor delivers billions of pounds of investment.

Delivering shocking figures of unfilled vacancies, The Royal College of Nursing reported continued nursing shortages would “severely jeopardise” the success of the whole NHS modernisation agenda.

It warned of an ageing workforce and a shrinking pool of registered nurses with as many as 20,000 nursing vacancies in England alone, according to the latest figures which were published in March 2001.

 In an independent analysis of the nursing workforce, the RCN found 24 per cent of registered nurses are set to retire in the next five years. Only one in eight nurses are under 30, compared to one in four 10 years ago.

Particularly bad news is in community nursing, where some 12 per cent of district nurses are aged over 55 and eligible to retire at any time.

Nurses who trained abroad have become a “vital” source of new entrants, making up 40 per cent of new additions last year, the RCN said.

The article goes on to inform us that the US has a similar problem.

The RCN called on Chancellor Gordon Brown to commit £3 billion over five years in his spending review to fund Agenda for Change, the programme to modernise NHS pay and careers structures across the UK.

This hugely diverse and brave modernisation programme is yet another issue that seems to be struggling with funding.

It’s interesting that I read this news just moments after another article about nursing shortages – in the care homes sector.

 A nurse shortage in the Isle of Man has prompted the temporary closure of a care home for elderly, mentally ill patients, I learn.

The Gansey unit at Southlands Resource centre, in Port Erin, temporarily closed for a month two days ago.

The decision has affected eight residents who have been moved to another specialist unit.

Assistant director of adult services Cath Hayhow said: “This decision is down to safety and not finance.”

Jan Watterson, whose husband is being moved said: “They could have tried to get on the case quicker and not left it until last minute.”

I too cannot help feeling the decision is down to some pretty short-term planning. How did things get so bad and why wasn’t there a response sooner?

Hayhow added: “The staffing levels are now critical and it is no longer safe to provide this service, we simply have no choice at the moment.

“We are advertising, we are interviewing and we are also working with agencies off-island to find suitably qualified staff.”

“It’s not ideal but we are following all the guidelines about how to deal with this situation – our standards of care are critical and the staff involved are incredible,” Hayhow said.

The department of social care said a recruitment campaign had begun and a decision would be made in September about the reopening of the Gansey unit.

This case is the tip of the iceberg. I fear that many other nursing homes will soon be heading down the same rocky path if the funding issue is not addressed at central government level and the work that our nurses do not given a higher priority.

Written by debbielq

August 30, 2012 at 9:16 am

Posted in Uncategorized

Isolation with the elderly – a new approach

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Isolation amongst older people has been a debating topic for long, long time.

It’s cruel psychological toll has been used to bolster the argument for residential care, for keeping open day care centres and not least, as a strong driver to support the Government-threatened Remploy, a national company specifically employing and empowering the disabled.

Today we work longer hours and later into our lives. It appears we are making a santitised return to the early days of the Industrial Revolution where ‘free time’ was at a premium.

Whether we like it or not, jobs continue to cut deeper into our existence as our work ethic intensifies.

This has had a profound effect on many people’s social lives. Careers not only help maintain a sense self worth, but also to fill a social purpose too.

Recently, Vicki Purewal, Head of Nesta’s Centre for Challenge Prizes wrote a guest post for campaigning PR outfit Forster Communications.

She posed a searching question: “In a recent poll one third of British workers confessed that the majority of their friends are colleagues from work and that their primary source of social interaction occurred in the work place.

“A sociable and rewarding working environment is no problem during our working years but what happens when we reach retirement? Could this lead to isolation?”

Some find leaving work embracing retirement a happy relief. But for those who put everything into work and little elsewhere, the end of a career can signify life not only slowing down but also losing worth.

Undoubtedly we have an existing loneliness problem among some of our elderly.

But I fear a bigger one awaits in the wings of a nation where pensions have been battered and a retirement age raised.

When the sociable lifeline of work is cut off and a sense there is little left to contribute or feel valued for creeps in, it is not surprising that retirement can result in loneliness, isolation and depression.

Purewal writes: ”What if we could find ways of keeping work based contacts together, rather than losing touch when they retire?

“At the same time, could we maintain a sense of being valued for what we have done and can still do, however old we are? These are some of the many challenges that must be overcome in the struggle against isolation and loneliness.”

She concluded that in bringing people together perhaps we can reduce isolation and increase the mobility of vulnerable older people, by creating new opportunities for people to give time, skills and resources.

Could creating employer or career alumni associations – groups where people of the same career backgrounds can meet, socialise and generally keep in touch through the network – be one way of reducing isolation in older generations, Purewal asks.

Nesta, the UK’s innovation foundation, has recognised the need for ideas like this by creating the Ageing Well Challenge, part of a series of challenge prizes to reward and test innovative ideas that can meet challenges faced by society today.

The Ageing Well Challenge has been set up specifically to encourage innovative ideas that reduce isolation in older people. The winning idea will receive up to £50,000.

It is time to get our thinking caps on? I think so.

If you have an idea that you think can help to reduce isolation in old age, apply at www.nesta.org.uk/givingchallenges

Written by debbielq

August 29, 2012 at 10:09 am

Posted in Uncategorized

Mental health: Is this a chance for progress?

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The recently published government No Health Without Mental Health implementation framework promises to give psychological conditions “parity of esteem” with physical ones.

Since publication, however, figures show that mental health spending is in fact falling further behind physical health for the first time in 10 years, as demand is rising.

It’s frustrating news, with service user-led charity the National Survivor User Network confessing it struggled to fully commit to the framework it helped to shape.

NSUN connects nearly 2,000 groups and people in England with experience of mental health distress to encourage service user involvement and influence in commissioning and policy.

Earlier this year the charity claimed the Government was failing to support its objectives and in fact in some instances was seriously undermining its aims.

The Department for Education’s decision to remove wellbeing and community cohesion from the school inspection regime is in direct contradiction to the strategy’s call for more early intervention and education.

Now free from these requirements, many schools are shutting counselling services and nine out of 10 academies are serving their pupils junk food.

I applaud the NSUN for standing up to Government policy which it believed to be wrong, but mental health issues at any level are never easy to address.

Thankfully the framework document no longer subjectively brands all mental health conditions an ‘illness’ and disempowered service users as ‘victims’ and ‘sufferers’ suggesting they have no control over their lives.

In practical terms the NSUN suggestions to emphasise the value of involving service users in the commissioning of their own services to an agreed standard, and enabling self-help, peer support, personalised budgets, training and education have all been taken up and will form part of the implementation instructions to medical and social care professionals, local authorities, commissioners, providers and employers, among others.

Great news.

 

In essence mental health service users recover best when they are given control over their own lives and treated as having assets and potential rather than as problems to be medicated and managed.

The Guardian recently reported that The Lambeth Living Well Collaborative, for example, has helped more than 200 psychiatric inpatients get back into the community by helping them fulfil their ambitions and in Hackney, NSUN has seen service users grow in confidence while building a commissioning advisory group to shape services to their needs.

But I’m left asking one burning question. Will this framework really make a difference?

We have a valuable chance of progress here but noisy issues of finance may, I feel, stifle these excellent initiatives.

NSUN has pledged to monitor the implementation, partly through the new Mental Health Watch scheme, where service users get involved in their local scrutiny groups and share intelligence and good practice.

Perhaps those of us with sound minds also need to pay attention to developments in this arena and remain constructively critical.

Written by debbielq

August 28, 2012 at 7:47 pm

Posted in Uncategorized

I challenge you: Watch this programme and don’t be appalled

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Is it me, or am I missing something here? I watched ITV’s Don’t Hate Us: Tonight programme about scarily hardened attitudes towards the disabled and expected a huge media response this morning.

Are there screaming headlines shaming those who bully, persecute, misunderstand and abuse the disabled? No! Is the internet awash with comment on this wonderfully produced programme? No.

Why? Because I fear to be true the comment of one woman interviewed in the documentary, who said “the world is not ready for disabled people.”

Perhaps it’s because it’s a minority issue, or because the key presenter of this piece of television last night was disabled comedienne Francesca Martinez (pictured).

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She was confronting, edgy, cutting and compassionate as she disclosed the fact that as London prepares to host the 2012 Paralympic Games, new figures reveal hate crimes against the disabled are at record levels.

Martinez, who has cerebral palsy, investigated whether a welfare crackdown –which includes reassessing whether people claiming benefits are fit for work –is behind an apparent hardening of public attitudes.

Her findings were heartrending.

Although there were an estimated 65,000 disability hate crimes last year only 2,000 were reported – and just over 500 resulted in a conviction.

And recent reports show that attitudes towards the disabled have worsened over the last year. Resentment towards some of the most vulnerable in our society is deeply worrying and like Martinez I too am concerned what triggers provoke such hatred.

Francesca travelled to the North East to meet Peter Greener and his family. Peter was subjected to a three-month campaign of abuse after a neighbour suspected he was faking his symptoms of disability to claim benefits.

CCTV finally captured his neighbour’s neighbour’s abuse campaign. “Because he thought I was fake, he’s called me a spacker, a cripple, a benefit cheat . . . a scrounger,” he said.

I felt angry, upset and somehow awkwardly impotent to implement change.

Martinez also met journalist and expert in the field of disability hate crime, Kathryn Quarmby, who feared that reporting of disability fraudsters combined with the government’s “anti-scrounger” rhetoric fuels resentment to the genuinely disabled.

The comedienne also visited Rugby to meet Sue Prince and Nikki Reid. Sue’s daughter Gemma Hayter was 27 and had learning difficulties when she was murdered in 2010 by a group of five of her so-called friends – a victim of ‘mate crime’.

I had never heard of ‘mate crime’ – a kind of subset of disability hate crime and it seems to be very specifically something that happens to disabled people, almost all of whom have learning disabilities.

Because of the problem of loneliness these vulnerable souls look for any friends they can possible find.

Initially they are flattered by the attention and often will put up with really quite high degrees of violence, I learned.

The interview with this murder victim’s sister and mother left me crushed. It was so powerful, so achingly sad. CTV footage of the gang who killed Gemma shows them taking her to the place of her death and returning laughing and joking.

Earlier this year, Minister for Disabled People Maria Miller, announced that 1,421 disabled workers would lose their jobs as Government funding for Remploy, a national company specifically employing and empowering the disabled, would cease.

Martinez and the Tonight team asked for just 15 minutes of her time to answer questions. She refused. What a great piece of PR for the coalition!

But the lack of response speaks volumes. It makes government claims on fairness for the disabled and its commitment to them hollow.

Our welfare state, once the model for the world, is in tatters.

If you missed the programme, here’s the link :www.itv.com/itvplayer/video/?Filter=323748

I challenge you not to be moved by its content.

Have a good weekend. Don’t forget to take the waterproofs.

Written by debbielq

August 24, 2012 at 8:03 am

Posted in Uncategorized

Why I want to hug these people!

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Image provided by the Dementia Services Development Centre and taken by Tony Marsh

The simple ideas are always the best – well, most of the time.

Dementia is a huge problem to manage when, in residential care, service users become distressed, angry and frustrated.

So I was hugely interested in a Guardian professional article by Clara Leeming which focuses on the case of 92-year-old Winifred Baguely and the seemingly simplistic treatment model in her Stockport care home.

Winifred is in her element when she is washing pots or tidying up. She spends much of her time helping Beryl, a housekeeper at her care home, and as she sweeps the corridors with her own dustpan and brush, she can often be heard humming.

Her life has been transformed by the activity at Bruce Lodge. Six months ago Winifred, who was diagnosed with Alzheimer’s four years ago after displaying dementia symptoms for 15 years, was extremely confused, often belligerent and her speech was difficult to follow.

Now her speech has returned and she is much happier.

He daughter Maureen Roscoe is quoted in the article, saying: “The difference is astounding. Mum was a housewife, a practical person who spent her life caring for her five children and our father, who died 20 years ago.

“Her desire to care for people was never blunted but the ability to do so was robbed from her and that left her very frustrated.

“These chores are helping her connect with other things from her past and are opening up new pathways in her mind. The first thing that we noticed had come back was her language – within a week of working with Beryl she was recalling words much better and introducing me to other people by name, whereas before she didn’t know who I was.”

The new routine is part of a Stockport council pilot scheme which aims to quietly revolutionise the way residential dementia care is delivered.

Bruce Lodge is learning to fit in with its residents, rather than the other way around.

I just want to hug these pioneers! How wonderful. How brave. Love it. Love it love it.

Why isn’t this standard practice in ALL care homes? This should be a national initiative.

Hopefully it soon will be as people become more aware of the need for people living with dementia to have a life rather than simply be cared for.

Over recent months, the 43-bed home has worked with consultants Helen Sanderson Associates to find out what makes individuals tick and reflect this in some personal time with a member of staff with common interests.

One man now goes out for a regular pub lunch and pint with his staff match, while a woman rummages in charity shops before going for coffee and a cake.

Someone goes to watch the aeroplanes at Manchester Airport, and another man plays dominoes and tackles large-print crosswords. There is a process of review to ensure activities remain suitable.

But like all good things, the fight to sustain them is often long and hard. The home commits a minimum of two hours a month for each person who lives there.

This wonderful enabling project is a staff-centric exercise and I’m sure it would benefit from extra funding. By hitting the sensory triggers of this people group lives clearly are being changed. The period of one-to-one attention is precious but I’m left concerned that, given the track record thus far, the policy advisors and number crunchers in Whitehall will be slow to release funds for this to be rolled out nationally.

Written by debbielq

August 23, 2012 at 8:09 am

Posted in Uncategorized

Clear strategy please on Independent Living Fund

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You can tell it’s the silly season. That time of year when parliament is on holiday and seemingly most other people too.

Suddenly no-one is available . . . sorry Mrs Thorltropp is on a fortnight’s break . . . and the news content on our TV screens changes.

But there’s one thing that seems to have slipped under the media radar during these slower news weeks. In the last days of the parliamentary term, almost unnoticed, the Department for Work and Pensions (DWP) issued a slim consultation document on the future of the independent living fund (ILF).

We are aware the end of the ILF has been in sight for some time.

In June 2010 it announced it was closing to new applications for the rest of the financial year because of insufficient funding. In December of the same year the government confirmed the fund would be permanently closed to new users and funding for existing users would be maintained until the end of the current parliament in 2015.

Yesterday, The Guardian put the matter into the public arena with an article by Melanie Henwood, a health and social care consultant.

The consultation is concerned with how the needs of the 19,373 users can be met “within a single cohesive care and support system”.

For sure, the closure of the ILF would be a significant decision and must be matched by a clear strategy that spells out how devolving responsibility to local government would work – something this government struggles with it seems.

Ms Henwood explains: “In 2006 Bob Hudson and I were commissioned by the DWP to undertake an external strategic review of the ILF, and we reported in 2007, making almost 70 recommendations. We concluded that it is highly anomalous for significant amounts of public money to be administered through a cash-limited, discretionary fund controlled by a board of trustees.

“The model produced inequity, variation in take up, arbitrary decision making and poor accountability. Such a paternalistic approach to allocating cash to support disabled people living independently appears anachronistic and out of tune with modern approaches to personalisation and individual budgets.”

The outcome so far is a recommendation of a full integration of ILF funding with personal budgets, rather than the continuation of a parallel system of social care funding.

Significantly, the consultation document also says that there should be no radical change unless, or until, a better alternative was in place in order to protect people using the ILF from disruption or loss.

I applaud this undertaking. Cynical, I may be, but most ‘reviews’ or ‘consultations’ have come to mean less at the sharp end of caring.

The ILF has played an important part in the development of cash for care, and it has been invaluable for people who have received support from the fund.

But, Ms Henwood writes, “it was always an anomaly. It was originally set up in 1988 to mitigate the impact of some of the changes in moving from supplementary benefit to the new system of income support. It was expected the arrangement would provide transitional protection only and would close within five years.”

This never happened. The fund proved highly popular and, despite the expectation it would support just 300 people, there were 900 applications per month in its first year, later rising to more than 2,000. At its peak in 2006 there were 22,000 people using the ILF at an annual cost of £250m, the invited columnist points out.

In a nutshell, proposals now focus on the fact that “the objectives of the ILF could be met within the care system administered by local authorities”.

In the past the ILF has provided a way for local authorities to securing additional support for high cost care packages.

It has also effectively concealed “the true extent of social care underfunding,” says Ms Henwood,

 When the limited budget hit the buffers it was clear the system could not continue to operate in this way.

There is a commitment to “fully protecting care packages of existing users until 2015”.

What happens beyond that, who knows? Judging by the White Paper episode of recent weeks, I’m sure there will be clear direction soon (not).

The government’s “preferred option” is that following the closure of the ILF, funding will be devolved to local authorities.

I agree totally with Ms Henwood that the big challenge in devolving funding will be how to ensure it reaches its target.

Ringfencing of funds in local government is not popular. My fears are that if is not, it may just slowly filter into general local authority coffers.

We need some direction AGAIN Mr Cameron. please.

Written by debbielq

August 22, 2012 at 7:59 am

Posted in Uncategorized