Neighbourhoods

‘Thou shalt not ask’?

Recently I’ve had the privilege of meeting several clients of good neighbour schemes. I thought I’d share a couple of insights.

I met I man, I’ll call him Danny, who had experienced mental health difficulties for many years following crushing in a crowd incident, which left him so damaged and with so many broken bones that he was assumed dead. He now can’t face people very easily, yet spoke to me with a lively, if battered, intelligence. Vulnerable to encounters on a difficult estate – he’d had an intruder a few nights previously - he lives with his dog in dismal poverty. He could do his shopping on the internet but makes himself go out to get it, between three and four in the morning.

So how does he use the internet? His next door neighbour lets him use his wifi password. Isn’t that brilliant? I’d love to know about the conversation that led to this. Talking about poverty, Danny said it’s a blessing he has no relatives, Christmas would be such a trial if he had to buy things for people.

Danny told me he’d like to go and live at the sea-side. “Even if I lock myself away I could still open the window and see people.” When was the last time you saw the sea? “I’ve never seen the sea.”

“Without the helpers from the scheme, I don’t see anyone, except once a fortnight I see my mental health worker.”

The organiser told me he had said to her – obviously reluctant to make demands of the scheme,

“I need someone to come round once a fortnight, in case I die.”

This relates to the ‘request scruple’ – the reluctance to ask for help – which I have mentioned before with reference to the research of Lilian Linders. This arises also in the second instance. One woman who uses the scheme, I’ll call her Annie, talked about her hesitation:

“Why should they have the time for me? … I grew up the old-fashioned way, ‘thou shalt not ask’. It’s not pride. It’s just not proper. You don’t beg… I’m not feeling sorry for myself, I’m just frustrated because I can’t do the things I used to do.”

Following a serious fall, Annie needed help of various kinds, and first had to overcome the misunderstanding that the scheme was just about providing transport. She takes care not to risk over-demanding: “I work out what’s important, don’t pile it up.” She spoke with delight about how a simple bathroom shelf had made so many things easier for her.

Annie says she has learned that

“If you have a problem, talk to them about it. If they can’t help then they will tell you what you can do.”

This points to the importance of information-sharing and advice that arises in the way the schemes work. The scheme organiser told me it is not uncommon for people to assume they could make only one request of the scheme. Under this misconception they could be holding back from making a modest demand for help, reserving the option for the possibility of a more serious need in due course.

 

Sixty-seconds of neighbouring

I was out front filling window-sill cracks this morning when one of my elderly neighbours appeared alongside, with a bottle of medicine. ‘I don’t want to come too close,’ he said, ‘I’ve got a dreadful cold. But could you help me to open this?’

It had a modern child-proof cap, which I loosened. As he took the bottle back I thought, perhaps this is an innovation that post-dates the last time he took medicine? That would be characteristic, for this is a ruggedly independent, practical man who would seldom ask a favour. We talked briefly about other things and off he went.

There are several classic neighbouring themes bound up in this tiny encounter: I’ll try to round them up concisely.

First, it’s a reminder that when we ask survey questions about whether neighbours ‘exchange favours,’ the point is really about the latent potential for support, together with the readiness to draw on it. Time and again we’ve had studies on aspects of neighbouring which say this happens or that happens to a given percentage, but don’t help us to get at the ways of optimising informal support. Seeing me out there, from his window or door – and faced with a medical need he had not managed to resolve by himself – my neighbour took the opportunity to draw on the accretion of adequate familiarity from years of recognition and the occasional few, largely inconsequential words. As I noted some years ago, the essence of neighbouring is that it is low-level and relatively trivial, but it accumulates.

Next, we have the old theme of visibly occupying the neighbourhood. I was outside and therefore legitimately open to interruption. It’s unlikely he would have gone round knocking, for such a favour. It reminded me of comments from a workshop participant years ago (reported here, p11), relating how long it had taken her to paint her front door, because of all the neighbourly conversations that followed from occupying that semi-private, pseudo-community space. I also recall someone in an audience deciding on the same basis that she was going to grow potatoes in her front garden.

And two more points, based on the fact that we have been neighbours for 28 years. This exchange was nothing to do with ‘visiting in each other’s houses’ – as some surveys like to frame relations; nor was it anything to do with knowing names. We call each other by our first names; I don’t know his surname and I doubt he knows mine. I have never been in his house nor he in mine.

An understanding of neighbouring that gets distracted by such details, it seems to me, risks overlooking more important ingredients: mainly - the fundamental importance of recurring visual recognition; that neighbouring is not the same as friendship; and that it is founded on respect for privacy and the navigability of semi-private space.

 

State intervention in keeping an eye out for older neighbours? Views from London, 1918

As the impact of the ‘Great War’ is much in people’s minds at the moment, this blog offers some reflections on neighbourly support for older people, originally published (unparagraphed, in tiny font) in 1918.

Lonely dwellers and their neighbours

‘It was stated in the newspapers recently that a woman, 73 years of age, living alone in a house in Gray’s Inn road, fell down stairs one Wednesday evening, and, being unable to move, was not discovered until the following Saturday. On the next day she died in the hospital to which she had been taken. Stories of this kind, or of solitary persons who die and whose bodies are only discovered after some time, are not infrequent, and such cases occur in the country as well as in great cities. Probably, however, they are rarer in rural districts and small towns, where eccentric characters and the poor and lonely are of greater interest to their neighbours than they are in the metropolis. It is difficult, indeed, to suggest any means which would prevent such an occurrence in the crowded area around Holborn, nor can we say that any duty of neighbourliness was neglected by those in her vicinity who went their daily way while an old woman lay at the foot of a staircase in a house which they had no reason for entering. Nor does society, the State, or the local authority appear to be called upon to interfere if persons of mature age , whether poor or not, prefer to live alone rather than in surroundings which would expose them to observation. In the absence of organised intervention it is usually the baker, or the milkman, or the postman, particularly the last in country districts, who reports that he cannot get the accustomed answer at a certain door, when further inquiry shows that a lonely dweller is ill or dead. It might conceivably be made an instruction to postmen to be observant in such matters, and to report the non-delivery of a letter through failure to get a reply to a knock at the door. But lonely dwellers receive few letters. There remain the baker and the milkman, whose services might also be requisitioned in normal times, but even then there are many cases where the customer fetches his own bread from a shop where his abode is not known. It is, indeed, likely that any such system as we have suggested, even if reinforced by the aid of the police, would not only lead to many false alarms, but would break down and be inoperative in a substantial proportion of genuine instances. Cases, therefore, such as that on which we have commented will continue to fill us with pity, but will not be averted unless and until the State undertakes even greater surveillance over the details of our daily lives than it does at present. Do we want that?’

The Lancet, 192(4959), 14 September 1918, 362-363.

 

Age friendly societies in our time?

Last winter I prepared a lengthy literature review on older people and social isolation, for an exciting research project being run by WoodGreen Community Services in Toronto. The paper is now available and I hope will be very useful for the range of material it draws together. It covers material on the built and green environment; quality of life, health and well-being; and social support and connection.

The project sought an understanding of the state and breadth of knowledge about the social isolation of older people in urban areas, with particular attention paid to housing form, and formal and informal care. The coverage is of international material in English.

It was an overview rather than a systematic literature review – the huge literatures on ageing, health, quality of life, loneliness and so on, combined with a limited budget, precluded close reading of methodologies used in the material described. The bibliography covers nearly 500 separate items. Consistencies in the research emerge of course, but there are also a few fascinating inconsistencies – for example around the connection between religion, older people’s social networks, and well-being.

Two characteristics of the literature struck me in particular as I was trawling and reading. The first is the stark invisibility of lesbian, gay, bisexual and transgender older people in any content that is not specifically about them. In the review I have distributed the material that is available, across several sections, so as not to compound that effect. The second is the number of calls that are made for increased participation of older people in decision making processes, alongside comparatively few accounts of such involvement.

I’m indebted to Diane Dyson at WoodGreen and to Angus McCabe at the Third Sector Research Centre, University of Birmingham, for their support throughout.

 

Informal networks save public money

The Neighbourhood Network schemes in Leeds have an enviable reputation. The first was established in 1985 and it’s clear the city is getting a return for its foresight and investment over the years. Mick Ward, a Social Care Commissioner with Leeds City Council, told the following story yesterday at an ippr event in London. I was struck by it partly because I’ve recently been writing about the interdependence of informal and formal care (this used to be called ‘interweaving’).

It had been noticed that an elderly resident was putting in frequent appearances at A&E in a very distressed, highly agitated state, usually in the evening. A volunteer from the local scheme went to visit her for a chat. As they made a cuppa in the kitchen, the volunteer noticed accumulated cans of Red Bull. It became apparent that the patient had a habit of getting through up to 14 tubes of the stuff in a day – hence the trips to the hospital. Mick observed drily that the £1.40 bus fare expenses claimed by the volunteer to help resolve the issue compared favourably with the cost of the fourteen visits to A&E.

 

Silver lining

A ‘friendship’ helpline for older people, called The Silver Line, has been launched. It uses specially trained volunteers to:

• Offer information, friendship and advice
• Link callers to local groups and services
• Offer regular befriending calls
• Protect and support those who are suffering abuse and neglect.

I think the subtle allusion in the title is brilliant. I’m pleased to see they will make calls as well as receive them. The ability to link callers to local groups is going to be heavily dependent on the national charities with local branches, since the structure of local CVSs has been so decimated that even where they still exist, their connections with independent groups is often tenuous or fortuitous.

I’d like to see the service gradually localised, so that helpline staff are more likely to recognise some of the things that callers are talking about. Geography and places can be useful conversation hangers.  

 

Loneliness and older people: where are the frameworks that can stimulate informal connections to protect older people against loneliness?

On Friday the Health Secretary Jeremy Hunt drew attention to the high numbers of people characterised by the Campaign to End Loneliness as ‘chronically lonely.’ This coincides with publication of a BBC survey, which claims that half of all adults in England experience loneliness. (The data from the survey are here (for England) and here (for GB)). The debate inevitably focused on older people, and I wonder sometimes about the loneliness of many people in late middle age.

Curious Point No.1. The Health Secretary rightly described the way we treat older people as a ‘national shame.’ He compared it to Asian cultures, where there is ‘reverence and respect for older people’ and ‘residential care is a last rather than a first option.’ Where this is the case, it makes sense to highlight it as desirable; although it wouldn’t be wise to take the comparison with Chinese culture (which is specifically referred to) too far, I think.

Take this study for instance, which finds little difference in the experience of ageing among older people in Shanghai and Canada. And then there's this UK study which found a high level of expectation for family support amongst Asian-Indian respondents, but Mr Hunt won't want to hear that this coexists with a high level of expectation for state support and an acknowledgement that the ideal of family support may not always materialise. He argued that we need to ‘restore and reinvigorate the social contract between generations.’ Indeed: so can we have a policy debate about how we do that?

Curious Point No.2. The Labour Party’s response to the speech includes this statement:

‘Families, friends and neighbours need a decent care system to back up their efforts to look after elderly people, but the reality is our care system is in crisis and has been pushed to the brink of collapse.’

I think there is plenty of truth in that; but it hardly excuses the last two Labour administrations for failing to take seriously the issue of an ageing population and for disregarding the accumulating social problems associated with the growing demand for care. Fifteen years ago it was urgent: now it is critical.

Curious Point No.3. While these news items were being churned I was in a breakfast seminar at the dear old Grauniad, on the topic of social capital and the voluntary sector. A bit passé, you might think. Surprisingly, most of the speakers fell plop into the puddle of implying that social capital = the result of what vol orgs do. Er, there must be some other sources of s.c. they could be helping with?

Debbie Ladds from the Local Trust rescued things a little by mentioning the value of setting up tea and cake sessions at local level – an example of something that works because the connections made and reinforced there are the ones that, as capital, can be invested and can bring returns. But this sort of potential remained unexplored and there was no other recognition of how informal interactions can be stimulated. Cue the same question for the Secretary of State for Health: where are the frameworks that can stimulate informal connections to protect older people against loneliness?

Ah, OK then, well cue Geoff Mulgan instead. At about the same time on Friday, over what used to be called the airwaves, he offered one suggestion on the Today programme (from 2:33:30, available for a few more days. Thanks Martin for the heads-up) suggesting that the energy within the Neighbourhood Watch network could be diverted to help look after older people who experience loneliness. I’m sure this already happens in some places informally; it might make sense to give it a formal basis, without jeopardising the informality of interaction of course.

Curious Point No.4. During the Today discussion Anthea Tinker (whose solid 1981 book on Elderly people in modern society sits right beside my desk at the moment), made the point that there are questionable assumptions about how family-oriented cultures (such as those in southern Europe) protect older people against loneliness. By way of extending the argument, consider this European research, which suggests that feelings of loneliness

‘were more prevalent in areas where living alone was rarest and where community bonds were strongest. Individual variables describing life situation did not explain the differences.’ (Emphasis added)

And finally, Curious Point No.5. The findings of the BBC survey suggest that people who practise a religion feel lonelier than those who do not; and are more likely than those with no faith to say they are experiencing greater levels of loneliness than they did ten years ago. This might be altogether unsurprising: long-held assumptions about the well-being benefits attributed to religiosity have been questioned in other respects (e.g.). I wonder if there is also something there about a proportional increase over the past decade in membership and influence of hierarchical religions (e.g. Catholicism, Islam) compared to non-hierarchical religions? Just a thought.

 

Formal and informal care for older people: an example of ‘reverse crowding out’?

I’ve been working on a literature review of older people and social isolation, which has necessarily involved tracing the history of some of the ways that societies support older people. All sorts of approaches lie scattered about – from almshouses through residential care homes, home help and sheltered housing, from community care and home-sharing to contemporary favourites like co-housing and age-friendly places. Are we building towards the optimum combination, or just working our way through a finite range of politically salient options?

Let’s see what’s been happening in Sweden, a country known for its commitment to welfare in general. In a recent interview for the European Urban Knowledge Network, researcher Cecilia Henning observed:

‘What is interesting in the Swedish example is that we have had a very decisive policy towards ageing in place, but we have found that we have gone too far… we have closed a lot of residential facilities… because the politicians and the municipalities think that we should not have so much residential care, we should have ageing in place. So instead, we give home care in people’s homes. But at a certain point old people want to go to residential care units because they feel insecure and lonely.’

This seems to suggest that informal care provided in the home to older people in the interests of ageing in place has ‘crowded out’ the state’s provision of residential facilities. In a conference paper Henning and her co-researcher Magnus Jegermalm report that

‘After cutbacks and changed priorities concerning Home Help the public sector have focused more on helping people with ‘heavier’ tasks involving personal care (e.g. dressing, bathing, feeding, using the toilet). This development have most likely led to that informal caregivers and volunteers commonly carries out ‘lighter’ tasks for someone who is a relative but might also be a neighbour or a friend.’

Hmmm. This appears to be an example of ‘reverse crowding out,’ whereby ‘private provision of a public good replaces existing tax-supported provision of the public good' (Isaac and Norton, 2013). Just what the neo-liberal ordered? (Although to be realistic for a moment - not an attitude that can necessarily be associated with neo-liberals - there doesn't seem to be very much research that supports the crowding out hypothesis in the welfare context).

What is clear is that the current ‘in-vogue’ approach, ageing in place, is, like all other approaches to support for older people, inescapably political.

 

 

The next housing crisis: what about all those bedrooms?

Successive governments’ reluctance to address the looming housing crisis is not news, but it creates news. The other day we had Tory chairman Grant Shapps, the man whose name sounds like a disease of the voluntary sector, making an international fool of himself for mistakenly and hysterically claiming the UN special rapporteur on housing had not spoken to government officials, and for calling the 'bedroom tax' by its popular name. It is an indefensible policy, so you can sorta see his problem.

More helpfully, on the same day Demos published a new report, The top of the ladder, on the UK’s ‘next housing crisis’ – the chronic undersupply of appropriate housing for older people. 

With some new polling and analysis of the English Longitudinal Study of Ageing, the report claims that more than half (58 per cent) of people over 60 were interested in moving; and more than half (57 per cent) of those interested in moving wanted to downsize by at least one bedroom, rising to 76 per cent among older people currently occupying three-, four- and five-bedroom homes.

‘A lack of choice of suitable homes to downsize into is having a negative effect not just on older people’s health and wellbeing, but on the rest of the housing chain, as 85 per cent of larger family homes owned by older people only become available when someone dies.’

 

Interdependence and a different kind of care in the community

Some years ago I wrote a piece on neighbouring and older people in which I placed some emphasis on the concept of interdependence. I certainly didn’t invent the principle but I was puzzled as to why it did not feature much in the literature nor among the expressed values of agencies working to promote the interests of older people.

I’m currently taking another look at the literature around neighbourhood support for older people and I note that the relative lack of interest in interdependence seems to prevail.

I’m not talking about the narrative in the popular press and broadcast media which problematizes the ageing population and implicitly presents older people as over-dependent on others and a burden on society. (This narrative is punctuated with patronising gasps of widespread astonishment at the occasional discovery of an older person who is active and involved). Nor do I deny that many older people are dependent and need committed care: looking after them is a social responsibility which should never be seen as unwelcome.

Researchers and commentators on ageing do not endorse the condemnatory ‘burden’ stereotype; but neither do many of them seem to grasp the fact that older people contribute to local neighbourhood life in many ways, subtle or emphatic. Nor do many seem to grasp the potential for even more older people to contribute, if the culture was supportive.

I don’t think it helps that policy is blind to the concept of informal support. As far as government is concerned, if you’re not volunteering formally – preferably under the aegis of a registered charity – you may as well not be doing anything for your fellow-citizens.

So it was with some delight that I came across this paper in the Journal of ageing studies, based on focus groups and interviews in Aotearoa New Zealand, which highlights the contributions made by older people to the places where they live (which the researchers call ‘care for place’). The analysis results in a framework of four categories of activity: volunteering, activism, advocacy, and nurturing – ‘helping and representing others, giving advice and support, or facilitating action, whether individually or as part of a group.’

This has always been the case I believe – from litter-picking to emotional support to informal childcare or taking in post or maintaining vigilance over local amenities, articulating public concern and spearheading campaigns and so on – but it needs to be described and acknowledged before the gravity of ‘the burden discourse’ drags us all down. So this is a very welcome piece of research.

And perhaps this is one of those rare occasions where some kind of locally-applicable ‘toolkit’ could be developed (sorry, I try not to use the word), to help community agencies demonstrate the extent of the ongoing contribution of those who society would readily discard. Quantifying the number of volunteer-hours would allow an estimate of financial value, in line with the WRVS study which showed that people over 65 made a net contribution to the UK economy of £40 billion in 2010. WRVS noted:

‘Our research shows that every year, each older volunteer spends an average of over 100 hours 'informally' volunteering and more than 55 hours in formal volunteering roles. This is worth £10 billion to the UK economy.’

 

Policy rushes in, where commonsense fears to tread

Occasionally in my commentary on neighbouring and policy I’ve had a go at sketching out roughly how close policy and regulation can get to the everyday practise of neighbouring. Area-based league tables of neighbourliness, for example, in order to shame the less genial neighbourhoods...? Don’t snigger, it could happen.

Here’s an example where policy makers have decided that people should care more for their elders. In China it has been deemed necessary to introduce an Elderly Rights Law to address the growing problem of lonely elderly people, by ordering adult children to visit their ageing parents. The law has been applied immediately: the BBC tells us that a 77-year-old woman brought the case against her daughter and the court in Wuxi has ordered the latter to visit her mother once every two months.

Imagine the visits, if you will – their excited surprise and warmth after one month and thirty days, their light humour, the imaginative gifts so sensitively thought-through, the hours passing in laughter and delight… er, no? What do you mean, you think the daughter might be reluctant and the elderly mother somewhat vindictive? Hmm, one might almost think family relations was a domain unsuited to policy intervention.

 

Think mutuality and reciprocity… and interdependence

‘Jacques is 14 years old. When he comes from school, he is welcomed by his mother and Paul H, their co-resident in the home, a man 70 years old. They are living together in one of the two kangaroo homes operated by the Public Social Welfare Centre in Sint-Jans-Molenbeek (Brussels). Each home accommodates four seniors with one single-parent family. Each resident has his/her own room, but the living areas are communal…

‘Paul, formerly a mail-sorter with the Post Office explains: "When I arrived here, I had lost my wife and was forced to leave my apartment. I felt cast loose, as if the world around me was collapsing. But since my arrival here I feel less lonely."’

This comes from a case study article on the European Urban Knowledge Network. It got me thinking about responses to the UK’s infamous so-called ‘bedroom tax’… Could co-housing offer an opportunity to emphasise mutuality and reciprocity over ‘traditional forms of support and care’ (to quote a recent UK Co-housing tweet)?

I thought I might find a one or two references to welfare policy on the UK Cohousing Network site, but just drew blanks. I can understand that they might want to steer clear of the torrid current politics. Wouldn’t we all.

But there’s an important theme here, and it’s reassuring to see how the movement promoting cohousing for older people is gathering momentum. Possibly, just possibly, it will give us all pointers for the future, for two reasons:

• First, just because it accepts a mixed economy to get things done, the cohousing movement doesn’t abandon the principle that many things are better for being collectively endeavoured, and that many things should be ‘public’; nor the principle that the existence of a public sphere is in everyone’s interests.
• And secondly, it seems to reassert the valuable notion of interdependence for older people (and I do mean ‘valuable’, in an economic as well as various other human senses). Some years ago when I was researching into neighbourliness and older people, there seemed to be some acceptance of this notion – pulling away from both a tiresome insistence on older people’s independence on the one hand and some inconsistent attitudes towards dependence on the other.

As a society we should have been exploring ways of providing infrastructure that makes interdependence and collective responsibility possible. We could pay a heavy price for our sluggish response to the looming crisis of old age, unless co-operative movements like co-housing serve to stimulate a widespread understanding of the necessity of mutuality and reciprocity.

(And I do hope you feel that this topic is a welcome antidote to the current desperate, morally bankrupt attempts to reify Thatcher).

Looking out for neighbours: resilience, recognition and responsibilities

The Atlantic has a piece by Sarah Goodyear on the contribution of social connections to community resilience in time of crisis, picking up on a New Yorker article (£) by Eric Klinenberg. Hurricane Sandy came close enough for some policy makers to have their suits splashed with a little nasty reality, in turn legitimating (for a short while at least) some public discussion of these issues:

‘As cities prepare for climate change in earnest, they’re going to need to harden infrastructure, change building patterns, and overhaul government emergency procedures. But they’re also going to have to put a greater value on the human connections that can be found in walkable neighborhoods where people know each other and support local businesses.’

The assumption that walkability might be a key criterion is an interesting one, and one of the comments to the article expresses scepticism about it. I’m aware of one study (Du Toit et al 2007) which found that 'walkable neighbourhoods are not necessarily more sociable places in which to live'.

However the researchers in that, south Australian, study were looking for 'strong' social ties between neighbours - a mistake in my view (and a very common one) because you don't necessarily need strong connections, or to feel you belong to a close-knit community, to have someone look out for you in time of crisis (although they help of course).

We can’t all be, and some of us definitely do not want to be, part of a close-knit community, as I’ve suggested often enough. What might help all round would be higher levels of neighbourly recognition – meaning, having been seen around the neighbourhood from time to time, perhaps with a smile or a few words: being accessible in time of need without invading others’ privacy. It's reasonable to assume that walkable environments are more likely to give rise to what I call sequences of informal recognition, which accrue to provide a form of social capital that has largely been overlooked in study and policy.

The point also needs to be made that when crisis strikes, and there are residents who happen to lack social connections, they are going to stand a better chance of being picked up and supported if there is an active local online network that people use to communicate openly and fast. If authorities anywhere in the world really are looking to invest in community resilience, they should be looking to facilitate the development of independent, citizen-led online networks.

Meanwhile back in the UK, not dissimilar themes have been raised following a claim by Care Minister Norman Lamb in the Telegraph that:

‘We have lost the extended family because families have become dispersed. We need to rebuild that neighbourly resilience that helps people stay independent. If someone is living on their own never seeing anyone, that is a dismal existence, and it often ends up with it all collapsing and them going into a care home.’

This is followed of course by the urging of us all to do more neighbouring; and a possible new slogan – this is not ‘big society’ but (tada!) the ‘decent society.’ Capitalisation and branding to follow, presumably.

The minister said that councils should lead the way in encouraging people to help their neighbours stay out of care. ‘I want local authorities to be giving people guidance about how they can maintain their own resilience, using their friends, their neighbours, their community and in that way build resilience and reduce the burden on the state.’

Lamb’s remarks aroused some contemptuous counter-argument from Sarah Ditum on Comment is Free. And to the extent that this is about caring, she has a point – the amount of unpaid care that is being carried out for people with an illness or disability has increased and is likely to keep increasing. Her riposte resonates perfectly reasonably:

‘It's not the populace that's resigning from its responsibilities to the vulnerable; it's the government.’

The minister has generalised unhelpfully and not taken the time needed to catch up with any thinking that anyone else has been doing, or to find out what is the current state of play. And we need not dwell on the trite assumptions about 'the neighbour support that used to be there'. But still, there is a worthwhile message here if it weren't so badly packaged. It would be responsible for local authorities to issue guidance which takes account of what is already going on – if they have the time or funds to get this done.

What seems to me problematic in the language Lamb uses is his hard-wired political compulsion to individualise the response, rather than acknowledge an obvious role for community development. This is typified in referring to 'independence' without entertaining the possibility of interdependence.

This is routine political contortionism I suppose. The government would like the beneficial consequences of community development without having to accept either that some people experience disadvantage or misfortune that is not their fault, or that they can address those disadvantages by themselves (without the disempowering arbitrariness of philanthropy) if supported in doing so.

 

 

Older people and informal neighbourhood care: an issue that won’t go away

JRF are starting to crank up their thinking about informal neighbourhood care and older people, and I’m starting to sit forward in the expectation that something really useful will emerge from their work over the next couple of years.

I was reminded just yesterday that we’re well behind the Dutch in our thinking and action on this theme (although they have a general election coming up with plenty of potential to go backwards fast).

Nearly three years ago I remember offering a somewhat disillusioned post after running out of steam and failing to get anyone interested in the issue of neighbourly support. Even Age Concern, who had supported my research and publication, could muster no interest. At the time the problem seemed to be that the ageing agencies were all preoccupied with what they saw as the ‘countable’ issues of pensions and benefits. Crisis, what crisis?

The crunch may be not so much whether high quality research and policy advice emerges – it surely will – but whether JRF manage to get any purchase on policy itself. High stakes, in an ageing society with its formal support systems being rapidly dismantled.

 

Neighbourhood care groups

Neighbourhood care groups and organisations provide an astonishing social resource which seldom penetrates the policy-media consciousness. Some I know a little about, such as Brighton and Hove Neighbourhood Care Scheme, and Tower Hamlets Friends and Neighbours (where I was a trustee for a while). Now, thanks to Bernard Leach, erstwhile head of sociology at Manchester Metropolitan University, I’ve been learning a little about a group which has been active in Chorlton, Manchester for 44 years.

Chorlton Good Neighbours (CGN) was established in 1967 by local people and has evolved to become a well-established charity offering a range of services to local older people. It currently has over 250 users and 70 volunteers. The group offers a range of practical support including transport and odd jobs for example; and various activities such as exercise classes, cooking sessions, and trips out.

CGN recently carried out their own research with a view to capturing the benefits that are generated by organising care collectively and providing a context for volunteers. The research was based on a survey which asked about levels of confidence to meet and socialise; health, well-being, independence and self-worth; sources of information and advice; sense of safety; and feelings of involvement. This exercise illustrates the great value in having high quality informal local arrangements for people in need of help and support. Take this quote for instance:

‘there is also a policy of ringing up people if for example, they don’t turn up for sessions they normally come to, or if a volunteer notices when delivering a newsletter that there is a lot of mail uncollected... We go the extra step, not just because it is the correct professional thing to do, but because volunteers and users know each other and care for each other.’

Or consider the chart below, which hints at the benefits felt from the range of activities run by the group:

The report suggests that:

‘Overall, the evidence base points to the conclusion that CGN’s activities do change users’ attitudes, lifestyles and their mental and physical wellbeing. It is reasonable to go on to conclude that such care services can lead to significant savings for both the NHS and the Local Authority’s Social Services…

Core activities such as home visits, wheelchair support, coffee morning, Sunday teas and day trips will remain at the heart of what we deliver as they provide a haven of friendship and support – neighbourliness – which enrich the lives of all those involved with Chorlton Good Neighbours.’

 For more details about the report, contact Bernard Leach – btleach { at } gmail.com.

Localism and equalities: dark age ahead

Over recent months I've been party to a few conversations about threats to the equalities and rights agenda posed by public service cuts and the coalition government's apparent enthusiasm for throwing out safeguards.

An example came up just the other day, with Children's Minister Tim Loughton quoted as saying that 'it is a "nonsense" that some carers have to get permission for everyday activities such as haircuts or sleepovers'. Yes but no. In many circumstances it's highly desirable that the parents of a child in care are encouraged to retain responsibility for precisely these kinds of decisions. As a foster carer there are definitely cases in which that is what I would want to happen, in the interests of the child, however awkward it may seem.

Only bureaucrats benefit from excessive regulation, but when you start looking at why some safeguards are in place there are usually minority interests at stake. It's depressing to have a minister of government showing such a nuance-free disregard for the rights and needs of parents.

I got onto this because I've been reflecting on the latest paper from the International Longevity Centre, on localism and neighbourhoods. Authors Dylan Kneale and David Sinclair argue that

'The Localism Bill should include greater safeguards to ensure that the rights of marginalised or minority populations to access a full range of amenities and services locally are protected.'

They go on to call for

'a joined-up approach among bodies representing minority and marginalised groups to research and lobby for changes in the way spending cuts affect marginalised populations.'

I didn't realise that it's well over four years since the ILC published their excellent paper on lifetime neighbourhoods - no less insightful or important now.

The present document is an update to that thinking, in a less sympathetic political context where for example we no longer have CABE to defend and promote good quality design of neighbourhoods, and instead we have the bizarre and nasty government fad of bashing planners and the planning system.

Dark age ahead, as Jane Jacobs foretold.

Social care provided by older people is worth £34 billion

WRVS have published distinctive research into the socio-economic contribution of older people in the UK.

The report, Gold age pensioners, claims that people over 65 made a net contribution to the UK economy of £40 billion last year, even allowing for the costs of pensions, welfare and health services. 'This equates to just over £100 million per day, challenging the widely held view that older people progressively become a burden and a drain on society.'

The hidden value of older people’s volunteering is said to be worth £10 billion per year. Provision of social care by older people is worth £34 billion, predicted to grow to £52 billion by 2030.

The contributions range from leadership or high levels of membership of local clubs and societies, to informal support looking out for vulnerable neighbours and helping them stay independent for longer.

• ‘Sixty-five per cent of older people regularly help out elderly neighbours – and are the most likely of all adult age groups to do so.’

• ‘Older people are very often the driving force for local community-based organisations, with active retirees combining their expertise, skills and experience to provide the leadership, as well as a disproportionate quantum of the membership, of many local organisations, groups and societies.’

I was told about this report yesterday while I was at a drop-in session for older people (part of our Neighbourhoods Connect project in Haringey) - at more or less the same time as one of the participants was saying:

'You can come here and make people cheery; and if you can do that, it makes you cheery too'.

 

The ‘request scruple’ and the demand for neighbourliness

Our society seems to be crying out with a perceived need to stimulate neighbourliness. The assumption is that the supply of neighbourliness in many residential populations is simply inadequate for the demand: people are not neighbourly enough, it seems, and the entire social structure is in jeopardy. The hunt is on to invent ways of stimulating neighbouring. So here's the Campaign to End Loneliness starting to capture ideas for instance, and we have one or two over on the 50 Ways site also. Is this the right approach?

Back in 2009 I had the privilege of editing the English language summary of a Dutch PhD thesis submitted by my friend Lilian Linders.

The study was about ‘the significance of proximity’ and looked at the nature of informal care at neighbourhood level. What Lilian found and describes is starting to excite the social welfare field in the Netherlands, and there are good reasons to reflect on her conclusions.

The research was carried out in a low income urban area, perceived as fairly cohesive in the traditional sense, with a population of about 2,400, clamped between an industrial zone and several highways. (I was driven close by last week, as it happens). Lilian speaks of ‘informal care’ in a very broad sense, she means I think the full range of informal support provided, including informal care and some very intimate tasks carried out by known co-residents repeatedly.

‘Apart from the willingness to help a neighbour, a plethora of problems like poverty, alcoholism, incest, disease, divorce, debts, domestic violence and loneliness was found. Therefore the dividing line between givers and receivers of informal care is blurred. The model is one of mutual aid.’

She found that most support was provided one-to-one, not on a collective (‘community’) basis, but simply because people knew each other. It had everything to do with trust at a personal level.

One of the things that Lilian latched onto, with keen insight, was the reticence in requesting neighbourly support. She calls this the ‘request scruple’ – a reluctance to ask for help. This contrasts sharply with the ‘support scruple’ – the reluctance to offer support.

Neighbours prefer social distance and are surprisingly reluctant to ask for support. Nonetheless, they do help each other, on an individual one-to-one basis, in personal and sometimes demanding and intimate circumstances.

The reluctance to ask for support extends to friends, acquaintances and family members, largely because of the fear of dependency and the social ideal of autonomy.

Lilian’s key finding is that the request scruple is far more of an impediment to informal care than is a shortage in the supply.

This helps to clarify the argument that informal care is not a consequence of neighbourhood cohesion: it doesn’t necessarily follow that if you have a cohesive neighbourhood, people will care for one another in time of need. That depends on personal relationships.

One last point. Lilian draws attention to the significance of mutual support between vulnerable people. This is a tidy example of the difference between the Dutch approach and the English. Big society thinking clobbers away at notions of charity and philanthropy, thinking those of us with some kind of surplus should be supporting those without. In the Netherlands, as I have been describing in recent posts, there is serious policy impetus behind the principle of informal care and mutual support.

You can see a clear English language presentation summary of Lilian’s work here.

Speaking to the study tour group last week, Lilian's colleague Rick Kwekkeboom had some important points to add, particularly around the invisibility of informal care. She noted that informal support only becomes visible when it is over-loaded. The role for formal services is to help people to care for one another and not get overburdened.

I don't see the request scruple as a peculiarly Dutch phenomenon. In the UK we could do with an approach to social support that acknowledges these nuances of mutual support, and is less obsessed with some kind of charitable or philanthropic motivation.

Previously:

Social networks and informal support

Will you still need me, will you still feed me?

Other posts tagged 'Informal support'

 

Social networks and informal support: the big shift for policy

It’s obvious that informal support and social networks can be critical to the way society looks after its members. When people can use their social networks to get support without going through formal agencies, there are social and economic benefits. Has the time finally come for this logic to be recognised in policy? (Image from Viil Lid).

I happen to think this is quite a big deal. I’m just back from an utterly absorbing study tour in the Netherlands, organised by my friend Jan Steyaert for researchers from the Centre for Social Justice in the UK. We were exploring policy issues around the changing nature of social care in the post-welfare society, and Eindhoven is replete with thought-provoking initiatives and articulate people who have been reflecting on the significant shifts implied for practitioners and citizens. I tagged along to make wonky observations in the background, a role to which I seem to be peculiarly suited.

The basis of lots of urgent fresh thinking is the 2007 Social Support Act (known as the Wmo) which requires a shift in care work and social work towards what is known as ‘welfare new style’. Of course, as in the UK and elsewhere, much of this is driven by the mismatch between increasing care costs and shrinking public funds; but here, unlike with big society, there is immediate and valuing recognition of people's pre-existing connections.

The main points that dominated discussion of Dutch care practice were these:

• Focus on the strengths and resources of the individual, not on their problems
• Map, stimulate and involve the individual’s social network as a key resource
• Emphasise collective rather than individual support solutions
• Use professional care as a ‘last resort’.

I think this is both radical and exemplary. Quite apart from the community development principle of bringing collective solutions into the frame, here we have at last got governmental justification for stimulating social networks, with policy makers pushing care agencies of all kinds to pay due attention to people’s social connections. For example, one disability adviser who visits people with particular needs begins with a conversation based on a simple social network mapping template. Expect to see rapid standardisation of social network mapping in the Dutch public sector.

No-one seemed to know how the idea came so marvellously to be given such primacy, but here it is. And the logic is straightforward. For a long time it has been apparent that formal care is too dominant, has unacknowledged negative effects, and is provided at unaffordable levels. Ergo, we need to recognise and invest in informal support; ergo, we need to emphasise and encourage social networks – especially at local level. Why has this not happened before or elsewhere? Is it because we don’t make measureable claims for the part played by social networks, because we can’t see the results? Is it because no budget gets attached to them, so no-one with influence wants to ‘own’ them? Incidentally, this is not about consigning professional care to insignificance, but about re-establishing an appropriate balance between formal and informal.

In theory the Wmo seems to use the term ‘informal care’ with reference mainly to long term intensive carers. But the term seemed also to be used to imply what we might call informal support, thus covering a broad spectrum from low-commitment, dip-in dip-out five minute neighbouring; through something regular perhaps like weekly shopping with or for a frail elderly person; to high-intensity 24x7 unpaid care for someone with physical disabilities. This breadth of meaning may reflect developments in thinking since the act, and would account for the emphasis on social networks.

One advice worker rationalised the process by saying that as a society,

‘We have to go back to normal and look after each other.’

And so philosophical and anthropological questions about ‘community’ get raised. On what scale and under what circumstances is it 'normal' to provide informal support to others? The nostalgic plea doesn’t work very well, I suggest: some people challenge the mythology of the close-knit community, others point to the downsides and the basis in necessity neighbouring, and so on. Against that, we need some basis on which to establish the levels of trust that can in turn give rise to useable network connections.

An acknowledged problem for the Dutch approach is that many people are reluctant to ask for support, to make claims on their social network, to invest in their social network or exploit it for such purposes. One observation we heard was that in some cases ‘the social network is broken’. Another story concerned an individual who appeared at first to have no appropriate sources of support, then when they went out onto the street with the social worker there was plenty of recognition by others and the individual acknowledged,

‘yes of course I have a network, but I didn’t want the network to know my situation’.

We heard about this on several occasions and in particular in the significant research of Lilian Linders – which I happen to know a little about and which I will describe in a separate post in the near future.

 

 

Informal volunteering continues to decline

I missed this when it came out a month ago but it's worth going back to. We now have Citizenship survey figures for informal volunteering for the first half of the present year (April - September) and the decline ought to be of real concern to policy makers.

Over a year ago I pointed out a five per cent decline within the space of a year. The proportion saying that they volunteer informally at least once per month is now down to 27 per cent; and once per year, 54 per cent. These compare with 37 per cent and 68 per cent respectively in the bumper year of 2005. I devised this chart from data supplied in Table 5 here.

I've suggested before that this trend might just be a bit critical in terms of care for older people. I'm writing this in the plush comfort of the night ferry (yes, free reliable wifi) on my way back from an insightful study visit to the Netherlands. Two intensive days of learning have clarified the argument for me sharply. The Dutch are well in front of us: their Social Support Act (2007) has led to a radical emphasis on informal support and social networks, which I want to cover in my next post.

Audrey's shovel

Audrey said I hope we don't get any more snow, I got fed up shovelling it. She told me how she'd made a shovel. Her saw was broken she said, so she had to use a bread-knife, to cut a flat piece from the side of a plastic box. She put a hole in it with a hammer and nail, and screwed it to a broom stick. Matter-of-fact-proudly she described how she shaved a little off the bottom of the broom stick to make it smooth underneath and scrape flush with the ground.

Audrey's in her seventies. She gets about indoors with one of those stable three-footed walking sticks and uses an electric scooter when she goes out. 'And I was the only one in my street who cleared the snow.'

Other vignettes and fictions

Loss of balance



Alice told me Rick, he must be nearly eighty, had gone down three times on the ice, he went down hard and his back is bad. I saw him go down on the corner she said, you know he goes out for his paper, it was treacherous, I won't go out she said, no you mustn't, I echoed.

Then up in the village by the stonemason, you know the pavement is so bad there said Alice, he fell again. How does she know these things. Anyway I said should I pop round see how he is does he want anything should I take him to the clinic, No.

And Doug said you can't do that he wont like that, you see he's very independent, he never had anyone care for him, you couldn't offer to help him, that would upset him.

Anyway I met Rick out of the paper shop a couple days later, well not very well he says when I asked, anything you need shouldn't you go to the, No, says he, Thanks, shaking.

Neighbouring is pretty much what it used to be

I was in London today, talking to two groups of people about neighbouring, trying to surface stories and engage interest. This afternoon I spent a good while talking to an older lady who has lived in the same house since 1957. Her memories of traders, customers and places where she had worked behind the counter or as a cleaner were vivid. Neighbourliness was simply based around her connections as a mother through her children and daily errands.

It was clear that there were plenty of people who she knew enough about to dislike and distrust thoroughly. Nowadays the assumption is that if residents 'know' a high proportion of others in their neighbourhood then everybody is probably getting on well together. This received wisdom is weakened by this lady's account: she was still spitting distaste for quite a few folk not seen for forty years and was ready to detail precisely why.

She felt neighbouring now was no different really, except that for her personally she knew fewer people, she couldn't keep track of the coming and going. When I asked what she thought it had been like for older people forty years ago, were they at risk of being isolated or did neighbours look out for them? she said they all had 'home helps' and meals on wheels, that's what was different. So maybe the state was bigger then, proportionately.

'When I was a kid'

I get very lucky in my work sometimes. Today I was in a community shop in Haringey for a drop-in tea and cake session for older people, and had a hilarious time.

Quite a few stories came out - like the one about the neighbour who kept a pig (this is inner city London we're talking about, in this case maybe ten years ago although memories aren't always reliable on dates). He took it for walks like you would a dog, on a lead. But not always on a lead. I missed the next bit of the story as I was sorting cups of tea but when I came back they were talking about butchers' shops.

Then there was a conversation about how 'when I was a kid' you didn't misbehave because everybody knew who you were. ("And mum said that if grandad found out, we'd all be in trouble"). So someone asked, surely you got up to some things you shouldn't have, didn't you? Oh well yes. David recalled how they got hold of a canoe and paddled it down the sewer, "about 14 of us, I don't think anyone found out about that".

Inside or out? Older people and homes

Here's a thoughtful article on the quality of life for older people in a good nursing home, by documentary film-maker Alan Gilsenan in the Irish Times:

'Real care does not reside in the building or its facilities... but rather in the spirit of the people within. Laughter seems to be a huge part of this: a shared sense of humour that engages with the elderly rather than excludes them. Time too is hugely important: the time to sit and talk, to listen. The ability to engage with each person as an individual rather than as a unit. Above all, tenderness. Time and time again, one glanced down a corridor or through an open door to see a gentle hand on a shoulder, a supporting arm, an easy hug. These little gestures spoke of some enduring goodness, some small triumph of humanity, in a health service so maligned and under threat.

'Strangely, while there is a sense of warmth and light inside the home, one would be less certain about the life for older people on the outside. Spending time with the many day-care users, who live independently in the community but visit St Monica’s for one day a week, one was struck by the loneliness and fear of many of them.

'The demise of neighbourliness and the onset of violent crime against the elderly was a constant theme. The quiet emptiness of weekends and bank holidays seemed to carry a particular poignancy. For many, that day inside St Monica’s each week was a lifeline of care and fun and support.'

This theme has been part of the thinking behind the Haringey Neighbourhoods Connect project underway with Networked Neighbourhoods, working with networks of informal neighbourhood carers. We can't insist that older people are necessarily better off ageing in place rather than in an institution, but we can take steps to make it more desirable as an option.

Older people in poverty

This is a note I prepared recently on neighbourhood support for older people in poverty, for a friend working in a think-tank who asked for my views. I had forgotten it, rediscovered it, and thought I would share it.

Apart from the obvious problems associated with declining health and mobility, many older people have difficulty adjusting to changes in their social and built environment. I see these issues in three groups.

• In addition to a general sense of discrimination against them, older people often feel economically discarded and left without a role, disempowered by the ethos of consumption, their values outdated and their memories not valued;
• They are often bewildered and challenged by the speed of change, for example in terms of the built environment in their neighbourhood, or in the cultural diversity around them;
• They will almost inevitably experience network erosion – the loss of personal contacts – as they age.

For older people in poverty, it is far harder to get protection from these forces. Inevitably they will struggle to compensate for the loss of members of their social network if they lack the resources (not just money and mobility, but also cultural capital and confidence) to engage new non-local contacts.

Furthermore, these are compound problems: being disempowered and experiencing exclusion makes it harder to deal with change in your environment; struggling to come to terms with change in your environment makes it harder to compensate for the loss of contacts; and so on. These accumulating effects cause profound social damage.

Policy tends to get no nearer to this cycle than through piecemeal support for formal schemes of carers and buddies. Worse, we try to resolve the difficulties by displacement, drawing older people out of their homes and into sheltered care, rather than addressing the issues that would enable more of them to age in place.

How can policy gain purchase on these issues? We need comprehensive cultural awareness in order to bring about change. We need policies that genuinely confront and reduce poverty. We need a media campaign that refreshes generalised respect for the fact of age. We need to promote localism – a policy emphasis on local solutions to social problems and the valuing of blended local cultures. We need to insist consistently on an intergenerational element in local initiatives. And we need policy to recognise and allow space for informal and semi-formal solutions, encouraging recognition of neighbours and stimulating interaction at neighbourhood level.

In this respect it is interesting to note how local online networks seem to be releasing a latent demand for informal opportunities for neighbourhood support, among people who are disinclined to participate in formal organisations. The potential for social media to help support neighbouring, especially for older people in low-income areas, merits early investigation.

Walk the neighbour

I was talking to a friend the other day about how her father, recently out of hospital, had become bloated without exercise, overweight, swollen ankles etc. She was having to go over and get him up and walking round the house, up and down a bit. I recall doing this with my mum, starting with the nearest lamp-post on the street and back, then maybe targeting the next one, a little further each time. In her case we were fortunate in that she had wonderful neighbours who helped, in many ways.

This is not a rare situation though and there is obviously a role for neighbours here. It couldn't be much more suitable for neighbourly involvement could it? No special skills needed, a very modest amount of mutually-convenient time, a little interaction, being there.

But as we know, older people tend not to want to trouble others; their children often don't know their parents' neighbours; and care workers are even less likely to know them, and more likely to retreat from safeguarding obstacles. One example I found here:

'My Good Neighbour takes me out for a walk and helps me with silly little things, like reaching items in the house that I cannot do. I cannot walk outside unaided so it is helping me keep mobile and to get some fresh air.'

Funding for work with older people: Wales

Are we to start seeing some incentives to develop social interaction projects with older people? The Big Lottery in Wales has just launched a funding programme for projects ‘to improve the quality of life of older people by providing access to befriending or advocacy services.’ Grants are available for between £200k and £1m, for projects that address two of the following outcomes:

• Reduced loneliness and increased wellbeing through improving social interaction
• Increased confidence and ability to meet the challenges and opportunities of ageing
• Increased understanding and use of rights and awareness and uptake of services leading to greater independence and choice for older people.

Older people and local social networks

Last week I went along to talk to a review group working on elder care for the Centre for Social Justice. They wanted my views on how neighbourhood support can be strengthened, and why it should be, to help older people to age in place.

I put some stress on the unrealised potential of new technologies: not so much from the familiar applications like telecare, but more from the point of view of local social networks. It's remarkable how little attention has been paid to the contribution of social media in strengthening and sustaining local connections and thus supporting older people in their neighbourhoods.

Here's an example. Independent Age have just published a report on Older people, technology and community, with the totally misleading subtitle 'the potential of technology to help older people renew or develop social contacts and to actively engage in their communities.'

Unfortunately most of the report is about already-well-known barriers to and uses of technology, not about the development of social connections, although there are revelations for me among the case studies. A main theme for the report is:

Increasing awareness in the public sector of the issue of social isolation and loneliness and encouraging public sector organisations to make adaptations to technology-based services that will help address the problem.

This is all very well but it risks over-emphasising the negative, misses the potential for older people to play interdependent roles, and completely overlooks the opportunity of local citizen-based online resources.

How come this lack of awareness persists? Three years ago Danny Bull, who set up MyNeighbourhoods told me:

‘Our senior citizens have been integral to our growth, fuelled by the possibility of real-world communication as a result of initiating contact with others online. We’ve witnessed everything from elderly users trading books locally to a bit of light hearted flirting.’ (I published the comment here in 2008)

The potential has always been there but I'm beginning to suspect that much of the problem lies with the age agencies and the attitudes of professionals. Understandably perhaps, they seem too often preoccupied with technical barriers that diminish the quality of life of older people. The more you have to deal with those problems I suppose, the more you are going to look at them in mechanistic ways, rather than recognising organic social solutions. (As an aside, there's also a need to differentiate the important range of skills and experience represented by the term 'older people', even though there's been plenty of discussion about how the younger old can support the older old). Neighbours are seldom recognised as part of the solution to older people's care needs (so all credit to the CSJ for their awareness): and as this report shows, people can reflect extensively on technological applications without seeing the potential to stimulate neighbourly support.

Then again, I may be wrong and very little online-enabled neighbourhood support is actually going on. But that's not the impression I've been getting.

Why older people should have pets

Let's lighten the mood here a little. A couple of years ago when I was writing a piece about the sociability of dogwalking, I read several research articles about the social and health benefits of owning a pet. Sometime I'll return to this theme, especially to consider the benefits for older people. Meantime, here's a fun piece (including a summary slide show) from USNews.com offering ten reasons why older people should have pets:

• Companionship
• Having a routine
• Exercise
• Less stress
• Getting out
• Making new friends
• New interests
• Protection
• Taking care of something
• Investing in life.

Thanks to Leo at Our blocks for the (indirect) link.

Will you still need me, will you still feed me?

The amount of emotional or instrumental support that you receive from your social network, and the amount that you give, can be calculated and represented on a reciprocity scale.

So you might give a lot of practical help to others and not need much yourself at the moment, scoring positively for instrumental reciprocity. You could have been going through a hard time and be needing more emotional support than you've been able to offer others, scoring negatively for emotional reciprocity.

Back in 1992, as I've been reading, some Dutch researchers plotted these scales for a large sample of older people. As we'd expect, instrumental support given decreases sharply with age. The researchers found that instrumental reciprocity began to decrease at the age of 64, echoing that rather crummy Beatles song.

More interestingly, they identified a turning point, where a relative surplus of instrumental support given changes into a relative deficit, at approximately the age of 66. Of course, you can expect your social network to decrease in size as you get older, and your reciprocity scale will also be affected by living in a care home where most of your instrumental needs are going to be catered for. The research seems to suggest that a sizeable minority of older people do deliberately seek to increase the amount of emotional support they give as their ability to provide instrumental support declines.

Unfortunately, as a society we're not very good at providing contexts for emotional support, so that too many older people experience a sense of dependence rather than interdependence, submerged below the hoizontal line in the graph.

I'm hoping there has been some follow up to this research: I've not found it yet, but would be keen to learn of it.

van Tilburg et al. Flow of support. In: Living arrangements and social networks of older adults, VU University Press, 1995.

Nutrition and community meals

Recently I've been building a wiki on neighbourhood support for older people, to try and focus information and understanding on this crassly-overlooked issue. I'll open it soon, but meanwhile if you're interested in contributing please get in touch.

Here's the sort of thing that goes into the pot, so to speak: ILC-UK have published a paper by Lisa Wilson on Personalisation, nutrition and the role of community meals. It notes that there is a strong underlying economic argument for supporting older people to remain independent and in their own homes, and for ensuring good nutritional status. It begins with a striking statistic:

'There are currently more people in the UK receiving meals in their own home than there are older people in care homes.'

Hence one of the main arguments:

'Meal provision and access to food must be considered a core part of social care packages and meals must be provided to at risk groups, not just to those who have reached the point of being unable to manage themselves.'

Unannounced visits: family, friends, salespeople

I remember my old mum used to delight in an unannounced visit, if I happened to be out for a long run or nearby with some time to spare. Many of us live highly-organised lives now though, and we have our technologies to check ahead for convenience. We don't do surprises. Saga recently published results from the Saga Populus Panel survey of over-50s, in which they asked about unexpected visitors popping in.

The unsolicited attention of salespeople (nowadays they always start by telling you 'it's alright, I'm not going to try to sell you anything...') is always unfortunate as someone who works at home and my sense is that the practice has increased noticeably in the recession. Thirteen per cent of panel respondents say it happens 'often' and the proportion is higher (17%) in the over-75 age group.

But the figures for family (35%) and friends (36%) are encouraging. The regional differences (eg family in London, 25%; in Northern Ireland, 49%) are stark if unsurprising.

The survey also asked how well people know their neighbours. Here too the figures are interesting, with just 1% in all age groups and all socio-economic groups saying that they 'don't know them at all'. (See my previous tentative conclusion that for the general population, about 5% of us have no contact with our neighbours).

According to the Saga Populus Panel data, about one third of over-50s say they know their neighbours well 'and often socialise together', while 64% say 'we talk and say hello sometimes'. For those over 75, the proportion who say they know their neighbours well and socialise is a stomping 44%.

I note that this was an online survey: does this mean the sample is biassed towards people who are more communicative?

Village facilities: putting it all together

I like the sound of this... Thanks again to Regen and Renewal, for this account of a new development on the Suffolk coast which combines sheltered housing for older people, a public library, cafe, parish council meeting rooms, social rented flats and homes for sale.

From the Regen and Renewal project review:

The communal areas here are central to the building. I could see that the residents used them to come together to have a chat. It's great that the cafe leads into the library, and these areas can also be sectioned off, which makes them more versatile. The break-out areas are full of natural light. The scheme successfully blends the need for older people to maintain independence in their own home with the need to avoid insularity. They can have privacy but they can also talk to people in the library or the cafe, which means these areas become hubs for the community. There are a number of opportunities for residents to communicate with the outside world.

Social policy and empowerment

Yesterday to an event launching new policy work by the centre-right Centre for Social Justice. Their new policy areas are elder care, youth justice, mental health, community cohesion, sport, and social return on investment; and given their realistic chances of influencing forthcoming policy, it's good to see these themes being researched and debated openly.

I'm particularly pleased that some effort is to go into understanding and promoting informal support for older people, and I'll be pottering along to talk to the CSJ in due course. Meanwhile, as someone with a fair bit of experience of think-tank events on the political left, a couple of thoughts that struck me.

First, there was an odd tendency to treat old ideas as new. There's nothing necessarily wrong with refreshing old ideas - it may be better than the current preoccupation with innovation-at-all-costs. One example was the suggestion that it's socially beneficial for young people to participate in sport; but when this view was put across by Iain Duncan Smith as if it were his intellectual property it was greeted by some of those present like a radical revelation.

Similarly the arguments for social return on investment were unveiled as if no-one had ever heard of it before, leaving me pondering with irony the amount of thinking and effort that went into this area (using different terminology) in the late eighties and nineties under a Tory government (I recall in particular their 'Invest to Save' budget, although it was hard to crack into with social arguments: I tried). And it's a bit discourteous not to acknowledge the strong tradition of work at the New Economics Foundation.

Secondly, there was a discomforting sense of moral prescription and crusade - for example in 'saving' young people from a life of crime - without a moment's reflection on the case for empowering those involved. An early question from the floor raised just this point, and went unanswered, as if the language were not quite understood. It seems a realistic ambition for me to see if I can get an appreciation of empowerment and interdependence embedded in the work on care of older people. Wish me luck.

Some things that fire people and book people have in common

I was at a meeting about care in the home for older people the other day, where one of the speakers mentioned a key source of information about people's care needs, for housing and adult care services: fire service personnel.

The point being that firemen and women frequently visit older people in their homes to check on safety and give advice, and are trusted public service professionals so they often come away with important information that is relevant to other services. Just a question of joining up.

Then yesterday I was talking to some community service librarians about their contribution to quality of life at local level, and their interests also are in effective partnerships to share information. Their staff too are trusted, although not usually uniformed; they too visit people in their homes and have a role in passing on information, although numbers are sure to be lower than they would be for the fire service.

Curiously, this morning I discovered a printed bookmark in the house, the sort you might pick up in your local library, which I hadn't noticed before. It promotes the library service on one side, and advertises for fire service personnel on the other.

All of which can be added to these thoughts about the role of fire stations and library buildings, to provoke thought about the overlapping reach of local services. And nothing to do with Fahrenheit 451.

Informal local support in severe weather

Two cheers for CLG who have rushed out a short document called Volunteering and neighbourliness: helping out in severe weather.

It's an odd mixture of advice about hypothermia and frostbite, some useful suggestions from Volunteering England, and encouragement to 'call in regularly on elderly friends, neighbours and relatives to see if they need help staying warm or getting provisions'.

It feels like some of the content should be on posters in shops, banks and post offices etc; some belongs in press releases so that local newspapers and other sources reproduce it; and some might even belong in leaflets for more general distribution.

Perhaps it's also worth thinking about a more considered version in advance of the next cold snap. Things like neighbours placing a home delivery order with a supermarket for an older person who may not have internet access; thinking about the welfare of their pets, which often worries them; walking in the house with an older neighbour - up and down the hall to get a bit of exercise can be very important. And CLG could be thinking about getting messages like these out through hyperlocal sites: by next winter please.

Informal care and older people: time for a campaign?

News of the year? The importance of neighbourly informal support for older people has been recognised in the Department of Health. From yesterday's press release:

With many older people living alone and more than 180,000 saying they have gone for a whole week without speaking to friends, family or neighbours, Care Service Minister Phil Hope is asking the public to make a New Year’s resolution to visit older neighbours more often.

Social interaction can protect older people’s mental health, helping to do their shopping will prevent falls and injury and keeping an eye on their health will stop them developing serious health problems and ending up in hospital.

What are the chances of this recognition being turned into some kind of strategic initiative, exploring ways of both stimulating and measuring levels of informal support (without booby award schemes for innovation, please) and promoting interdependence?

A year ago we had the results of some work on meaningful interaction (admittedly it all went quiet from the moment of publication). But against that, I have not forgotten that older people were short-changed in the report of the Commission on Integration and Cohesion.

Would a change of government help? Will the recession cause people to revert to a more localised way of life? At the risk of seeming naively bubbly at the start of a new year, would anyone care to join me in working out what is needed under the broad heading of a campaign?

Previously: Copenhagen for the ageing crisis

A Copenhagen for the ageing crisis?

Short moan. This past couple of years I've been at quite a few events about social policy and older people, and on each occasion conscientiously made a point from the floor about the ageing population and the looming crisis of informal care. I've written to people in think tanks and the Guardian and so on, and blogged about it. Policy concerning older people in this country is largely concerned with pensions and benefits, and those themes dominate the debates and the thinking.

Back in July I sounded more patient, referring to

'the simmering question of quite when policy will get hold of the issue of informal social care and start to do something about it. Given the difficulty I had in getting the ageing agencies interested in neighbouring I'm not sure where the impetus is going to come from.'

Just for reference and as an indicator, the recent government consultation on the Ageing Strategy had just two questions in the section (ch.8) on communities and neighbourhoods:

Q9. When you stopped driving, what helped you stay mobile and active in your community? What options would have helped?

Q10. We want to improve attitudes towards ageing across society. What more could be done to challenge outdated stereotypes and tackle negative perceptions about being old? Can you share good examples of where this is already happening in your local community?

I'd feel even more disillusioned if it weren't for the fact that in the Netherlands they're doing something about it, running several pilot projects on how to stimulate informal support at local level, and I'm lucky enough to be involved in that work. In the UK, policy blindness to this growing crisis is a disgrace.

End of moan, for the time being, because here's Jackie Ashley in the Guardian with more influence, arguing that 'It could be as serious a threat as climate change, yet so far politicians have barely considered what needs to be done about our ageing population.'

How long will the politicians leave it before any Copenhagen-style twelfth hour consideration, I wonder?