Love is all around…

The 14th February has become synonymous with love and depending upon your perspective it is either a day for the purchase of over-priced red roses or a day of true romance.
It’s a little known fact that some of the relics of the famous St Valentine, whose day it is, lie in a church in the City of Love. Paris? Rome? Venice? I hear you suggest but No – Glasgow. St Valentine is (at least in part) resting in the unlikeliest of places – in the Church of the Blessed Duns Scotus – in the Gorbals, a part of the city once synonymous with gang violence and searing poverty.

Just like any relationship, expecting the unexpected and challenging stereotype are probably two useful characteristics for this St Valentine’s Day. In that light three stories struck me in the last week that have relevance and challenge for the care sector. They are each about relationship and value, about human contact and dignity.

The first was the news of the growing challenge of loneliness facing our population.

In a world which presupposes relationship as being intrinsic to well-being it was noticeable that last week saw the launch in Glasgow of research by the National Campaign to End Loneliness which found that of the 15,000 older people in the city, it is estimated that 10% can go days or weeks without having any contact with anyone. It is stated that loneliness and its impact can have such negative health determinants that it is the equivalent of smoking fifteen cigarettes a day.

With over 1.4 million in the United Kingdom reported as being lonely, the issue has not surprisingly become one of great significance with both a Scottish Government Strategy and a UK Minister with responsibility for loneliness to name but two political responses.

With around 7.7 million people living on their own, of whom around 2.2 million people are over 75, the issue of loneliness is likely to become of even greater prominence.

But I for one have become increasingly uneasy with some of the loneliness narrative. It is certainly important that as individuals and communities we should try to include, involve, engage and enable participation and contact. But we also have to be careful that we don’t develop some reverse morality when faced with such loneliness data.

Being on your own is not intrinsically negative and much of the recent debate has ignored the benefits of solitude. There is a world of difference between social isolation and forced loneliness over which you have no control and which you do not desire, and the reality for many which is a decision to be single and alone. Have we lost the capacity and ability to be alone? There has been an automatic presumption of the negativity of aloneness in much of the consideration of these issues. What we need rather is a serious debate about what loneliness is and what interventions are needed, which will be beneficial for both the individual citizen and society as large. I am not convinced our sometimes guilt-ridden knee-jerk reactions have developed such maturity.

The second insight from last week’s media came from a disturbing report from the Leonard Cheshire charity. This research is not unrelated to the issue of isolation and loneliness we have just considered. The research undertaken as a result of a Freedom of Information (FOI) request has shown that a third of Scottish councils commissioned 15 minute visits for the provision of personal care in 2016/17. This has meant that over 5,000 Scots were being subjected to the degrading practice of flying visits. At least 5,182 people received personal care visits of 15 minutes or less for support with intimate care, based on data from councils that responded to the FOI request.

Freedom of Information responses from councils in Scotland found that one in three – 31% – were commissioning 15 minute visits for the provision of personal care in 2016/17.

For many individuals receiving support at home, 15-minute personal care visits barely allow for tasks to be completed, let alone to develop a positive relationship between the individual and their carer.

Given that in January, the Scottish Government’s Minister for Social Security Jeanne Freeman launched a consultation and draft strategy on isolation and loneliness, highlighting the link between loneliness, poor physical and mental health, one might ask what benefit such short, task-oriented visits are making. They do little for effective mental well-being but then given the Mental Health Strategy hardly mentions older people its maybe not a surprise that there is a priority on loneliness but not on some of the causes of it.

Leonard Cheshire’s Director for Scotland, Stuart Robertson said:

“These damning figures show that many vulnerable people are being failed by the social care system… We have to urgently address this scandal and ensure people receive the person-centred care they deserve. No one should have to choose between going to the toilet or having a cup of tea, and this practice must come to an end.”

I couldn’t agree more with Stuart Robertson and Scottish Care has called over a long period of time for an end to the shame of short time and task oriented visits which leave no room for dialogue and dignity, never mind conversation and relationship. It is really sad that on a day we are celebrating love and relationship, for so many their only opportunity for exchange and interaction is reduced to a fragment of time.

The third media story I remember from last week was the report that the well-known and formerly respected broadcaster Jeremy Paxman, told an audience last week that he is in favour of removing the vote from anyone over the age of 65. This is somewhat ironic in the week we celebrated the 100th anniversary of woman’s suffrage.

Paxman’s easy dismissal of the contribution and role of the over 65s is indicative of the acceptable ageism that is all too prevalent today. Paxman states that the elderly have done very well out of life and that they are now using their voting power to ensure that they, rather than young people, are getting the best out of the state.

On St Valentine’s Day love has surely to be for more than a Hallmark day. A society where loneliness becomes a political policy priority, but not where the same political system is prepared to allocate resource to address the issue is less than it should be; a community where contact is reduced by the arithmetic of affordability does not in any sense value those who it should care for; and a place where older age is considered to be beyond contribution – such a society needs to rediscover the essence of a love and regard for others, which can’t just be for one day.

Donald Macaskill
@DrDMacaskill

2017 saw Angus Health and Social Care Partnership provide funding for care home staff to attend a series of learning and development days. Staff were able to hear speakers on a variety of subjects including – UTI Prevention; Well Being in Dementia Care; Adult Protection; Maintenance of Hearing Aids and Management of Chronic Pain. Events were held locally and care homes sent staff within their own locality. Having secured funded places I felt sure that this would be of interest to all care homes in Angus and the majority of care homes took up this offer. Sessions involved presentations from a range of services. Interestingly, those people who previously had had little contact with care homes would remark on the enthusiasm and knowledge of care home staff.

After the sessions, homes developed action plans for change and then reported back to session presenters as to how they had got on. Many of the homes came up with well thought out plans but for me one home stood out.

The staff of a small home in Carnoustie rose to the challenge and the range of actions was inspiring – from developing posters for families on over use of antibiotics to starting up a “relax shack” for supporting people with chronic pain. Time and again they would come to follow up sessions with their new ideas and brimming with enthusiasm for further knowledge which they would then use to improve the lives of the people in their care.

I would like to say well done to the team at Braehill Lodge in Carnoustie – at a time of worry and concern over funding and the future of care homes they have taken advantage of opportunities offered.

For 2018 we are going to continue our development days but in a different format making full use of new technology in an effort to make the sessions more accessible across Angus. I suppose the message here is to take the opportunity and try to use it for improving the lives of people living in care.

 

Ivan Cornford,

Local Integration Lead, Angus

Since I started at Scottish Care I have noticed a change in the advertising feeds that show up on my computer. Clearly some algorithm has assumed that my interest in health and social care, and the human rights of older people is because I have aged significantly in the last 6 months (mind you, given what I have seen by way of pressures on the sector, there could indeed be some figurative truth there).

It has been an interesting experience to see aging through the eyes of an advertiser. Many of the photographs contain trendy looking silver haired ladies – ‘move over sage and beige, grey and black are where it’s at’. The women smile back at me with a confidence that I could only have dreamt of in my twenties. They have seen, and quite possibly, done it all.

But as the products move from beauty and adventure to assistive, there is a marked change in the photographs. The face vanishes to be replaced by hands. Oh so many wrinkly hands. Or backs, they are popular too.

The philosopher Levinas describes the face as “Living presence”, the Oxford Dictionary defines faceless as “remote and impersonal”. Whilst there is countless research into the reasons behind this de-personalisation, and campaigning to refocus the lens, the reality remains that the portrayal of older people in advertisements is often the opposite of presence. It is absence.

And whilst it may be a reaction associated with ignoring the stark reality that will affect us all, surely this is a point where we should afford ourselves some dignity.

Perhaps then it is of no surprise that theme of absence is what I also see the social care sector battling with.

In my final blog of 2017, I raised a thank you to our partner organisations for our invitation to the table, but this is still work in progress – the independent sector have representation at only 7 out of 32 IJB’s. I also asked our partners to listen. If presence is only notional, then there will be no useful impact. Without our voice, it is not possible to properly map and evidence the landscape of the health and social care sector as a whole. Without that map, it is not possible to commission or deliver effectively.

At yesterday’s Scottish Evidence Summit hosted by the Alliance for Useful Evidence and Iriss, everyone was asked to take away an action – mine is to tackle that disconnect between evidence and implementation. The health and social care sector as a whole needs to incorporate our evidence and make it real and applicable, and, have the bravery to follow through with necessary action.

So, let us stand up proud of our contribution to the sector – social care is so often the buffer for health care, it seems obvious that they need to be considered in totality.

And with that, let us stand up proud of aging – 2018 may be the year of the young person, but do not let that distract us from the bigger picture. Young people will get old too.

Greater presence and indeed prescience of aging and older people should bring greater presence and prescience of the sector, so let’s ban those faceless photos, and raise our voice in a manner that will be heard.