Today is Remembrance Day and with current global events there is an added poignancy and relevance to a day which focuses on remembering those who sacrificed their lives for others and to renewing our focus and efforts on the struggle for peace.

This year the Royal British Region has designated the theme of this years’ Remembrance as ‘service.’ They state:

‘Physical, mental or emotional injury or trauma; the absence of time with loved ones; or the pressures that come from serving, highlight why the Remembrance of service is so important. This year we mark significant anniversaries united by the theme of ‘Service’.

The concept of ‘service’ has been much in my mind in recent times. A few weeks ago, when I was in the family home in Skye, I looked out an old box which contained ‘war medals.’ I knew they were there and in truth when younger they were objects, we used to play with. This was probably the first time, however, that I looked at them seriously and was surprised by what I discovered. They belonged to my paternal grandfather who I knew had fought in the First World War but who never spoke about his experiences. He was even at his best a gruff, strict disciplinarian who to a child who met him infrequently seemed to be quite a source of fear.

What caught me by surprise was the discovery that he had been awarded two First World War medals and it was only when I explored more and chatted to family that I discovered that as a young man he had joined the Royal Navy and had fought in the First World War before then joining the Army and specifically the Lovat Scots where he ended up as a decorated soldier. He ‘’saw service in two services.’ To offer yourself in one service is remarkable in itself but to then transfer to another theatre of war which was even more dangerous struck me as remarkable. Like so many young islanders he left his community to go to distant places with a concept of ‘service’ which was one which sadly led many of his peers to their deaths as the local memorials attest only too clearly. Service to your nation and community which cost many their futures and which rightly those who will have had loved ones in any war or conflict will remember today and tomorrow.

There are numerous meanings to the word service and each of them conveys something about the depth of relationship to and for others. It could be service which once was the act of religious worship or the dedication of a life as part of a religious community; it could be used to suggest the work of an employee in a household (as my late granny who spent years ‘in service’) or more contemporaneously it could be the service you receive from an artisan or the service you receive in a restaurant;  So many meanings for the one word. It is therefore maybe not surprising that the etymology of the word is complex with some scholars suggesting that it is rooted in the Proto-Italic word serwo meaning “shepherd,” and others saying it has the connotation of ‘guarding and looking after’. Both convey a sense of protective care and support. Whatever the origins of the word there is an undoubted sense of a dedicated and focused giving of your ‘self’ to another which lies resonant within service.

I know many people who give and offer service to others. There are few who nowadays are required or who choose to offer service militarily like my grandfather, but there are countless thousands who offer service in smaller ways in their communities and to others.

There are so many unsung volunteers who continually give of their time and talents to support others in a wide range of activities and charities; there are thousands of individuals who every day offer service to a neighbour through simply being there to have a conversation and spend time with them, or for those who are unable to do so, to do their shopping or to take them out. There are hundreds who volunteer in charity shops and foodbanks, and who work for community groups, youth organisations and support groups.

Service seems intrinsic to the best aspects our humanity – the regard for others before a focus on self.

Today I will find a place to sit and be quiet, to think of the service to others which led so many millions to pay the ultimate sacrifice of their life not for a political cause or even a national interest but so that those they loved more than anything could be free, and safe and healthy and what they considered to be true evil would be vanquished.

I will find a place to think of those I knew personally who are no longer here but whose heroism was hidden by their hurt and yet shone forth through their concern and compassion for others.

I will find a place to remember all who across the years gave and still give to others, because for them to be human is to be connected in care in a chord unbreakable, even as they fail to recognise their actions as true human service.

I hope you too can find such a place to remember the service given yesterday, the service still offered, and the service still to come.

I hope to also read afresh the words of the American 19^th century poet Ella Wheeler Wilcox whose poem ‘The Two Kinds of People’ still I think rings true with its challenge today:

‘There are two kinds of people on earth to-day;

Just two kinds of people, no more, I say.

 

Not the sinner and saint, for it’s well understood,

The good are half bad and the bad are half good.

 

Not the rich and the poor, for to rate a man’s wealth,

You must first know the state of his conscience and health.

 

Not the humble and proud, for in life’s little span,

Who puts on vain airs is not counted a man.

 

Not the happy and sad, for the swift flying years

Bring each man his laughter and each man his tears.

 

No; the two kinds of people on earth I mean,

Are the people who lift and the people who lean.

 

Wherever you go, you will find the earth’s masses

Are always divided in just these two classes.

 

And, oddly enough, you will find, too, I ween,

There’s only one lifter to twenty who lean.

 

In which class are you? Are you easing the load

Of overtaxed lifters, who toil down the road?

 

Or are you a leaner, who lets others share

Your portion of labor, and worry and care?’

 

Two Kinds of People – An Ella Wheeler Wilcox Poem

Photo by Jelleke Vanooteghem from Unsplash.

 

Donald Macaskill

 

 

I have been through in Edinburgh a fair bit this week and on one day found that I had a lunchtime hour to spare on Princes Street – I then remembered that the new Scottish Galleries had just opened in the refurbished National Galleries. I popped in and I wish I had had the whole afternoon free. This is a must see if you are in Edinburgh and definitely a reason for us west coasters to travel through!

Personally, I think the designers and curators have done an amazing job in making the new space accessible and intriguing. But of course, what matters most are the art works. There is something for everyone on display, though still admittedly but a small percentage of the treasures of the National collection. Personal loves were the seascapes of William McTaggart, the breathtaking spirituality of Margaret MacDonald Macintosh, the display of the Celtic revival and most of all the vibrant beauty of the works of Phoebe Traquair. I’ve see her works in situ in Edinburgh over the years but this was the most coherent museum exposition I’d come across.

Phoebe Anna Traquair (1852-1936) has pride of place in one part of the new galleries. She was an Irish born artist who was a major contributor within the Arts and Crafts movement not least in her adopted Edinburgh where her skills as an embroiderer, painter and jewellery maker flourished.

I find artistic imagination both inspiring and thought provoking. The success of this new gallery is that it allows you to find your own interpretation and sit comfortably with it. It doesn’t treat the viewer as in need of introduction and education but as capable of their own mature personal insight. One of the problems of some modern gallery refits (and I think especially here of my beloved Glasgow Kelvingrove which I visited almost weekly as I grew up) is that sometimes they are so earnest in their desire to inform that they crowd out personal perspective and treat you like a child. But I am sorry – I do not want my imagination to be curated by somebody else’s interpretation. The National Gallery in Edinburgh brilliantly granted me space to be inspired and to imagine.

Imagination is an intriguing phenomenon. It possesses an astonishingly powerful capacity. It is the energy that sources through the veins of inventors, it is the spirit that turns an impossible ask into an achievable task, it is the fire which burns away the sameness of the known and lets the human mind and collective society dare to be and do differently.

Our neurological ability to imagine is controlled by the neocortex and thalamus alongside the brain’s other functions such as consciousness and abstract thought. The developing discipline of neuroscience is leading us to discover fascinating insights into the power of imagination for human individuals. It recognises that the food and fuel of our imagination is our experience and memory – the new and innovative is birthed from our openness and awareness to the world around and within us, but is not constrained by any sense of traditional ‘knowledge.’

Albert Einstein famously said: “Imagination is more important than knowledge. For knowledge is limited to all we know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.”

As such imagination is an art and science which I strongly believe should not be left to be the preserve of artists and creatives alone. It desperately needs to become a key skill and attribute of the many not the few and most especially of our political leadership. The recent writings of Geoff Mulgan have sought to argue for the critical importance of our politicians being schooled in the science and art of imagination.

I thought of the necessity of political imagination, of leaders going beyond the predictable safety of the known to adventure into imagination, as I sat giving evidence at the Scottish Parliament on Tuesday as its Health and Social Care Committee explored the plans for a National Care Service and considered the current state of social care. Away from the technicalities and mechanics of a parliamentary bill and all potential amendments to that, away from engagement of all stakeholders and political parties and the centrality of the voice of those who use support and care services, what struck me during the whole session was the singular lack of exciting vision and imagination.

We have a unique opportunity to dream bigger and build a social care community in Scotland, one which advances the human rights and dignity of individuals. We have an opportunity to imagine bigger and better and yet what I see and hear around me is a limiting of vision and a boundarying of possibility.

I also thought of imagination but in a much more positive vein when I had the pleasure of taking part in a design workshop run by the RSA and Scottish Care on Wednesday in Glasgow Caledonian University. A room full of designers, social care creatives and frontline staff who together dared to dream about a better social care world in Scotland. It was not a diet of pie in the sky but rather was rooted reality trying to re-shape possibility. I’m looking forward to the work of this ‘Social Care Emergency’ project over the next few months because it has an honest energy and optimism about it.

But back to my Edinburgh hour – the Phoebe Traquair painting that drew me in most of all and had me gazing for a long time was ‘The Awakening.’ Painted in 1904 the museum card states:

‘This mysterious image represents the awakening of the human spirit. An angel points, with an arrow, to several figures sleeping in a meadow. They are partially bathed in the light of a rainbow, signifying better times to come…’

Scotland’s social care sector badly needs the illumination of imagination that can bathe our current reality in rainbow hope of better times to come. That will only be achieved not through the predictable mundanity of closed room discussions like the Verity House Agreement between COSLA and the Scottish Government but by an adventurous collective re-imagination of possibility. I don’t think given the reality of these challenging times that we have any alternative but to get around an inclusive table and do the work of imagining a better social care system and I’m convinced that that work should start afresh now.

In a week where the challenges and promises of AI has been much in the news, one of the few things I suspect that distinguishes us from ‘the machine’ is our art of imagination, the science of dreaming differently and creating afresh; the bringing together of spirits and hearts to re-shape reality. Whether it is social care or any other issue we are, I believe, best served by fostering our imagination rather than a sole reliance on ‘knowledge’ and I for one want to spend more time in places and spaces that feed my imagination.

Donald Macaskill

 

When a plan prepares for failure: the crisis of social care.

We are all of us used to the art of planning. Whilst there are occasions and moments in our lives which happen ‘out of the blue’ and by ‘happenstance’ most of the major events of our life involve a degree of planning. Be it the birth of a child, getting married or moving into a new house, planning is part and parcel of an event’s positive outcome and success.

It wasn’t for nothing then that planning was considered to be intrinsic to the art of successful political leadership. Benjamin Franklin (one of the greatest US Presidents) once wrote: “By failing to plan, you are preparing to fail” and another great strategist Winston Churchill stated: “He who fails to plan is planning to fail”.

An examination of both their writings shows the extent to which careful, meticulous, and methodical planning was intrinsic to the successes of their leadership whether militarily or on the political and domestic front.

The importance of planning has been to the fore of my mind this past week, and it has indeed been a busy one in terms both of politics and the world of social care but we are probably in these last days of October and given its 24 hours before the clocks go forward, at a key stage in both the meteorological season and in terms of the state of our social care system in Scotland.

We are also at that time of the political and parliamentary season when the gears go up a level or at least change. The party conference season is all but over (though the Scottish Greens meet today) and the curtains are being drawn on the political conference theatricalities with their usual mixture of aspirational optimism and depressive pessimism dependent on which party you belong to, which polls you are reading or which pundit you speak to. And of course, the party conference always grants the opportunity for those in government to pull rabbits out of unexpected hats in order to leave loyal followers feeling a bit more positive as they walk, drive or train into the approaching winter. In Scotland that has seen the bizarre and for me misplaced decision to freeze the Council Tax at a time when thousands are going without social care because of a lack of funding.

In the last week Parliament started to stir itself from its post-conference slumber.

For those of us in the world of health and social care, the annual joy which is the publication of the Scottish Government’s Winter Preparedness Plan took place on Tuesday last. Presented by the Cabinet Secretary for NHS Recovery (we now know why ‘social care recovery’ was not in the portfolio title) this work of seasonal solicitude comes this year with an empty budget and no additional resource – that is if you come from the social care world. But like all Halloween seasonal offerings it had its own mixture of fantasy and reality – the fantasy was that it pretended to be for the whole health and social care system, the reality was some extremely worrying failures to really understand the social care world and the very real crisis it is enduring.

But it has not been the only event this week because we also had the publication of the Real Living Wage and the announcement that from next April it would now £12 an hour. This recognition that those who are the lowest paid deserve a significant wage increase is to be welcomed but it poses a problem for the current Scottish Government.

Regular readers of this blog will know that for months – along with others- I have called for our First Minister and the Cabinet Secretary to come true on the promise to pay social care staff £12 an hour. A promise made in April 2023, only to be underlined 20 weeks later when it was announced that workers would have to wait till April 2024 to get that salary increase. And lo – instead of the intervention bringing real positive change, enabling organisations to retain and attract new staff through the summer, autumn, and winter – we are now faced with the reality that come next April there will be no additional benefit, no additional attraction for those thinking of staying or joining a social care organisation. A significant political misstep and own goal and before anyone opines that there was no resource available – let’s just say I am sick to the proverbial of the way in which this administration magics up money from invisible corners when others strike, protest or complain. There is resource – it is all about priorities and what is deemed to be of greater value and what is considered as of lower significance – and the social care world isn’t blind to that political and fiscal truth.

As the seasons change, we are going to be moving into a winter period which will bring about real challenge. We’ve already seen thousands spent by the Government on a campaign to remind people to make sure that they only try to access support from the right source at the right time when they really need it. Nothing wrong ordinarily with such messages but when a system is so fragile and collapsing, they have a ring of preparatory avoidance about them.

Then we have the actual winter plan. It is not a plan worthy of the name because to my mind at least (and dare I say for most people involved in contingency, emergency, and resilience planning) you prepare for an impending challenge by making sure (amongst other things) that you have all the data, all the information, all the facts available to you. This plan is devoid of reality because singularly in its development and political articulation it has failed to fully and realistically involve those who are going to be responsible for delivering the majority of social care provision. Now I have no problem in the public sector saying this is our NHS and public sector winter planning – but I do have an issue with the pretence that this is a plan which is for the whole system and that it has included all. At the risk of repetition nearly 70% of social care provision in Scotland is delivered by the third and independent sectors. A plan which does not include them, speak to their reality, address the challenges of their workforce is not a plan worthy of its name – it is a delusion, deceit and exercise in political spin-doctory.

The third and independent sectors do not have all the answers to the crisis of workforce, lack of integrated working, misplacement of resource, lack of preventative and community-based care and support – but asking us might just have helped. It is not too late – so Scottish Government could start to pay social care staff £13 an hour from now (working up to a Fair Wage); we could invest in community based homecare to ensure people really are able to remain independent at home for longer; remove competition from care and increase collaborative practice; pay the registration fees for all those wanting to enter the social care system (regardless of employer); remove requirements for qualification if you are in the last years of career and so on and so on. We are not short of ideas just a system and political leadership wanting or willing to listen.

I really hope the winter will be one which we get through without long waits at A and E, increasing delayed discharges, a rise in the number of people unable to access urgent social care, and a continued drain of workers from social care organisations. I really do hope the early signs I am seeing of delayed care packages; people being told they do not meet ‘emergency criteria’ and perversely care workers being laid off because of a lack of ‘work’! are not harbingers of what is to come. But the failure to include, involve, listen to, and learn from the social care sector does not give me much confidence.

Apparently another political leader, Dwight Eisenhower, this time said ‘”a bad plan is better than no plan”. That may be true philosophically but the quality, naivety and lack of whole system thinking of the Scottish Government and COSLA’s Winter Preparedness Plan 2023-2024 is leaving most of us in social care extremely anxious about the weeks and months ahead.

Donald Macaskill

I’ve been spending the last few days in Skye where as many of you know my family originally came from and where I still have close relatives. It is always good to return ‘home’ and to catch up with folks, explore parts I do not know and get on with some tasks. It is an escape from my world of work into a place that simply possesses another rhythm and pattern of living to anywhere else I know. In October the seasons meld into one another on Skye but this time despite the robust winds the weather has been glorious, and I have rarely seen the place look more beautiful and awe-inspiring.

Yesterday with other members of my family I spent some time re-painting the lettering on a family gravestone. Might seem an odd activity but it was both rewarding and humbling to spend time in making sure that the names and memories of my kin would be visible despite the Atlantic gales which sweep that part of north-west Skye. It was good to share stories, learn new things and be together. One of the people whose name I repainted on stone was my uncle Donald who sadly died in his forties now some forty years ago.

Donald was my mother’s only sibling which in itself was an unusual fact in a Hebridean family pre the Second World War. His birth was difficult, and it resulted in him developing some learning disabilities which included a stammer and stutter that more pronounced the more anxious he was. But I absolutely loved Donald as a child and adolescent and very much regret the fact he died when I was in my late teens. His instinctive knowledge of nature, of animals and the seasons was far more important and impressive to me than the fact he struggled to read and could barely write. His influence on me was marked not least in that I became aware through the time I spent with him how much he was the victim of bullying and harassment because of his disabilities and especially his stutter. Although at times he found communication difficult what was certainly the case was that with patience and interest anyone could communicate with him and vice-versa. Sadly, not all people showed him such patience. Far from it. He had a manual job and one of his foremen made his life a simple hell with constant mimicking of his speech and other behaviours which today would have resulted in dismissal. But not then. The truth was that though Donald tried to hide his upset I knew how much it hurt him to be the victim of such belittling inhumanity and to be continually the object of another’s derision and amusement.

I thought a lot yesterday about how hard his life was as I re-painted his name on his gravestone. So, it was with some sense of synchronicity that in searching as I often do for what is happening in terms of the global calendar of events and occasions that I found out that tomorrow is Stuttering Awareness Day.

Organisations like the Scottish Stammering Network use the day to raise awareness of stammering and also to challenge and address some of the stereotypes and presumptions which exist around this remarkably common condition. They and other groups are well worth exploring not least if you are involved in the world of social care and support where many individuals who receive services and support in their own home or in a residential home live with stuttering or stammering.

Stuttering or stammering is a disruption in speech pattern involving disruptions, or dysfluencies, in a person’s speech, but there are nearly as many ways to stutter as there are people who stutter. Yet like so many conditions it is often misunderstood. It is now widely recognised that stuttering is a neurological condition which impacts and influences the production of speech and the use of language. But as with my uncle so many presumptions are made about people who stutter, and they are often the victims of discrimination and inappropriate treatment. In addition, the impact of such behaviours upon the self-esteem and self-value of those who live with stuttering can often be very negative indeed.

In exploring a world, I knew so little about I discovered that there are many myths and misunderstandings around stuttering, including amongst other things that:

‘Because fluent speakers occasionally become more disfluent when they are nervous or under stress, some people assume that people who stutter do so for the same reason. While people who stutter may be nervous because they stutter, nervousness is not the cause.

Emotional factors often accompany stuttering but it is not primarily a psychological condition. Stuttering treatment/therapy often includes counselling to help people who stutter deal with attitudes and fears that may be the result of stuttering.

Adults and children who stutter may sometimes be hesitant to speak up, even if they are not otherwise shy by nature. People who stutter can be assertive and outspoken, and many succeed in leadership positions that require talking.

Although the manner in which people stutter may develop in certain patterns, the cause of stuttering itself is not due to a habit. Because stuttering is a neurological condition, many, if not most, people who stutter as older children or adults will continue to do so—in some fashion—even when they work very hard at changing their speech.’ (see About The NSA – National Stuttering Association (westutter.org))

It is estimated that perhaps one per cent of the total global population stutter but that perhaps as many as 5% of all children go through a period where they stutter. It is also generally accepted that stuttering is more common among males than females. In adults, the male-to-female ratio is about 4 to 1; in children, it is closer to 2 to 1.

In other words, these are remarkably common phenomena. It is therefore really important that appropriate support and resource is identified to addressing the issues of those who stutter or stammer.

I leave you with a poem written by Natasha Foster called ‘Lighting Candles’ . Natasha wrote of the poem:

“Sometimes I have felt that my stammer stole the words from my mouth, but in writing, I can express things as I want to. There are losses and gains connected to having a stammer, and I tried to reflect that in my poem.

‘I called my poem ‘Lighting candles’ because when I’m open about my stammer, and share my experiences, I like to imagine lighting a small candle of awareness in others. I find motivated to think of increased ‘light’ being shed on the subject, and how this might help me, and others like me, who stammer.”

LIGHTING CANDLES

Knotted words

Angry Heart

Shame and pain

A faltering start

A sense of grief

At a life a bit bashed

By a loss of speech

Some opportunities dashed

My stammer is my uneasy friend

One that will probably stay till the end

City Lit, Stamma, and my fellow peers who know

Helped me change my thinking, learn and grow

I’m working on being a woman of pride

My stammer lives within me, part of me,

By my side

I’m free to speak with a stammer

And share who I am

My person, my experience, my spirit, I can!

Unknotted words

Thankful heart

Self acceptance and hope

Every day is a new start.

(Taken from Poem: ‘Lighting candles’ | STAMMA)

Donald Macaskill

In just under a month on the 1^st November the working group which published Scotland’s Bereavement Charter for Adults and Children will be holding a webinar entitled ‘The Space Between: understanding anticipatory grief.’ You can sign up for it and get more details here. On the day we will hear from invited speakers who will reflect on the loss of a parent, the loss of a child and sibling, and the loss of a loved one who you have cared for. The day will also see the publication of the refreshed and updated version of the Charter Guidance document which contains advice and guidance on grief and bereavement. At this time there will be a new section focussing on anticipatory grief.

The phrase might seem a bit strange or alien to those who are not part of the bereavement and grief support world. Sadly, however I suspect the experience of anticipating grief will be all too familiar to many of us.

Anticipatory grief is variously described but in essence it is the grief which starts before someone dies. It is a grief which is often not talked about and sometimes people can be made to feel guilty if they talk about the loss of someone who they know is going to die. So, they shut up and dismiss their feelings. Yet for many of us who have known a loved one who receives a terminal diagnosis like cancer or who has been diagnosed with a condition such as dementia, the grieving can start there and then. It can be terrifyingly immediate and overwhelming. All the lost dreams and possibilities, all the dashed hopes and aspirations, all the places unvisited and the plans unfulfilled. Knowing that someone you love and care about is going to die is a waiting which paralyses the soul and empties you of the few tears you may have left.

My twin brother died from cancer close to 6 years ago and it has taken until now for me to mention that truth in this weekly blog despite all the writing and speaking I undertake on grief and loss. Many twins reading this will recognise that there is often a connection between twins which you feel to be unique and special. It might not always be easy, and distance and the passing years might lessen it, but growing up so inter-connected with another person from the first moments of life onwards can make the sense of grief all the sharper and more painful. And in truth having spoken to a few twins it is a grief that is rarely talked about or shared.

After my twin’s death one of the most challenging series of statements I had to deal with came from those who said things like ‘it was good you had time to prepare’; ‘at least it wasn’t a sudden death’ or ‘you’ll be content that he is at peace now.’ There is a grain and a morsel of truth in some of those sentiments, but their uttering is a dagger to the heart. I know I am not the only person who has heard such words. So many people today will have recently experienced the death of a loved one who they knew was going to die … but we always hold onto the hope, the dream that they would have more time, that there would be more space to make memory and build togetherness… and yet it was not to be. There is no peace in waiting for hurt.

Waiting for someone who means so much to you to die does not prepare you it exhausts you. Waiting for death to come does not make the emptiness of absence any easier it makes it feel even more hollow. Waiting for death does not make the sheer sorrow of the moment any less raw and real.

Years of working and being amongst the dying and the grieving has taught me how little I know about living and dying. But one lesson whose truth I sense as authentic is that grief is not a moment but a series of memories; it is not a task to be undertaken and fulfilled, but a work to be struggled with for what seems forever. It is a journey whose destination is unknown and whose completion is ever in the future.

Maybe that is what those who are anticipating grief and those who are living through it share. A sense that we are changed because of the love we feel for another here and yet absent, present and gone. For they have riven us through with their loving and we are moulded into who we are by our knowing of them.

As for my twin, I think about him every day – like so many bereaved I hear his voice, sense his presence and catch myself wanting to talk to him; I hear his laughter and his passion; I want to pick up the phone and tell him my news or just hear his voice again. To just have another minute to say what was left unsaid and to say a proper goodbye knowing in truth that I could never finish the sentence of love in any time of minutes and hours. Even as I write this, I can feel the shiver inside my body. Grief sits with me, and I have grown used to her presence, but it is one that continually empties me of energy. So, no I cannot accept the experience of some that knowing about the inevitability of death, that anticipating it, prepares you for the reality.

As many of you know I find solace and escape in the reading of poems. Sometimes I find myself coming across esoteric and rare poems. One such which I recently discovered was in a famous group of poems in the tenth-century manuscript known as the Exeter Book. They are stunningly moving medieval reflections on isolation, loss and grief. One of the most famous is called (in a modern translation) The Wife’s Lament, and speaks of the loneliness felt in summer day, a loneliness brought about by isolation and grief. It introduces to the reader a word ‘uhtcearu, a compound which means ‘pre-dawn-sorrow’, ‘grief at early morning’. In Old English uht is the name for the last part of the night, the empty chilly hours just before the dawn, and so a particularly painful time for grief and loneliness.’

I resonate so much with that sense of uhtcearu because for me at least it is in the last hours of night, when the world is still and strangely silent, that loss feels more intense and memory of those not with me seems to settle in beside me, both to soothe and in love to call me into another day. As we anticipate the dawning of the day we move our grieving heart to face the light of another absent day and we know the task of living through memory is to mould our lost love into a new beginning, however hard, every day. But the morning only comes if we allow the uhtcearu.

Donald Macaskill

Dr Eleanor Parker from Oxford University has written a brilliant piece on the Wife’s Lament. See The Wife’s Lament. A Medieval Poem about Isolation | TORCH | The Oxford Research Centre in the Humanities

Photo by Abbas Tehrani on Unsplash

This coming Tuesday (10^th October) is World Homeless Day. It is also a day on which for some time World Mental Health Day has been held. The occurrence of both these awareness days on the same date is perhaps not accidental because sadly there is often a close relationship between mental ill health and the causes of homelessness for many people.

World Homeless Day’s primary purpose is to raise awareness of the serious issues faced by the homeless population globally, as well as giving a focus to some of the issues which can act as a cause of homelessness.

This past week I was speaking with a former colleague who is now working for a charity that supports people who are homeless. I was reflecting with them that from my own awareness there seemed to be more rough sleepers in the centre of Glasgow when I walked through the city than I could remember for some time. It would appear that personal observation is not an inaccurate one. I was also struck by an observation he made which was that he and colleagues are seeing more and more older people becoming homeless and that older people’s homelessness is often ‘hidden and hard’.

According to a report from Shelter there are around 300,000 people across the United Kingdom who are currently experiencing homelessness. In Scotland a Scottish Government report at the end of last year highlighted the growing extent of homelessness which is indeed on the rise, increasing 10% from previous data.

One of the particular issues which interests me personally is the growing number of older persons who are becoming homeless. This is the hidden homelessness my ex-colleague referred to. Indeed, one of the first people I ever met in a residential care setting was someone who had spent a great deal of his adult life being homeless. By the time I had met him he was in his late seventies and bore all the scars from years of living rough, or time in various hostels and temporary accommodation settings. He found himself in a care home supported by understanding staff and fellow residents and perhaps for the first time in a long time having his specific needs addressed in an inclusive and positive manner. He had first become homeless as a result of a relationship breakdown and from personal mental health struggles and had found it increasingly hard to both get a job and to get himself out of the spiralling addictions which had become his lifestyle. Over the years it has become clear to me that many residents in our care homes have lived with chaotic lives up until that time.

Whilst the Scottish Government report last year highlighted that the majority of those who are homeless are under the age of 49 there is still a sizeable group (some 12%) who are over 50. It also showed that older people often fail to maintain accommodation (frequently in the private rented sector) as a result of physical as well as mental health issues. Yet this older group is least likely to take up the opportunity of temporary accommodation.

Age UK has argued that it is important for our older age citizens that we recognise that homelessness does not just mean rough sleeping. It can equally be circumstances where an older person does not feel that it is safe to remain in their own home or has been forced out of their own place because of family or community breakdown. It can also be the case that the death of a partner or a spouse can make someone homeless. Sadly, we are also increasingly aware that the cost of living crisis has prevented some people from maintaining their homes to a standard that makes them safe, and even more common that a developing or new disability or illness makes someone’s home no longer suitable to meet their needs.

As we move into autumn and winter many of us are concerned that the homes of many of our older citizens will not be fit for purpose and that many older Scots will join the growing numbers of those who are in reality homeless even if they are not noted in the official statistics. Despite record figures being reported in the media of those being made homeless in Scotland, as Citizens Advice Scotland have stated this may only be a fraction of the true story:

‘Citizens Advice Scotland spokesperson Aoife Deery said: “This is the horrifying impact of the cost of living crisis and the housing emergency. There is a serious risk these figures are the tip of the iceberg, as people can’t keep up with essential spending.

“Across the Citizens Advice network we have seen that advice on actual homelessness has been growing as a proportion of housing advice for the past few months. In fact, homelessness advice in December 2022 was up 34% from December 2021 as a proportion of all homelessness advice.”

I hope we can all of us this coming Tuesday and in the days and weeks to come reflect on the issue of homelessness in our communities, and most especially to think of older people and the reasons they may become homeless.

In so doing we might ponder the words of Ian Macmillan who wrote in last year’s Big Issue for last year’s World Homeless Day:

A Shakespearean Sonnet About Doors by Ian McMillan

It’s not much to ask. Just a door to lock.
A door that won’t break when someone kicks it.
Door with a keyhole. Respond to that knock
Or not. My choice. It’s broke so let’s fix it:
The world, I mean. Not the door. That’s ok.
It’s my door, to my room. Look: here’s the key.
The world, though. That’s different. Somewhere to stay
Is what we all need. Somewhere to be me
And not just someone you blithely ignore
When you see me sleeping on the street.
Let’s begin with this. A door. Just a door
To start with. A door. Food. Then light and heat.
The world must respond to this simple truth:
Let’s all have a door. Let’s all have a roof

National Poetry Day: Read this exclusive poem about homelessness by Ian McMillan – The Big Issue

Photo by Jon Tyson on Unsplash

Donald Macaskill

Whenever I am with a group of people who come from outside Scotland one of the commonest questions I get asked – as I am sure we all do – is “Where do you come from?” I have to confess it is a question I have often struggled to answer and have probably given contradictory and different replies over the years.

“Where do you come from?” might simply be a request for geographical birthplace origins but it is so much more.

For me the answer is I was born in Glasgow and lived there in my formative years, then returned again as an adult. But as I walked the streets of Partick, or learnt academic lessons at Gilmorehill, or experienced life’s lessons through the delights of the city’s west end, there were undoubtedly times when I felt ‘at home’ but I’m not sure I ever felt it was the place ‘where I was from.’ That for me is the place where you feel that you truly ‘belong.’

Belonging is an intriguing concept. It can be the space that you call home, the physical bricks and mortar that offers shelter, security and nurture. But it can often be the place that yearns deep within you. For me it has always been closer to the places I sense in my blood – most especially Skye where my parents came from, where I spent every holiday, I had up until my twenties, and where even today after months and months of absence makes me feel different when I arrive there. And lest you think I’ve swallowed a dose of romantic escapism – I don’t think belonging necessarily is always positive or comfortable it can also be a place that unsettles, contradicts and challenges- but it is through all that a place that pulls you into itself and which possesses a magnetic irresistibility. Memory of place can both heal and hurt.

The role of place and the nature of belonging in our character and personality has long been recognised to be of psychological significance. Where we are born and where we live matters on so many counts; where we feel we belong aids our wellbeing and this is perhaps especially true as we age and grow older.

Tomorrow is the annual United Nations International Day of Older Persons. It is a day when we are all encouraged to think about key issues for older age across the globe but most especially in our own communities and nations.

One leading organisation, the Centre for Ageing Better, has chosen this year to focus on the integral role of older people to their place, and the importance of place to ageing well. Like many age-friendly organisations their work is in part grounded in their knowledge and awareness that the place where we live has a huge impact on our wellbeing as we age. So this year they are focussing on the need to celebrate ageing in our community’s past, present and future.

As they state:

‘This year’s IDOP theme encourages people to get curious and be proud about your place; to come together across age-groups to discover your place’s past, to celebrate the diverse range of people and places making yours a great place to age, and to commit to make changes, so more people can enjoy good later lives in your community – now and in the future.’

The ageing-in-place agenda posits that the preferred environment for older adults to age is in the community, where they can remain active, engaged, socially connected, and independent.

So how are we doing? Are we helping people to stay in place? What are we doing to make our streets and communities really inclusive of older age? This is both about the physical and built environment but also about attitudes which include, value and recognise the contribution of older age citizens.

Yesterday I walked through the city centre of my old ‘home city’ Glasgow and by my personal assessment it is not a space that is truly inclusive. Pavements which appear to prioritise cyclists but confuse citizens as to where they should walk or be; on street shop display boards that challenge someone who uses a wheelchair or who has a visual impairment; graded and stepped areas which are an invitation to slips and falls; and pedestrian crossings requiring the speed of a Usain Bolt to get across in time. A frantic, busy commercialism that seems detached from the patience and pace required to support customers living with dementia or simply with the frailty of growing old. Now I don’t want to be banned from entering Glasgow – I could just as easily have mentioned Edinburgh, London or Newcastle. The cities I’ve been in recently simply do not strike me as having prioritised ageing in place.

I think we could and should do so much better. If we are going to take ageing in place seriously we have to recognise as a whole society that we have a long long way to go. And it makes both societal and economic sense not least as the relative disposable income and spending older citizens dwarfs any other age group. But put simply our city centres have excluded themselves through urban planning which has not been age aware or sensitive.

Our population is ageing and in a decade its composition will be very different from what it is today. We need civic leaders to take ageing seriously and not as an afterthought; to create urban communities that foster belonging and equality.

But we also need there to be a wider political recognition that ageing in place with all the benefits that brings to the citizen and to the wider health economy does not just happen by accident but it has to be adequately resourced. It’s not just the physical environment that discriminates against older age.

The stripping out of funding for community based third sector groups; the lack of sustainable support for homecare organisations which foster continued independence, and the hollowing out of support for respite and older persons day resources and services are making it an uphill battle for older people who want to continue to belong to their place to remain where they want.

As the Centre for Ageing Better make clear:

‘ simply changing the built form is not sufficient to create a more inclusive environment for ageing since places are more than physical spaces. Viable environments are articulated through a strong sense of place, defined as the social, psychological and emotional bonds that people have with their environment. A strong sense of place results from having access to supports for active participation, opportunities to build and sustain social networks, and assuming a meaningful role in the community. In contrast a feeling of displacement or ‘placelessness’ is associated with alienation, isolation and loneliness, often resulting in adverse health and well-being outcomes, particularly amongst vulnerable older adults.’

Being able to age where you want should be a fundamental right of citizenship in our communities or we are at risk of creating ghettos of demography.

We all of us need to be given the tools and resources which enable us to belong in the space we choose to be.

This place has grown old with me, its ground has held my feet, its grass has cradled my belonging, its hills have nurtured my hope; its rivers have soothed my dreaming; its streets echo with the laughter of memory, its doors open up to new conversation; it’s where I want to become young in my older age.

Donald Macaskill

Photo by George Hiles on Unsplash

I have been thinking a lot in the past week about inclusion and what really makes people feel that they belong, are valued, heard and taken seriously.

I am fortunate in that for the last six years I have served as a Director on the Board of a UK non-profit organisation called the National Development Team for Inclusion (NDti). NDTi states in its own self-description that as an organisation and group of people that they ‘want a world where everyone matters.’ And that their ‘work helps create opportunities for independence and choice for everyone…(their) passionate and committed team raises aspirations and outcomes for children and young people at risk of exclusion, people who have a learning disability, autistic people, older people and everyone’s mental health and wellbeing.’

Having witnessed so many of the amazing cutting-edge programmes and pieces of work undertaken at NDTi, I can attest to the truthfulness of the mission statement being worked out in action. At the heart of what they do is the emphasis on inclusion, on ensuring that those ‘on the edge’ do not drop out of our perception or disappear from our notice. It is also the sense that inclusion does not just happen by accident but through determined focus, action and energy. The recognition that we live and work in a diverse world, where difference is celebrated and valued is one thing. But inclusion is more than the recognition of diversity, it is positive action and active steps taken to enable all to be valued, heard and given a place and space so that power can be held and choice exercised.

This coming week across the United Kingdom employers and many organisations will be thinking about what it means to include people who work in their organisation or indeed what it means to deliver services and supports that are fully and truly inclusive. That is because National Inclusion Week 2023 runs from the 25th of September to the 1st of October. It is a week run under the auspices of the organisation Inclusive Employers which is the UK’s first membership organisation for employers looking to build inclusive workplaces. Their work is well worth a look.

They get to the heart of inclusion and indeed talk of inclusion when they state:

‘Inclusion is a broad subject and is a term that trips off the tongue of many. However, people have different understandings of what the word means.

Cambridge Dictionary’s official definition for inclusion is:

“The act of including someone or something as part of a group, list, etc., or a person or thing that is included.”

Simply put, inclusion in the workplace is about ensuring that everyone feels valued and respected as an individual.’

I used to deliver a group exercise when I was a freelance trainer years ago in which I asked people what it meant to them to feel that they were included. They went beyond dictionary definitions to talk about feeling valued, being heard and listened to, being noticed and having a sense of importance; of not being rejected when they made mistakes or were not behaving as well as they might wish; they spoke of people seeing beyond labels, stereotypes and reputations. Most of all they spoke about feeling that they ‘belonged.’ But they time and time again commented upon the truth that inclusion was not easy, it had to be worked for and often that task took many years.

It is maybe a happenstance of timing that today is also the United Nations International Day of Sign Languages. There are few groups or individuals who are more excluded from our communities than those who are deaf or hard of hearing.  In 2018 I wrote a blog  called The Right to be Heard about the experience of so many who were receiving care and support from social care services but whose hearing issues and challenges were not always recognised or prioritised. Indeed, it was then and still is now clear to me that as a whole society we do not work sufficiently hard to include those who are deaf or hard of hearing, and that that lack of priority worsens when people age and get older.

I said then:

‘To be excluded because you cannot communicate, to be shut out because people do not understand, to be ignored because you are not valued and recognised … that must surely be real emptiness and abandonment.

Yet that is precisely what the day-to-day experience of tens of thousands of our fellow Scots feels like every single minute of every day. They are excluded because we have created a distance which separates them from us and us from them. We have failed to hear and allow people to be heard and thus the distance has grown into a divide.

I have, to my shame, only recently become as fully aware of the enormous extent of hearing issues facing the population of Scotland. The fact that in Scotland 40% of the population over the age of forty, 60% over the age 60 and 75% over 75s experience some sort of hearing difficulties I was wholly unaware of.’

The United Nations states that according to the World Federation of the Deaf, there are ‘more than 70 million deaf people worldwide. More than 80% of them live in developing countries. Collectively, they use more than 300 different sign languages. Sign languages are fully fledged natural languages, structurally distinct from the spoken languages.

The Convention on the Rights of Persons with Disabilities recognises and promotes the use of sign languages. It makes clear that sign languages are equal in status to spoken languages and obligates states parties to facilitate the learning of sign language and promote the linguistic identity of the Deaf community.’

More recently I have come across some amazing examples of sign language poetry and deaf poetry which as genres are emerging into mainstream poetic appreciation and are very dynamic in form and style. They are poetic expressions in a language rarely understood which speak to issues of exclusion and discrimination. Whether as employers, as providers of care and support, as citizens and members of communities, as friends or family, we all need to become more aware of the glorious diversity of sign language and the inspiration which is ours to receive from those who are deaf and hard of hearing. Inclusion for all does not just happen it needs to be worked at , it is a task of both hand and heart.  All this is brilliantly expressed in the poem ‘My Hands’, by Stevie Drown:

Then I looked into the mirror and
Saw the good this looking back,
I had to take the positives–
Put them on the right track.

I thought a lot about it
And now i want to shout,
The wondrous gifts God gave me
Outnumber what He left out.

So let me take the challenge
In meeting life’s demands–
I have the power to change things,
And it lives here in my hands

For a wider discussion of poetry and sign language poetry see  American Sign Language (ASL) poetry (lifeprint.com)

Donald Macaskill

Photo by Sharon Waldron on Unsplash

I’ve been thinking a lot about dementia this past week in no small part because Thursday (21^st) is World Alzheimer Day which is an annual opportunity for the global community to reflect on the extent and impact of Alzheimer’s and all dementias upon our lives and on those around us.

I’ve spent the week at meetings including opening talks on re-shaping the cost model for care homes, as a member of the Alzheimer Scotland Long Term Care Commission, as a member of the Reference Group involved in drawing up Scotland’s next palliative, end of life and bereavement strategy and visiting a Glasgow homecare provider celebrating its 10th anniversary. In each and every one dementia has been in my mind.

On the edge of one such encounter I started to chat to Jane. She spoke to me this week about her husband whose Alzheimer’s is getting progressively worse. He was very unsure about venturing out, had lost a lot of confidence and his moods were increasingly unpredictable. Jane like countless thousands of family carers was knackered. She remarked that her husband when they went out nowadays always said ‘Give me your hand …’

Any parent reading that phrase will doubtless remember, as I do, the changing pattern of hand-holding which is the mark of childhood progressing into age. To begin with in nursery and early primary school there was almost an automatic nature to hand holding. A small hand patterning the need for reassurance and comfort would reach out to take yours. The sense of touch and comfort infused both. Then as the years went by the suggestion that not holding hands when others were about eventually gave way to dropped hands and ‘adult’ non-contact accompaniment which in turn disappeared as independence made parental walk redundant.

I was reminded of all this as Jane spoke to me about how her husband now reached out to hold her hand, to seek comfort and reassurance, to search for safety and the known in the troubling which a disease like Alzheimer’s brings to those who live with it and who love through it.

Give me your hand …might well be the call of those around Scotland living with today with Alzheimer’s disease. An invitation made to national Government who must surely start to right the wrong which has inflicted thousands whereby they have to sell all they own to ensure their loved ones are looked after in a care home. The Alzheimer Scotland campaign for fairness and yet the words of many like me continue to fall on deaf ears and unresponsive political reaction.

And lest my usual critics reply that self-funders are getting ripped off – the reality is by all independent assessment the true cost of nursing home provision in a nursing care home is around £1200 to £1400 which coincidentally is what most local authorities charge self-funders. Yet the rate the State pays is only £888.50 for a week of nursing care and £762.62 a week for residential care. If nothing else only £126 a difference when nursing is 24/7. Those doing the alleged ripping off are our political leadership of all colours and in most contexts.

Give me your hand … might well be the call of those frontline care staff promised £12 an hour by our First Minister in April 2023 and then told 20 weeks later that they would eventually get it from April 2024. Many are trained specialists in dementia care and support and hundreds every month are leaving the world of social care because of the perceived sense of devalue. Comparisons are rarely helpful but as one dementia carer said to me two days after the First Minister said wait till April the Scottish Government announced a pay increase for the police of 7.5% (and well deserved I’d say!) but far from having to wait till next April it’s being backdated to last April! That is economic and budgetary decision-making which prioritises some over another – simples!

Give me your hand …might well be the sentiment of those who are meeting yet another new carer in their home because the provider organisation that delivers the care and support either cannot recruit and so has to use agency staff or is stretched so thin that continuity and continuous care – so important for someone living with dementia – becomes impossible.

Give me your hand …might well be in the minds of those who live in care homes and all their families as yet another care home gives notice that it needs to close because of the inadequate level of public funding – the valued and excellent Erskine charity is having to shut down part of its provision. And yet central Government states it is not its issue but that contractual arrangements are between local government and providers. An ignoring of fiscal truth and public duty if ever there was one.

Give me your hand … might well be in the minds of the wider population as the Census returns this last week highlight the fact that over the last decade that the older age population in Scotland has grown by nearly a quarter. Let’s celebrate that reality of longer living rather than proffer talk of burden and challenge – but at the same time as we value later life living let us make sure that those who live with dementia in later life in Scotland can belong to a society and nation that really walks the talk of equality and human rights rather than pay lips-service to its most valued citizens in their older age.

Give me your hand is one of my favourite poems of Iain Crichton Smith who I often mention here. It describes the changing seasons of love and loss and might well be a descriptor of the autumn of living that many who live with Alzheimer’s go through. I hope as we travel through this autumn that somewhere sometime somehow our leaders in the civic realm will reach out a hand to hold up those who desperately need it and who live with all dementias.

Give me your hand.

Give me your hand.
The autumn has come.
We will walk under the trees in the one light that

is single as steel.

The trees are without crowns.
They have lost their silks.
The queens have left us.
They are without gowns, naked to the weather.

Give me your hand.
The cold has come.
You will feel in your bones that shiver of zero,

that posthumous kingdom.

The trees are like thermometers shining and

visible.
No sap is seen in them.
The sap has descended into the earth.

Give me your hand.
We are like children in an old story written by

Hans Andersen in the autumn.

 

Taken from ‘Modern Scottish Gaelic Poems’, Canongate Press, 2009.

Donald Macaskill

I am writing this a few hours after the end of the Global Ageing Conference which has been taking place in Glasgow over the last few days. The event was held under the auspices of Scottish Care, the National Care Forum and the Global Ageing Network. It brought together hundreds of individuals from close to 50 countries to explore issues of aged care and support, ageism, technology, sustainability and so much more. The debates and discussions were lively, and challenging.

Yesterday morning there was a particular focus on human rights and participants were privileged to hear a presentation from Dr Claudia Mahler, the United Nations Special Representative on the Enjoyment of all Human Rights by Older Persons. I was shocked to learn that the role of older person’s rights was so marginal in the world of the United Nations. I had known that age was not mentioned in the UN Declaration of Human Rights now 75 years old. I had also known that there was no distinctive Convention (as there is for disabled persons or children) to protect the rights of older people, but what I did not know was the limited extent of current day priority for older person’s rights. Indeed, Dr Mahler noted that only 0.5% of recommendations from the United Nations directly related to older people. To be frank this is both shocking and appalling given the proportion of older persons in the population of most countries across the world.

The previous day attendees were inspired by a presentation on the challenge of age and the potential of older age by the distinguished thinker and strategist, Prof Sir Geoff Mulgan. I have already referred to Geoff Mulgan’s work in this blog. In his opening remarks Geoff Mulgan spoke about the way in which the city of Glasgow had been transformed over the years since his first contact with it in the 1980s. He suggested that this was evidence of the way that change can happen but perhaps not always overnight or in the short term. In doing so he remarked on hearing the inspiring words of the trade unionist, Jimmy Reid and his speeches. Prof Mulgan’s reference made me look again at the work of Jimmy Reid, not least his famous Rector speech.

Jimmy Reid was a shop steward at the Upper Clyde Shipbuilders (UCS), and as such he opposed the proposed withdrawal of subsidies by the then Conservative government. This would have led to the closure of most of the business and the loss of 6,000 of the 8,500 employees. A work-in resulted which was an alternative to the withdrawing of labour during a strike.

Reid was elected as Rector of Glasgow University by the then student body in October 1971 and delivered a famous speech in 1972. It became an overnight success after it was published by the New York Times and is considered one of the greatest of all political speeches. Based as it was on the Marxist idea of alienation. One famous passage lamented the “scrambling for position” in modern society and stated that the “the rat race is for rats. We’re not rats. We’re human beings”.

 

Reid spoke about the way in which the working people of the yards and city ahd been alienated from the political leadership of the time; how the poor had been alienated from the exercising of their rights and that this was a denial of their humanity and equal dignity.

I hesitate to suggest that had Reid been delivering his speech today he might have used the language and framework of human rights to make broadly the same observations. But in truth I do think that there is at present an alienation of older persons from civic and popular society, not just in Scotland but elsewhere.

A survey carried out by Age Scotland and published in the last few days showed that more than two-thirds of older Scots “do not feel valued” by society, evidencing a sharp increase in the number of older people feeling that life has got worse for them. Two-thirds of people over the age of 50 said they don’t feel valued by society, up from 51% in 2021 to 66%, and more than half (56%) felt life in Scotland was getting worse for older people, up from 34% in 2021. These are depressing and alarming statistics and reflect badly on Scottish society and our political leadership.

I think there is validity in saying that older people are increasingly feeling alienated from the society and communities in which they find themselves. The prevalence of ageism and age discrimination, its societal and cultural acceptance and normalising speak to the heart of our current human rights debate.

Those who framed and shaped the original human rights legislations and frameworks emphasised the inherency of dignity as the starting point for a consideration of being human in relationship with others. But how can you feel a sense of dignity or experience worth and value if you are alienated from all that grants those sentiments and feelings to you? How can you hope to be heard and understood if you are denied voice and action? How can you make your presence felt and your needs known, if you are excluded and granted no presence?

That is why I believe that internationally the time has long since come for there to be a United Nations Convention on the Rights of Older Persons, in order for all governments and public or private bodies to be held to account for actions or inaction. That is why I believe that the time has come in Scotland for us all to support the campaign for an Older Person’s Commissioner.

‘The time for older age has come’ was the comment of one of the delegates from India who spoke this week. Alienation only ends when justice and equality regardless of age, class or circumstance sits at the heart of our being in relationship with one another.

 

Donald Macaskill