The following blog is the text of an address given on the 28^th March 2023 at the Luminate ‘Arts and Ageing’ Gathering at the Festival Theatre in Edinburgh.

 

When I was asked to say a few words at the start of this event I did I have to confess wonder what I could say that I haven’t said already to a good number of you over the years – and although I’m a great believer in re-cycling I thought I should at least say something new lest I fall foul to the accusation that with age comes the repetitiveness of remembrance. That’s not to say that what I have said in the past isn’t worth repeating – he says defensively – indeed at the start of this contribution I want to underline a challenge I have often given – especially on the first full day of a new First Minister.

I want to ground all that I say in a few minutes in the earth that the human right to creativity, the right to self and artistic expression, is a fundamental human right. And we need to see that right visibly and vocally articulated in the new Scottish Human Rights Act when it eventually appears. This is not the stuff of occasional opt in, less important than other interventions, do when you can or when resources allow – all that we do today and reflect upon is as fundamental and as intrinsic and as critical as the adequate resourcing of the rest of our civic and individual belonging.

But I have decided to hang some reflections this morning on the words of invitation to join this event – because for me – amongst other things the arts and ageing are about exactly what we hope to get from the event today – namely connection and inspiration and reflection.

Connection is intriguing especially for us solitaries in the room. Yes, I recognise in the words of the poet that no one is an island and that we are all part of the main – but I’m sure I’m not the only one who you know sometimes just wants to be alone! I want to find that corner in the room that encloses me in the security of encounter on my own terms.

I was chatting to someone contemplating going into a care home recently and the one thing that was putting him off – was the thought he would have to be with people 24/7 – that there would be loads of groups and forced camaraderie. That there would be no place for privacy to hide to take off the mask of pretence we all show the world and simply just to be! Now of course that’s a stereotypical fear – and I’m with him – but the truth is much more complex and subtle.

The creative arts whether they are used in care facility or community setting; in one’s own home or in your local – do indeed have the potential to connect, to meet loneliness and break down isolation but they also have the capacity to offer privacy, to help you to discover your individuality and become stronger in your sense of self and identity – in truth the arts are for both islanders and mainlanders.

When I think of connection the image that comes to mind is Avril Paton’s Windows in the West – you probably know it – as someone brought up for many years in a Glasgow tenement it expresses for me what that uncoordinated accidental connection is and portrays the mess of living in community in all its glory.

I could spend a morning exploring the story behind each window, the children fighting, the lovers yearning, the couple settled into slippered age, the partners re-designing avoidance, and so on  – it’s a painting that for me represents a deeper truth about connection, living in community and in proximity with others;  the truth is that people who come together under the canopy created by the creative arts are able to be empowered to be themselves, to live their lives anew and afresh, to choose to be in connection or apart. But always to be changed. The creative arts have both the ability to affirm individual identity and creative community, collective cohesion and passion.

Connection cannot be forced – you just create the moments for happenstance  – the creative arts are the hospitality makers of place and space that enable connection and which provide the nourishment to keep it going when the being one with another becomes tough and challenging.

So today as we connect to one another – can we also think about how we use our work to allow others to connect. Are we creating enough emptiness for connection to happen or are we predictable in our design of the moment; have we created enough silence for language to be heard or have we suffocated the echoes of personal story by intrusive commentary? Do we create the space and place for being in community and the even harder moments of nurturing the aloneness which is essential for connection?

Inspiration is the second expectation and hope for today. For those of us in this room the connotation of age with inspiration is self-evident and natural. We know that the art of imagining and the power of the imagination to restore and renew does not have a use by date. We have witnessed folks in very late age discovering for the first time or anew the power which the creative arts can bring to their sense of self, their image of the world, they have refreshed the person, people and community they want to be.

We have seen the moments of pure joy when someone discovers inside themselves the words they have always wanted to articulate; when someone paints the image that has struggled to take form and substance; when in touch and movement a new expressiveness is born, and a new story is told.

We know that just as it’s important to ask older people how they want to live in their future, so we need to make sure we are nurturing the imaginative dimension of human living and loving well into older age.

The creative arts at their best are the midwives of an imaginative birthing that brings new possibilities, unimagined dreams and unheard-of possibility to older age.

Even in the latter days of breath there is still a desire to be someone to someone; to do something new; there is still a yearning to find, to discover, to experience, to be changed and to explore.

The power of imagining the places beyond the known and the realities beyond the possible do not decline as we age. They just take a different form and more than anything they need the creative arts to foster and nurture their birthing.

But as Anne Gallagher in her opening address has challenged us are we in danger of making our art fit into a clinical science; to perversely limit the boundaries of creativity by being too focussed on outcome and discernible benefit; by using the metrics of identifiable and quantifiable science instead of the dynamic of experience and moment, intuition and instinct, encounter, and expression?

I have always and continue to believe that there is a massive primary nontherapeutic value in the arts – they are valuable in their own right not as something which improves one or changes you – and I know that there is a fine balance there – but when I listened to Mozart in my twenties, Springsteen in my thirties, Natalie Merchant in my forties, Taylor Swift in my fifties – my primary motivation was enjoyment and the experience – is there a danger I wonder especially in resource constricted times that we develop too reductionist an approach to the creative arts in terms of ageing?

And I wonder if maybe there is one specific area where more than any there is a risk that we turn our creative arts and their contribution into therapeutic value and outcome – and indeed that we are only funded and resourced where we can show benefit and improvement in a neurological and clinical sense – and that is in terms of dementia?

A diagnosis of dementia as most of us in the room will know is not a full stop in the grammar of creativity but a new paragraph – but we must be wary of the dangers of presumptive response – I think we must give space to be shocked and surprised – to be pulled away from predictable expectation and onto a journey with the person into new territories of the mind and landscapes of the heart. Life with dementia is not about maintenance it is about living to the full.

I feel an increasing sense that especially in the way in which we support people with advanced dementia that we spend too much of our time in the country of yesteryear – that too much focus is placed on memory and moments and experiences and tools of recollection and remembrance. There is clear neurological benefit in that – I am in no way denying that – but there is also clear benefit neurologically in enabling people to discover the new as well as re-discover the old, to create anew as well as to re-member, to begin afresh rather than re-visit – there is a warmth and comfort in the familiar but there is also a liveliness, an energy, a passion and joy in the new sound, the new place and in the new creation.

The last of the three themes is closely related to what I have just said, and that is reflection.

Reflection in older age is palpably different from the reflective snatches of living we have when younger – and so it should be – because to deny the reality of a life well lived is absurd. The pace slows and changes – rhythm finds a new beat and novel movement – but what glorious richness we have in older age!!! A lifetime of the raw clay of encounter and experience to be moulded into the creation of the present moment pregnant with time lived and lives loved.

We need to give people the opportunity to find their own expressiveness and to discover the language that may have lain dormant within them or indeed to have been deliberately suppressed because of negative stereotypical attitudes to the arts or the contribution and worth of the arts in society.

I think at times we are fearful; of leaving people who are older to reflect lest the pain of memory grip too hard – but there is nothing truly to be feared from the quietude of age; there is no coldness in the absence of activism; for so many it is in the space between the sounds that we learn to understand a new language, form a new way of looking at the world, and to feel restored and renewed in our own selves.

Conclusion

So active creativity has a unique place in the ageing of our society, in active, passive, accepting, challenging age. But we are not talking about waiting for the tick tock of finality as if we are passive recipients of the inevitable. No way.

I believe for all ages the creative arts are a call to purposefulness and decision. One of my favourite poets is the American Mary Oliver who in 2020 wrote in ‘The Summer Day.”  It is a rich poem which describes life and existence from the perspective of a grasshopper. It finishes with these words:

‘I do know how to pay attention, how to fall down into the grass, how to kneel down in the grass, how to be idle and blessed, how to stroll through the fields, which is what I have been doing all day. Tell me, what else should I have done? Doesn’t everything die at last, and too soon? Tell me, what is it you plan to do with your one wild and precious life?’

You will quite possibly have seen the last two sentences quoted in many places. But for me –  for later age the power of the poem is in the question

‘Tell me, what else should I have done?’

What else is there but “falling down in the grass, being idle and blessed, strolling through the fields all day.”

As others have argued this is a ‘provocative question. What is a purposeful productive day as you age? Is it not the contradictory wild impressiveness of the idle industry of a grasshopper? Is it not the creativity of the self for the single outcome of energising the moment? Is it not about the surprise of the encounter, the binding of belonging and the silence of reflection?

Everything dies at last Oliver reminds us – alas ‘too soon’ – the creative arts at their best I believe encourage us to live intentional and not accidental lives, to be the directors of our own play rather than actors for another’s text, to mould the clay of our being into the shape of our desire, to pen the language of our yearning and to dance the steps of our choreography.

What do you plan to do with ‘your one wild and precious life’??

That is a question for all ages.

The creative arts perhaps especially for older age more than anything I know pose that question every day and give the whisper of an answer in response.

Keep adventuring for you do not know the change and contentment, the joy and exhilaration, the pathos and the soothing you bring in the work you do. And let us today and all days connect, inspire, and reflect together.

Thank you

A video recording of this talk as it was delivered can be found at https://luminatescotland.org/resource/arts-and-ageing-gathering/

 

 

Dear next First Minister of Scotland.

I am writing this open letter to you all appreciating currently that you are very busy campaigning for the role as leader of the SNP and as a consequence as First Minister of Scotland.

You may not be aware that today is the last day of National Careers Week. It is a week where right across the country schools and colleges have been focussing on supporting young people and others to think about their next steps and future careers. In some senses for each of you the campaigns you are all now engaged are about taking your own careers to the next level.

You will therefore doubtless appreciate that the importance of helping young people and others who might be seeking a change in their job role or career is a key part of the work of organisations such as Scottish Care, representing as we do hundreds of charities, private providers and employee-owned organisations in social care who employ tens of thousands of our fellow Scots. As part of our month-long campaign #careaboutcare this past week we have been publishing videos and stories of those who work in homecare and care homes across the country. Who better to tell others of the amazing valuable role of care and support than those who are doing it every day!

Working in care and support is a job like no other. Yet what a care worker does today is unrecognisable to what might have been happening ten or twenty years ago, but we suspect that many people still hold an outdated view of the job of care. Care and support roles are regulated, they require the person to be registered and also over time demand that person gains a qualification. The women and men who work in social care are highly skilled professionals who undertake such important work. This is the life-changing work that helps people remain independent, live the sort of life they want, and if they require additional support to provide that in a way that values their voice, treats them with dignity and which places their control and choice at the centre. Working in care and support is an amazing role. That is why we spend so much time encouraging others as we have with young people this past week to consider a career in care. There are few jobs or careers which allow an individual to change the lives of others quite literally and to be with folks through the hardest and most challenging moments of their life.

I am sure you will therefore have no difficulty in agreeing with me that our frontline carers model the best of who we are as a society and that it is the responsibility and duty of those who lead us, who make decisions around budgets and how we spend our resources, to in turn treat our frontline social care staff with equal dignity, respect, and value.

Yet sadly that is not what we have been hearing in the days since we started our campaign. We are instead hearing from workers who are contemplating leaving the sector because they have been told that all they are worth is £10.90 an hour which is as you know is nearly 20% less than someone doing the same job in the NHS. It doesn’t much feel to them that there is value and respect. We are hearing that the lack of fair contracts and low levels of resource are stopping employers from offering better terms and conditions, including secure salaries to frontline workers. We are hearing that people are exhausted and tired because they continue to face so many challenges and risks to their health, yet they do not have the protections that others have. We are hearing of dedicated skilled individuals growing weary that years of promise and  declared priority have come to nothing.

Our simple ask of you is ‘How much do you really value social care both in terms of its workforce and its organisations?’

 I know that campaigns are often full of rhetoric and promises but the women and men who are struggling through snow and poor weather conditions today at all times of the day to go out and care for others – they deserve to know what you plan to do about social care if you become First Minister? How much in very straight terms are you prepared to pay our frontline carers? Will you continue to say £10.90 is all they are worth because that is what you can afford? Will you find monies as you did for the teachers and our NHS colleagues or do social care staff not count in the same way and are somehow lower down on the scale of value?  So please tweet, speak or announce what your plans for social care are.

Those who are contemplating a career in social care regardless of their age deserve to know under your leadership the extent to which you value them, the organisations that employ them and perhaps most of all the people who receive the care and support they provide. Is it worth making social care a career for life? Are we going to see our frontline care and support staff receive a pay award that treats them with dignity and respect?

 

Thank you.

Donald Macaskill

On Wednesday 1^st March I was delighted to be able to attend the virtual launch of the Scottish Care led social care campaign which runs the month of March. It is a campaign which whilst led by Scottish Care is involving a range of others – its primary purpose is to raise the profile of all the key issues facing the social care sector at the present time. In a week which has witnessed so much debate and discussion around social care the need for this campaign has never been more necessary and urgent.

There are several main themes in the campaign and one of them is to help us all have a greater understanding of what social care is. Regular readers of this blog will know how much I bemoan the way in which social care is continually – not least by the media and by our political leaders – seen through the lens of the NHS. Yes social care when it is functioning at its best is able to reduce the demand on our acute and secondary health services. Yes, social care can help to address the huge number of people who are unnecessarily delayed in hospital. But in truth if you only see social care through an NHS lens then you will effectively be blind to its extent and to its promise.

Social care is many things but at its heart it is a set of services and supports, whether for children, adults or older people, which enables people to live to their fullest; allows them independence, purpose, control and choice and helps all our communities to flourish and thrive.

To achieve this, we have some of the most progressive policy and legislation anywhere in the world but have sorely failed to implement these in practice. This week we have heard that the plans to create a National Care Service are now on pause which in itself was an attempt to address the gaps between aspiration and implementation, rhetoric and reality.

But in truth social care in Scotland has not been reaching its potential for a very long time – the patient has been in intensive care and in need of resuscitation – and the major reason for that is the lack of appreciation and value which has for years resulted in a woeful inadequacy of financing and investment in not only the workforce but in the organisations that employ them. It is reflected in the fact that there are hundreds upon hundreds of individuals living in our communities who have social care needs, some assessed , many not. The high level of unmet need is just as critical and dangerous as the delayed discharges in our hospitals but receives a tenth of the attention and focus it deserves. The inadequacy of treatment is especially seen in the way in which we reward, recognise and pay our frontline social care staff. I think it is frankly obscene at a time when the massive recruitment challenges facing social care are talked about so openly and so frequently that we have in the last few weeks created such a chasm between social care and the NHS.

The pay offer which has been negotiated for NHS colleagues and which has been much lauded (even if to date not formally accepted) has rightly valued our nurses and health care workers. But what might have escaped those patting their own backs is the real world effect which means that from April 2023 a social care frontline carer will be paid nearly 20% less for doing the same job as a frontline healthcare assistant in the NHS. This chasm is shameful. What about all the talk of integrated services – of one system – of co-dependency, and an appreciation that the NHS without social care is like a one-sided coin? What are we going to do about this arithmetic of disgrace?

We find ourselves in the midst of a leadership battle within the SNP and in the weeks up till the 27^th March we seem to have entered into a no-man’s land of decision paralysis – meanwhile social care organisations are losing staff hand over fist and frontline workers are looking over at colleagues in the NHS and wondering why is there such unequal treatment. After all social care staff are registered, regulated and require to be qualified. Why no equality? Why no level playing field?

And lest someone reads this and falls foul of the easy trap of blaming charitable or private providers they need to be reminded that over 70% of social care is paid for by the public purse at rates of contract that make it impossible to pay staff what they deserve and still remain sustainable as a charity or a private provider. That is why every week in the last few weeks I have had owners and directors of charities, care homes and home care organisations in tears telling me that they will have to close, hand back work, refuse to accept any more Council funded residents because they pay at least 40% less than what the true cost is, or indeed stop receiving any new residents. You cannot ever reach the land of fair pay for workers if you do not have fair contracts and commissioning. We are reaping the harvest of fiscal neglect and a lack of strategic priority.

The responsibility for the enduring long-term crisis in Scotland’s social care system is the culpability of national and local government. What else can you call a 20% differential between the NHS and social care? What else can you call the reality that in-house local authority care homes on average spend £1,200 plus a week to support a care home resident and yet the same authorities pay private or charitable care homes around £830 a week for nursing care and support which is about £5 an hour to care for some of our most valuable citizens.

There is a deadening hypocrisy which has for years corrupted the social care landscape and we have now reached a stage where unless central Government funds an adequate pay reward for frontline social care staff, invests resource in meeting the energy and cost of living crisis, works with the sector to make Scotland’s small often family run private care businesses and smaller care charities sustainable, then we might as well say goodbye to any local social care provision, forget about economic growth because families will have to give up their jobs to support their relatives, and start accepting the reality of an unsafe NHS. And let us not forget the neglect of the thousands of unpaid family carers for so many years.

Everyone will rely on social care at some point in their lives, and it is a truism that the sector only becomes important when that happens. But in truth the urgency of this hour means that there might not be a sector around to provide the support you and I might need in the future unless we act now. We want to see action taken to tackle the social care crisis.

I dearly want the leadership candidates for First Minister to start telling us what they are going to do to rescue social care because it is going to be, whether they recognise it or not, a top priority in the early weeks and months of their time in office. I want them to tell us beyond campaign soundbite how much they value social care staff – and let it not be £10.90 an hour. I want them to show me how much they value social care away from the shadow of the NHS? I want them to show me they really understand why hundreds and thousands of talented professionals are leaving the sector and to commit to working with  with us to support the organisations that employ them. If a factory closes or a major employer ceases to operate we set up a Task Force – we urgently need such priority in virtually every community across our land. A slick paid-for TV campaign to recruit people to work in a sector that cannot afford to retain them won’t cut it.

Now is the time to #careaboutcare. Now is the time to #shinealight on the social care sector; to get beyond the myths and discover the amazing women and men who are the cradlers of compassion within all our communities. They deserve so much more than Scotland has given them. They and the charities and private organisations that have kept social care afloat in Scotland are weary, tired and exhausted but they know that now not a future land of promise, is the time to save social care in Scotland.

Join our campaign and find out more at https://scottishcare.org/social-care-campaign/#1669210952025-1e98646a-819e

Donald Macaskill