The following blog is based on a talk given on Monday 15^th August at the inaugural meeting of the GCVS Health and Social Care Network. SeeNetworks – Glasgow Council for the Voluntary Sector (gcvs.org.uk)

 

I am absolutely delighted and honoured to have been asked to speak at this the launch and opening event of the Glasgow Voluntary Sector Health and Social Care Network. As has been advertised I want to speak about why I think social care is so fundamentally important to both individual citizenship and wider society in Scotland; how the essence of the Feeley Report needs to be upheld and implemented; how a human rights and inclusion perspective needs to be at the heart of social care delivery, and lastly why social care needs to be seen as distinctive from, different to but yet intrinsically complementary to a robust health and wellbeing system.

I suspect that there will be little I say today which will come as novel or new because GCVS and other civil rights infused disability organisations have been stating much the same, championing and campaigning for what I am talking about for decades and decades.

In starting our conversation where better to start than me explaining the title of this talk. ‘Always the Bridesmaid and never the bride.’. First of all, I have to thank Lynn Williams who used the remark in a conversation we were having about the way in which social care seemed to be being ignored and sidelined in so many of the meetings and discussions she and I sometimes share. It felt then and still do now that the title was apt – but then I explored where the phrase came from.

The phrase first originated in a music tune, but it came to huge prominence when the mouthwash brand Listerine in 1924 launched a series of advertisements with the slogan “Often a bridesmaid, never a bride”. These ads portrayed a forlorn woman by the name ‘Edna’ or ‘Eleanor,’   who was unlucky in love and for reasons unknown to herself and was never being able to find love and settle down. The manufacturers marketed the mouthwash by insinuating that everyone around her, even her friends knew the real reason for her lack of success- Halitosis (bad breath). But since it’s an embarrassing subject to bring up, they wouldn’t tell her. This line of advertising sold millions of bottles of mouthwash increasing the company’s sales from $100,000 in 1921 to over $4,000,000 in 1927.

It just goes to show how a phrase can have such a power to convey a message – and whilst the way we use it today is significantly divorced from taking fun out of someone – it has a sense of never being the centre, the focus, special and valued – always playing runner up or the forgotten one. Never getting the main focus and prize. So is that really the case for social care in Scotland in 2022 – you bet it is!

But what is it I am meaning when I talk about social care. After all definitions are important and I am so often in meetings and at events – not least with those who comment about the sector but do not work in it or use its services and support – when they think they know what they are talking about but evidentially it soon becomes clear they do not – and yes that especially includes our politicians and media.

The common misunderstanding is that social care is a series of services which are done to and for a person. It is the tasks and functions that help someone or support them. In fact, in a lot of the recent debate – not least on the National Care Service – the word social has dropped out completely – we are to have Care Boards – but I want to argue that care is not the same as social care and social care is more than simply care (especially if that care is narrowly understood and defined)

I am quite sure if we did a straw poll of what social care was for most of this audience it would not primarily be about services, and tasks and functions – but would be much broader.

For me social care is about connection and relationship, about belonging and being, independence and community. It is for me something which is profoundly about enabling people to be and become fully human to realise their potential and to flourish until the last gasps of living and loving.

There are loads of definitions of social care – the one I often use is this one – it has a forward dynamic – it is not about doing to or for – but enabling, empowering, – it is not about bringing order into the messiness of living but allowing that life to mess up the order and bring creativity, vibrancy, energy, and vitality to life.

‘The enabling of those who require support or care to achieve their full citizenship as independent and autonomous individuals. It involves the fostering of contribution, the achievement of potential, the nurturing of belonging to enable the individual person to flourish.’

That is why social care is so important – it is social – it is connectedness, citizenship, discovering abilities and celebrating diversity. We need to re-discover the social in social care – and tell policy makers and politicians to take their hands off something which will long outlive them and of which they know not.

Social care is therefore for me a human rights issue and a human right in itself.

More of that in a minute – but one of the problems in the ‘Always a bridesmaid’ scenario is that people – even those who should – simply do not recognise and value the massive role and contribution which social care is making every day to our society.

The work of many not least the SSSC has highlighted the economic benefit of social care to the Scottish economy – but that is often lost – even our latest national plan for economy and business Does NOT mention social care -a shocking dereliction of ability and priority and an even greater marginalising of the value of the sector.

Even just last year another report – this time commissioned by Enable showed that far from being a burden on public finances, the sector contributes more than £5.1 billion Gross Value Added (GVA) to the country’s economy and supports some 300,000 jobs.

That report demonstrated that social care’s direct economic impact is more than £3.3bn GVA and its indirect economic impact, through supply chains and supporting industries, contributes £800 million. The impact of the sector from employees spending their wages generates £1.1bn.

 

So, given all this – and the shocking failure of our economic leaders to recognise social care and its prospect as an economic driver and contributor – much more than many other valued sectors – what is going on here you might well ask? … you could ask a lot about why it is that social care is marginalised – always the bridesmaid and never the bride –

… but I hardly need to articulate the reasons to this audience – is it not the same reasons which in ancient times saw the ban on anything other than perfection in Greco-Roman sculpture and art? Is it not the same attitudes and reasons which saw throughout history the diminishing of those who were different because of disability, mental health challenges or health needs – a diminishment which still goes on to this very day? Is it not the age-old desire to have disability – out of sight and out of mind – shut off from the mainstream, prioritised as other? Is it not the same source of behaviour which has created a cult of youth and beauty and which even today dismisses older age as having had its day, finished its contribution, not worthy of voice or listening to? Is it not the same attitudes which have never treated dementia as a disease of equal health impact such as cancer or diabetes because primarily it impacts upon the lives of women and of those who are old.

The answer is of course discrimination and inequality, the othering of those who we can label, the dismissing of value and voice, of contribution and importance. It is as old as the heavens and as perverse as it has always been.

That is why we who use, access, work in and are involved in social care supports have to find a voice to challenge the status quo – to say enough is enough – we will not be marginalised or silenced – this is our lives and livelihoods – if we change and do things better, seek to be better, to reshape and reform then we can do so much better; we can then celebrate social care as an essential component to civic life and Scotland.

Now both those elements – a broad inclusive definition of social care and a sense that social care had the potential to be an economic driver and contributor to the whole economy can be found richly running through the Feeley Report

I have to confess to something of a Damascus Road conversion to the work of the IRASC – I was a cautious critic at the start because I thought that the task Derek and others were set was impossible to achieve within the time frame given and that they would not fully and properly engage and consult and involve in anything other than a tokenistic manner. It is to the immense credit of Derek Feeley and the whole tram that what resulted was such a dramatically positive and at times visionary report.  It was a report set at a particular time, but which managed to capture the spirit of the hour, to offer pragmatic solution and to describe reality warts and all.

 

The problem is that today or at least for me the Feeley report feels like a dream slowly disappearing into the distance, having been touched by the cold abnorming of political reality and opportunistic pragmatism.

Feeley rightly emphasised the contributive economic and societal nature of a social care system which worked well and enabled the flourishing of all within community. He rightly addressed the implementation gap – or for me the chasm between aspiration and the legislative potential of things such as Self-directed Support which could and should and can still be transformative and revolutionary – he described in words of your making and shaping the practice reality for people who receive care support. Why is it that everything feels like a battle and grind to achieve what should be the right of those who are supported?

This is not the place to go into detail on the NCS – but oh I groan at the gap between vision and reality, between energy of Feeley and the lethargic texts and framing we are now presented with. There is such a slew of despond when by a thousand deaths of bureaucratic implementation, the whisper of originality and the spark of excitement is silenced and snuffed out.

There is still time to shape and influence to try to keep the jewel at the heart and not just create a mini-NHS with the failings its parents are unwilling or unable to recognize such is the adoration of the original.

But you see I am more and more convinced that social care is too important to be left to the politicians and professional policy makers. Indeed, social care is more than the National Care Service – it is more than a service or system, a model or framework – it is about lives and people, about dreams and relationships, about freeing the person to become and the community to flourish – the NCS may enable that, but social care is much much more …

Social care cannot be left to be the plaything of politician and commentator, the disinterested only thinking about a vote or a story, or a sale or a system-  It is ours – those who use and have used, those who are family and informal carers, the frontline workforce in projects and care home, homecare and addiction services, mental health recovery and day services – and so many other places where the SOCIAL matters and takes place and shape.

It is not time to be silent during consultation; it is time to press upon our elected representatives that they cannot get away with half-baked, half costed and half resourced plans and ideas – this is our life, and it will shape our future community – we cannot get it wrong.

The title of this talk is ‘Always the bridesmaid never the bride’ – it is time for social care to take centerstage – not as the bridesmaid to the NHS bride, not as the handmaiden, the Cinderella, the forgotten one, the one who gets the crumbs from the NHS table. We must call out the lazy political speak and mantra which sees the world through NHS eyes, which perceives the need of social care by its impact on the NHS – such as classically the debate about delayed discharge. Such myopic obsession with the NHS is damaging, dangerous and obscenely short-sighted.

Living well in community, independent and with a life that is flourishing is just as important and worthy of resource, political attention, and popular valuing, as the emergency and acute and dramatic success of hospital, GP, nurse, and clinical professional.  They are symbiotic partners of a whole fount of wellbeing.

It is the people on this call and beyond who have the power to advance, to rescue and to advocate for social care support. It is time to make the system human rather than transactional. We cannot continue to have a system which is built around the cult of maintenance – keep people as they are, where they are, who they are – that is the complete opposite of social care which is about enabling the person to change and grow, to flourish and renew, to adventure and discover. Independence is too important for it to become a matter of constitutional debate – independence is first and foremost, most, and best – the enabling of a person to be who they are and to grow to their full potential often in relationship to others.

For me we have a very real potential to rescue the human at the heart of social care – to nourish the social within services and to discover the breadth and depth of a mature modern social care world. That potential is rooted in recognising that social care is, as I stated above, a profound human rights issue.

I have written – at some length – about why I think we need to seize the opportunity of Scotland creating a Human Rights Act – and to become the first nation to explicitly describe what the rights are engaged when we seek to incorporate the International Covenant on Economic involved in the Economic, Social and Cultural Rights into Scottish law – now I know the right to health is critical within that.  But I want us to go further and to make explicit – even with the likelihood of progressive realisation – the human right to palliative care, the human right to bereavement support and explicitly and most fundamentally the human right to social care.

The right to health has been interpreted more than just the right to physical and physiological health – in case law it has included emotional and psychological health, but I really hope we can go broader than a loose definition of wellbeing to say that social care – regardless of age – is distinctive, it enables the fulness of life and the achievement of other fundamental human rights and without it being protected as a distinct right then others are diminished. Social care is a human right – it is my right to flourish and thrive, to be independent, to have voice – this is not about attending to my health needs but meeting my social care needs. And in that sense social care can only be judged as a human right realised through the United Nations human right test principles of availability, accessibility, acceptability, quality, participation, and accountability

It is not enough to have a new National Social Care Service, or another set of legal obligations, you become the bride when you are treated as valued and wanted, centre-stage in economic and societal priority, considered as worthy of focus and attention, adequately resourced and prioritised, and for me social care to be human has to be seen as a human right with all the protection that affords, not just a bridesmaid to the NHS bride.

Last week I wrote in my blog about the potentially devastating impact of energy cost increases on the care home and homecare sector in Scotland. In response to that several people got in touch to say that there was a dimension of the cost of living and energy increases that was rarely talked about in the mainstream media – namely the impact on older people who live on their own and on their health and wellbeing.

One correspondent put it fairly bluntly when she wrote:

“I feel as if what is happening around me is something over which I have no control. I am on a fixed pension which was a struggle at the best of times but allowed me if I saved to get some things for the grandkids. Now I am either going to have to cut off the heating for most of the winter or not be able to give my grandchildren what I want to. I am going to have to choose between love and heat.”

Despite my attempt to reassure and suggest what I think is a priority and which her grandchildren would consider a priority – i.e., to heat and be warm – I am ashamed that in 2022 an older woman who has given so much to her community and society, and to her family should be having to contemplate making such a decision.

But her choice describes the situation for countless thousands across Scotland today. Unlike those in work who can argue for an increase in their salaries to match the spiralling inflationary costs; or who can potentially work more in order to bridge the gaps – the vast majority of older Scots are on fixed incomes and pensions which at the moment are restricted. They are in a very real and costly Catch 22. The consequences of some of the choices they are making now and will make in the autumn and winter are devastating and, in some instances, might be deadly.

Professor Linda Bauld,  a leading academic at Edinburgh University and who has become a familiar face during Covid, yesterday appeared in the Herald saying that the steep increases in prices could spark a public health emergency with a rise in deaths.

She is quoted saying:

“We know from history that when people lack access to basic resources including energy and food there are health implications… Cold, damp housing exacerbates respiratory conditions for adults and children and results in worsening of symptoms for a range of chronic conditions.

“Not having enough money for transport means people can’t travel to appointments with health services or to collect prescriptions.”

There is nothing new in this reality, nothing new in the fact that older people are more vulnerable to winter deaths because of rising respiratory conditions; nothing new in the fact that more heart attacks occur after a cold spell and nothing new in the poverty faced by older Scots. What does not seem to be new is any political response regardless of where that might come from.

That is not to dismiss some of the interventions which have occurred, and I would encourage anyone who knows any older person to be aware that we are in the last week of being able to apply for additional assistance. People living on a low State Pension should check their eligibility for Pension Credit and apply ahead of next week’s cut off point on Thursday as it could mean an extra £650 of financial support which could help with rising energy bills. There are more details available from Age Scotland and others. But sadly, I suspect all the interventions to date will not prevent the major health emergency we are about to face as a whole society – unless action is taken  and all this said in a week evidencing yet more massive energy producer profits.

In an earlier study from Age UK it was stated that 220,000 older households in Scotland will have insufficient income to cover their essential spending this year. They estimate that the poorest older households in Scotland will need to drastically up the percentage of their net income spent on essential goods and services from 70% in 2021-22 to 87% in 2022-23 due to higher costs of living.

Every day we seem to be hearing yet more negative news with little action or comment from both the Scottish and UK Governments. It is one thing to respond to an emergency and have fault lines found in the response, it is quite another to walk into a nightmare fully awake and to fail to take action which could save lives.

Therefore, it is not only our care homes and homecare services which risk collapse and which will result in inevitable deaths in the coming weeks and months, but people at home on their own over the next few months who will be asked to make life and death decisions, and for many the wrong choice will inevitably follow, and for countless others there will be no choice at all.

Donald Macaskill

I was in London this past week and had a couple of hours to spare between meetings and on the recommendation of a colleague I found my way to the Design Museum in Kensington. The building itself and its displays are well worth a visit – not least as the air conditioning is fantastic in a city with 30-degree heat even when I was there! But I was there specifically to see an exhibition curated by the Design Age Institute in collaboration with the Design Museum, The Future of Ageing, which explores ‘how design is transforming the way society can support everyone to age with greater agency and joy.’

I have written quite a few times in this blog and elsewhere about how we need as a whole society to reconceive the way in which we design the built environment to better include and accommodate the needs of an ageing population. Specifically, I have suggested that we need to stop building aged care facilities separate and apart from the communities in which people  actually live. I have remarked about how ridiculous it seems to me that so many of our housing developments are inaccessible to the needs of a population which will become the dominant group within the foreseeable future. I cannot remember the last time I was in a modern built housing estate which had an adequate mix of bungalows or at least accessible accommodation.

The Future of Ageing exhibition was interesting, less from the perspective, that it was coming up with starkly original designs or suggestions but more from the fact that it argued about the urgent criticality that the whole design community, from technology and robotics, from townscape to rural environmental planning, from kitchenalia to social media, have all to seriously start accommodating the needs of a population who will soon be its majority customers and consumers. In so doing designers have to involve older people in the design process and have to stop treating older people as a homogenous group as if older age is bereft of difference and diversity.

The exhibition highlighted an often-ignored reality that although by 2040 more than a quarter of the UK’s population will be over the age of 60 what is less well known is the fact that over 70% of that ageing population will not be needing support or assistance in normal and daily tasks and activities. Those of us working in social care have a narrowed perspective for obvious reasons, but it is true today and hopefully even more the case tomorrow that the vast majority of older people will not need care and support until a very late stage in life if ever. Yet as a society we continue to view older age so negatively, as a deficit and as something which limits ability perhaps especially in the world of design. As the exhibition declares it is time to put some joy back into ageing which was put succinctly by one contributor in a short and incisive video when he declared “Don’t let people with no abracadabra stop you from making magic!”

‘The Future of Ageing display celebrates how design can help us reimagine products, services and environments to enhance our experience of living in later life with a selection of prototypes, sketches and research from projects that are being developed by Design Age Institute and its partners.’

One of the prototypes I enjoyed the most was ‘The Centaur’ – a self-balancing, two-wheeled personal electric vehicle for people with difficulties getting around. Its inspiration and designer is Paul Campbell from Centaur Robotics who asserts that “I want to end the social isolation resulting from reduced mobility and I believe good design can do that.” The Centaur is designed for the world as it is – it can fit through normal-sized doorways, under desks and tables, and gives a significant degree of autonomy to the person who uses it.

There were several insights within this exhibition but the one that left a mark on me was the statement that we should stop seeing the world around us as one we need to change in order for people to fit in but that we should enable people as they are to better fit into the world as it changes. The argument of the past that it is the environment that ‘disables’ and so we must change it to enable inclusion, is put aside by the assertion that we must equip those who are ageing to enable them to better use the world, adapt to their environments as they find them, rather than to seek to change the world around us. I personally think the issue is a both/and but I cannot deny the practical insight of someone like Patricia Moore who is an industrial designer, when she asserts, “Stop designing for disability and start designing for usability.”

From ‘Gita’ – a hands-free cargo-carrying robot, the ‘Home Office to Age in Place’ – created to integrate flexible living and working space for later life, and ‘Hearing Birdsong’ – a digital ‘audioscape’ app that uses the sound of birdsong to engage visitors with their hearing health there is a lot to see in this small exhibition but all the designs have one thing in common and that is they perceive age as a positive source of inspiration and enjoyment, rather than something to be ignored and excluded.

But the challenge for us all is to look beyond the stereotype and presumption and to re-design the world around us so that it becomes truly inclusive, as one participant said of age in general: “It’s not the way you look  it’s your outlook that matters.” For after all as the hashtag of the event declared #WeAreAllAgeing

Donald Macaskill

It is eleven years ago today that the ultra-talented Amy Winehouse died from alcohol poisoning at the age of 27. She is best remembered for her famous songs’ ‘Rehab’ and ‘Stronger Than me.’ I first saw Amy on the Jools Holland Show early in her career and could immediately recognise a talent which went beyond mere ordinariness or description.

Amy Winehouse did not have an easy life with periods of drug and alcohol addiction, mental health and relationship challenges. Her album ‘Back to Back’ became the UK’s bestselling album of the 21st century albeit for a short time.

I have been thinking a lot about Amy this week partly because of her music but more directly because of her story and the grief and loss that results in those left behind following such a traumatic and sad death.

In my own personal and professional life, I have witnessed first-hand the raw reality of the way in which alcohol and drugs can change a person and devastate a family. The death of a loved one to addiction empties a person like nothing else and so often that emptiness is filled with questions and guilt, with a sense of ‘if only’ and of regret, and with a continual self-examination as to whether you could or should have done more.

I have always admired the work of Scottish Families Affected by Alcohol and Drugs. https://www.sfad.org.uk . I was therefore very pleased this week to have had the chance to meet a colleague from that organisation. They do a wide range of work including a focus on bereavement support and most of it is undertaken at local level. When someone in your family is affected by alcohol or drugs one of the main things you feel is a sense of isolation and aloneness and the way in which SFAD and others can help connect you to others, to limit the isolation, to support through mutual understanding and connection becomes invaluable.

My primary reason for speaking with SFAD this past week was to form links between their bereavement work and the work of Scotland’s National Bereavement Charter. The Charter, whose organising group, I am honoured to chair, is growing from strength to strength with new resources being developed all the time to help anyone across Scotland be better supported in their grief and loss. The aim of the Charter is to ensure that anyone who requires support and care following a bereavement is able to access that and that Scotland becomes a world leader in a human rights-based approach to grief and bereavement. Those who lose loved ones through drug and alcohol deaths have an especially hard journey of grief and loss and it will be a mark of the Charter’s progress as to whether or not we are able to make their journey any easier.

One critical dimension experienced by so many who experience the death of someone to alcohol and drugs is the societal stigma that often accompanies such a death. Someone once described this to me as ‘furtive grieving’, her felt sense of having to hide the cause and reason for the death of her son to a heroin overdose because she felt that others would dismiss both him but also her pain, grief and loss as somehow ‘self-inflicted.’  She told me it took a long time for her to stop saying her young son died of a heart attack and to be open about the reasons for his death and that that openness helped her in her grieving.

In a heart-felt plea in the media this week, David Strang, the chair of the Scottish Drugs Deaths Taskforce spoke about the newly published “Changing Lives” report which makes 20 recommendations and 139 action points that it says will help turn around Scotland’s record drug death numbers. The shocking and sad statistical truth is that in 2020, 1,339 people died as a result of a drug overdose. The report calls for the creation of a national stigma action plan because of the reality that societal stigma and discrimination results in not just personal and family trauma but in unnecessary death. When deaths do happen, that stigma continues to re-enforce discrimination and makes grieving and bereavement all the harder and more painful.

Grief shrinks you. It makes a person small in their body. It shrivels up hope and dreams. It’s emptiness echoes with a silence no sound could ever soothe. Grieving the loss of a loved one to drugs and alcohol makes many feel like they need to hide their grief and so makes bereavement unnecessarily traumatic. We desperately need to transform cultural and societal attitudes to alcohol and drugs not only so that lives can be saved but also that when loss does happen grief can be freed from the shackles of societal disapproval and discrimination. The tragic legacy of someone like Amy Winehouse should be not only her amazing music but an urgent need to end the stigma around all drugs and alcohol deaths, to encourage society to start a mature debate on all the issues without the stance of moral superiority that often occurs, and importantly by so doing to let loved ones who grieve be able to make that journey in openness without societal stigma.

Donald Macaskill

Summertime is often the time of year that I manage to do some reading separated from the normal rhythm of work issues. Over the last couple of weeks in amongst the usual whodunnits and attempts to see merit in ‘bestseller’ lists, I have also been re-visiting some thoughts and texts which I had put aside for that elusive ‘quieter time.’ In that vein I have been exploring some writings around the concept of ‘generosity’ especially as it relates to social care.

Generosity is often dismissed as an old-fashioned concept but I’m very much of the opposite view believing that generosity as a concept needs to be more embedded in our individual and societal discourse. In fact, the last week busy as it has been with political intrigue and debate has struck me as one that would have benefited greatly from a bit more generosity of spirit and action. But more significantly having had the privilege of witnessing so many acts of compassion and care over the years at the hands of both paid and unpaid carers I am convinced that generosity is wired into humanity but also that it needs to be cultivated, nurtured, and promoted.

The dictionary defines ‘generosity’ as ‘the quality of being kind and a willingness to share.’ Many psychologists have argued that by inherent and instinctive nature people are generous, that they act in ways which seek to better another and to benefit those around them. They have stated that the innate predisposition of children at an early age is not to be selfish and narcissistic but to help others. What is more there is an abundance of research evidence which shows that being generous to others is of psychological and emotional benefit to ourselves:

“A growing body of research has revealed numerous psychological and physiological benefits of giving, challenging common conceptions about the relationship between money and happiness. In 2008, for example, Norton and his colleagues conducted a study where they gave $5 or $20 to people and then instructed them to spend it either on themselves or someone else.

Later that evening, the researchers checked in with the participants to see how they felt emotionally. The group that gave money to others reported feeling happier over the course of the day. What’s more, the results showed no emotional difference between people who received $5 and those who got $20. “  (from How generosity changes your brain – Big Think )

The act of giving is something which might indeed come easier to some than others but it is clearly at the core of social care and support. Being generous with one’s time and skills, with knowledge and ability are a tremendous expression of mutuality with another, especially perhaps someone to whom one is not linked to in any other way than through work and professional role. But the real dynamic of generosity which is at the heart of care support and indeed all of social care is the generosity of individual humanity. When you support or care for another you give of your self – there is a dynamic exchange which alters you. You are and become a different person when you support and care for another. I am not denying that there is a cost to care and an element sometimes of sacrifice, hurt and pain in the compassion and support given, but in most instances the person caring is changed in a  way that helps to fulfil their humanity.

I personally think this generous essence of care is what makes care support a unique profession and role. Over the years when I have met and talked to people about the jobs which they do in social care they have often used phrases such as “It makes me feel better,” or “I get such a buzz out of giving to others.” This is generosity in action, an act and way of being with others which changes the recipient but equally which changes the care giver.

Our society would benefit a great deal from such a spirit of generosity in all our interactions and exchanges, and it would be changed were we to recognise that we need to do more to value and reward those whose essential roles are to be generous to others.

All this is wonderfully captured in ‘When Giving Is All We Have’ by the contemporary American poet Alberto Ríos.

When Giving Is All We Have.

One river gives

Its journey to the next.

 

We give because someone gave to us.

We give because nobody gave to us.

 

We give because giving has changed us.

We give because giving could have changed us.

 

We have been better for it,

We have been wounded by it—

 

Giving has many faces: It is loud and quiet,

Big, though small, diamond in wood-nails.

 

Its story is old, the plot worn and the pages too,

But we read this book, anyway, over and again:

 

Giving is, first and every time, hand to hand,

Mine to yours, yours to mine.

 

You gave me blue and I gave you yellow.

Together we are simple green. You gave me

 

What you did not have, and I gave you

What I had to give—together, we made

 

Something greater from the difference.

https://poets.org/poem/when-giving-all-we-have

Donald Macaskill