When I was growing up, there were a few select books that appeared every year with faithful regularity on my grandmother’s bedside table. One of them which is still going strong with its distinctive purple cover was The Friendship Book.

First published in 1938 by D.C. Thomson & Co., it is an annual publication best known for its gentle reflections, uplifting prose, and moral wisdom. It offers a short thought, poem, or inspirational reflection for each day of the year. It is a book that doesn’t shout, but whispers comfort and companionship.

I once asked my grandmother how it was possible to have something new and different to say about friendship every day of every year. She replied, with a smile, that true friendship is a conversation that never finishes.

How much truth was there in that sentiment. Because in the world of social care, especially for older people, friendship is not a seasonal sentiment instead it is a daily necessity. It is the thread that binds together lives that have been frayed by loss, change, and time.

As we mark Book Week Scotland 2025, with its theme of Friendship, we are invited to reflect not only on the stories we read but on the stories we live. For those of us who work in social care, and for the thousands who receive it, friendship is not a luxury rather it is a lifeline.

There is a somewhat perverse irony that we live in an age when people have more opportunities than ever to make friends, thanks to technology, global mobility, and social networks. Digital platforms, online communities, and instant communication make it easy to connect with others across distances and cultures. People who might once have been isolated because of geography, disability, or social circumstances can now find like-minded communities online.

However, research suggests that many people today actually feel lonelier and have fewer close friendships than in previous generations. Social media can create connections but also foster superficial interactions rather than deep, enduring friendships. The way we live our lives, with busyness, frequent moving, and remote work, can make it harder to maintain long-term, in-person relationships. And culturally, former community structures like local clubs, churches, or neighbourhood groups that once supported friendship networks are often less central in people’s lives.

So while the potential for making friends is greater than ever, the quality and depth of those friendships may not always be as strong as in earlier, more community-based times. But the truth remains that friendship is intrinsic and fundamental to living in community with others, no less so than in older age.

Friendship in older age is not just a social nicety we know it also to be it a psychological necessity. Studies have shown that older adults with strong social networks experience lower rates of depression and anxiety; they have improved cognitive function and memory retention, possess greater resilience in the face of illness or bereavement and all in all have enhanced physical health, including lower blood pressure and better sleep.

These are not abstract benefits. They are real, lived experiences. I remember speaking to a woman in a sheltered housing complex who said:

“I’m 83, and I’ve just made a new friend. We walk together, we talk about books, and we laugh. I didn’t think I’d feel this alive again.”

Friendship is woven into the fabric of being in community. I’m struck by this every time I visit my family in the islands, where belonging to place and people still shapes lives. There, friendship is woven into the fabric of care. It is found in community-led initiatives where neighbours become carers, and where the boundaries between formal and informal support blur into something more humane.

In urban Scotland, friendship is the antidote to isolation. It is the volunteer who visits every Thursday, the care worker who knows the names of grandchildren, the fellow resident who shares memories of wartime Glasgow. These relationships are not incidental; they are central to wellbeing.

Yet, too often, our systems fail to recognise the value of these connections. We measure minutes and tasks, but not the moments of meaning. We audit medication, but not the comfort of companionship. If we are to renew social care in Scotland, we must place friendship at its heart.

But this is, after all, Book Week and we must affirm that books have always been companions. For older people, especially those living with dementia or facing bereavement, stories can be bridges to memory, identity, and connection.

I have sat with individuals who, though struggling to recall the present, can recite poetry from childhood or recount the plot of a novel read decades ago. Literature becomes a lifeline to the self.

In care homes across Scotland, reading groups are springing up not just as activities, but as communities. Residents read aloud, discuss characters, and share their own stories. These are spaces where friendship is nurtured through narrative.

A gentleman in one home told me:

“I never thought I’d read again. My eyesight’s poor and my hands shake. But every Tuesday, we gather and someone reads to us. It’s like being back in school but better. We laugh, we argue about the endings, and we remember who we were.”

Books also offer a bridge across generations. Grandchildren reading to grandparents, carers sharing poetry, volunteers bringing stories to life— all of these moments create connection.

The Scottish Book Trust’s annual publication, Scotland’s Stories: Friendship, is a testament to this. It gathers voices from across the country, including those often unheard such as older people, carers, those living in rural isolation. It reminds us that storytelling is not the preserve of the young or the literary elite. It belongs to all of us.

More positively, innovation in care technology is opening new doors for friendship. Digital storytelling platforms, virtual book clubs, and reminiscence apps are helping older people stay connected, even when mobility or geography pose challenges.

But technology must serve humanity, not replace it. The warmth of a shared story cannot be coded. A virtual hug is not the same as a hand held in silence.

As we look to the future, we must ask: how do we design care systems that foster friendship? How do we train carers not just in clinical skills but in the art of listening? How do we ensure that every older person in Scotland has the opportunity to be known, to be heard, and to belong?

Let me end with the words of Peter Mackay, Scotland’s Makar, whose work often explores the intersections of language, memory, and connection. In his poem Anamnesis, he writes:

“We are made of stories, stitched into skin,

Of voices that echo long after the din.

In the hush of a room, in the turn of a page,

Friendship endures, defying age.”

This Book Week Scotland, let us celebrate friendship not only in fiction but in the lived realities of those who depend on care. Let us honour the storytellers in our care homes, the poets in our communities, and the quiet revolutionaries who build connection in the face of loneliness.

Because in the end, it is friendship that makes us human.

Donald Macaskill

Photo by Sabinevanerp

At the Global Ageing Conference in Boston, I found myself not just attending a keynote but entering a new narrative; a reframing of ageing that challenges our assumptions and invites us to imagine a different future.

Dr. Joseph Coughlin, founder of the MIT AgeLab, delivered a speech that was both intellectually rigorous and emotionally resonant. It was, in his words, “a call to rewrite the story of old age.”

I then on Wednesday had the pleasure of visiting the Age Lab and spending time with Joe and his amazing colleagues including Fullbright Scholar Elisa Cardamone from Edinburgh’s Advanced Care research Centre where I am honoured to act as Chair of the Academic Advisory Board.

Coughlin’s work has long been about exploding myths. In The Longevity Economy, he writes:

“Oldness is a social construct at odds with reality that constrains how we live after middle age—and stifles business thinking on how to best serve a group of consumers, workers, and innovators that is growing larger and wealthier with every passing day.”

This idea – that ageing is not decline but transformation – resonates deeply with my own thoughts about how our Scottish Gaelic concept of dùthchas, the sense of rootedness, belonging, and identity shapes how we care.

In Boston, Coughlin reminded us that “after age 65, society says you’re done. But in reality, you’re very likely to live another 8,000 days.” That’s a third of a lifetime. What do we do with that time? What stories do we tell?

In Scotland, we are grappling with the crisis of social care. But as I’ve argued before, crisis can be the birthplace of creativity and the spark of innovation. Coughlin’s keynote and his recent book Longevity Hubs: Regional Innovation for Global Aging offer a blueprint for renewal. He and co-author Luke Yoquinto define a longevity hub as:

“Any hotspot characterized by a disproportionate level of innovative activity aimed at the older population and related markets.”

This is not just about technology it’s about storytelling spaces. Coughlin reminded us that “story is the most powerful technology in the world.” Storytelling spaces are the places where older adults co-create solutions, where care is not delivered but designed, and where ageing is not feared but embraced. He writes:

“Emerging longevity needs encompass not only health and wealth but also social and mental well-being.”

Imagine a Longevity Hub in the Highlands. A place where dùthchas meets digital. Where crofters, carers, technologists, and artists collaborate to reimagine ageing. Where the stories of elders are not archived but activated.

One of the most compelling metaphors Coughlin offered was that of a GPS for ageing. He suggests that the traditional map of ageing is outdated, built for a world where retirement was short, predictable, and largely passive. But today, with people living decades beyond retirement age, we need a new navigation system- one that reflects the complexity, diversity, and potential of later life.

“We’ve added more life to our years, but we haven’t updated the map. We need a GPS for ageing that helps us navigate not just where we’re going, but who we want to be.”

This metaphor resonates deeply with our Scottish experience. In rural communities, where dùthchas anchors people to place and tradition, ageing is not a linear journey but rather it’s a landscape of memory, contribution, and identity. But even here, the terrain is shifting. The old waypoints and markers of retirement, dependency, institutional care, no longer suffice. We need new coordinates.

Coughlin’s GPS is not just about direction- it’s about agency. It’s about giving older adults the tools to chart their own course, to make choices, to remain connected.

“The future of ageing is not about finding a destination- it’s about designing the journey.”

This invites us to think of ageing not as a descent, but as a pilgrimage – a journey rich with possibility, shaped by relationships, values, and aspirations. In Scotland, we might say that the GPS of ageing must be calibrated to our cultural compass: one that values community, intergenerational solidarity, and the wisdom of lived experience.

Without a new GPS, we risk getting lost in outdated assumptions.

“Most of our institutions—from housing to healthcare to transportation—are still designed for a world where ageing meant withdrawal. But today’s older adults are mobile, connected, and ambitious.”

Are we designing services that help people move forward, or ones that simply manage decline? Are we offering pathways to purpose, or just places to wait?

Coughlin’s work also highlights the power of women in the longevity economy.

“Women outnumber men, control household spending and finances, and are leading the charge toward tomorrow’s creative new narrative of later life.”

This is a call to listen more deeply to the voices of older women in our communities, those who are often the backbone of informal care, community leadership, and intergenerational connection.

He also dismantles the myth of the “average senior.” Just as 25-year-olds differ widely, so do 65-year-olds.

“There’s no one-size-fits-all senior. Yet businesses often lump everyone over 60 into the same box, leading to poor products and outdated messaging.”

This insight is vital for our policy and practice in Scotland. We must design for diversity, not age. We must move beyond the dependency ratio and see older adults as contributors, creators, and citizens.

Coughlin is clear:

“Technology without empathy is just engineering.”

This is a warning and a guide. In our rush to digitise care, we must not lose sight of the human. Smart homes, wearables, and AI can enhance independence but only if they are designed with dignity, inclusion, and story in mind.

In Boston, I heard stories of older adults using tech to stay connected to grandchildren, of care homes becoming design labs, of intergenerational teams solving problems together. These are not just anecdotes- they are narrative shifts.

I return to Scotland with a renewed conviction: that the renewal of social care begins with the renewal of story. We must tell better ones. We must listen more deeply. We must design not just for longevity, but for legacy.

Let us build our own GPS for ageing. Let us honour dùthchas. Let us co-create a future where ageing is not the end of the story, but the beginning of a new chapter.

As Coughlin writes:

“The longevity economy is not just about living longer—it’s about living better, with direction, dignity, and design.”

Let us chart that course. Let us tell those stories. Let us navigate the future of ageing with courage, creativity, and care.

 

Donald Macaskill

 

The following is adapted from a speech given in Fort William on the 24th October at an event organised by Angus MacDonald MP whose primary focus was to explore his proposal to create four new 60 bed care homes in the Highlands. After reflecting on the nature of social care, its current challenging state in relation to sustainability and workforce pressures, I went on to suggest some actions which might make a difference.

So what can be done ?

Like many others we will continue to lobby for a new approach to immigration which is sensitive to demographic truth rather than political rhetoric – Scotland needs, wants and values our international colleagues, no more so than in social care – and with the pain of Brexit still felt so acutely we need the UK Government to restore a skilled workers route, or at the very least to allow Scotland to develop such a model.

It also goes without saying that we need a Budget both in Holyrood and in Westminster that properly values social care not as a nice to have but as a fundamental partner to NHS funding and provision.

But there are other things we can do which I think can help.

I want to suggest several actions:

1. A Highland Weighting Scheme.
2. Flexible models of care, including co-housing, intergenerational living, and community-led support.
3. A reformed understanding of what care home provision in remote communities needs to look like
4. Flexible regulatory and registration arrangements for workers and organisations.
5. Investment in co-ordinated digital infrastructure to support remote care delivery especially in homecare.

1.

One practical solution is the introduction of a Highland weighting– a regional pay supplement for social care workers in remote and rural areas.

Social care providers in the Highlands struggle to recruit and retain staff due to:

• Workforce availability
• Terms and conditions cf to other sectors
• Seasonal employment patterns
• Higher travel costs.

A Highland Weighting scheme would also recognise:

• The higher cost of living in rural Scotland.
• The complexity of delivering care across large distances.
• The lack of affordable social housing.

Such a scheme could be structured similarly to London’s, but tailored to rural realities:

There are some key components

• Base supplement for all care workers in designated Highland zones
• Tiered rates based on remoteness (e.g. mainland vs islands)
• Travel allowances for mobile care staff
• Housing support or relocation grants.

The London weighting scheme has shown that:

• Targeted pay supplements can improve recruitment and retention.
• Inconsistencies across sectors can cause inequality
• Transparent, annually updated models(like the Minimum Income Standard) help maintain fairness.

Applying these lessons to the Highlands would require:

• Clear criteria for eligibility
• Cross-sector coordination
• Annual review mechanisms

Other countries do this:

• Australia offers a range of financial incentives for health and social care workers in remote communities, particularly through the Remote Area Nurse Incentive Package and similar schemes for aged care and disability support.

Key Features:

• Retention bonuses and relocation grants.
• Higher base salaries in remote zones.
• Accommodation subsidies and travel allowances.
• Often tied to return-of-service obligations.

Canada – in the Northwest Territories, care workers receive a tax-free northern allowance to offset living costs and attract staff to remote communities. A similar model in the Highlands could include tiered supplements and housing support.

South Africa introduced a rural/remote allowance for social workers and other social services professionals (SSPs) working in designated remote areas. The scheme was developed using a GIS-based remoteness index to scientifically identify eligible locations.

Key Features:

• Allowance covers costs related to transport, housing, schooling, and lack of amenities.
• Aims to equalise pay between urban and rural sectors.
• Targets vacancy hotspots where recruitment is most difficult.
• Approved by the Social Development MINMEC and supported by national funding.

There are further models in Japan and nearer home in Portugal and northern Spain.

2. Community led-models of homecare.

We must also look to community-led care. We must embrace new models of homecare tailored to rural realities.

For instance, in Rannoch and Dunkeld, local trusts are developing a care-at-home service governed by the community itself. It combines paid staff and volunteers, local governance, and flexible scheduling to meet individual needs.

Again, there are clear international lessons:

Canada has adopted an Integrated Rural Home Care model

The Canadian Home Care Association (CHCA) promotes integrated care models tailored to rural needs, emphasising safety, dignity, and quality of life. Innovations include mobile care units, community-based nursing, and partnerships with Indigenous communities for culturally appropriate care.

In the United States there are many ‘At Home’ Service Models. For instance the innovative PACE (Program of All-Inclusive Care for the Elderly) combines medical and social services to help seniors stay at home safely with an emphasis on rural and remote living support – from St. John’s United (Montana) and Missouri Slope (North Dakota).

In Australia amongst many rural responses there is the IMOC Program (Innovative Models of Care trialling multidisciplinary care models in remote towns, including in NSW. There is the PRIM-HS Model in Mareeba in Queensland which is a community-led and co-designed model integrating local government, clinicians, and volunteers and aged care providers focussing on sustainable, locally tailored primary and social care for rural populations.

3.

Care homes must also evolve.

Flexible models like co-housing, intergenerational living, and small-scale community homes are being trialled in rural areas across Europe and could be adapted for rural Scotland.

We have also to be prepared to build not what is wanted and needed now but what is going to be acceptable in 10 or 20 or 30 years – and all the signs are in the UK and internationally that when people do need to move into residential care they want small, purpose built residential settings within local communities – and which are embedded, adaptable, and supported by technology.

Research by Alzheimer Scotland last year advocated for what has become known as the ‘small supports’ model – which many in the sector are only too open to deliver but which at the moment is wholly unaffordable because of the low levels of funding through the NCHC.

Indeed, Scottish Care and other stakeholders have done work on costings for a 20-25 bed care home model rather than the current model of 50 plus. But whilst it might be desirable it is wholly unaffordable within the current fiscal envelope. So key to all this change for care homes is a radically revised Cost Model within the National Care Home Contract.

4.

Flexible regulatory and registration arrangements for workers and organisations.

I am aware of the work that Jaci Douglas from the Care and Learning Alliance has been leading on in terms of the Single Care Model in the Highlands. I was pleased to meet Jaci and hear of this innovative work and I shared with her that similar models had been and are being developed and delivered in rural Canada. There several provinces maintain professional registries for early childhood educators, often linked to broader care workforce strategies. These registries support career mobility and professional recognition across child and adult care sectors.

The work of the Highland consortium is exciting, and I hope will go from strength to strength –

‘It is about taking a holistic approach in rural communities, an opportunity for people to live and work in their communities in a way that is flexible, everything needed is met i.e. person has child care which allows [her – more often women] to go to work and to care for parents or other loved ones which otherwise wouldn’t be able to.

Many carer roles are part time in smaller communities, not enough hours, this combined role would allow more full-time opportunities, this can be the difference between working and not is it worth working when not enough hours.’

To succeed it needs regulatory change and flexibility.

Australia at this very moment is actively exploring a national registration scheme for care workers that spans aged care, disability, and early childhood sectors. The so-called ACRN Proposal (2025): advocates for a nationally mandated, harmonised, and legislated registration and education scheme for all care workers. This would allow for cross-sector mobility and ensure consistent standards across community and residential care settings. Note this is not just for rural communities but it is felt by stakeholders that these communities will especially benefit.

Effectively and put simply we need to adjust our registration frameworks to enable a more flexible approach to services across the age spectrum and across sectors; and secondly we need to enable a much more flexible approach to workforce so that we get away from siloed professionalism which is not only failing us but in truth is divorced from the realities most younger workers want to experience and live in.

5.

Investment in co-ordinated digital infrastructure

The Care Technologist Project in Baillieston and other models developed by Scottish Care and now being adopted at scale in England – equip older adults with smart lighting, voice-activated devices, and robotic pets. In rural areas, such tools can reduce isolation and support independent living.

These innovations show that rural home care can be responsive, personalised, and sustainable – that is if we invest in the right infrastructure and leadership.

Conclusion

We are at a turning point.

We can continue to patch a system that is fraying. Or we can build something better- something rooted in fairness, shaped by lived experience, and responsive to local needs.

Social care is not just about services. It is about relationships, dignity, and the right to live well.

I spoke at the beginning about the sense of belonging that people like my Skye grandmother have always spoken to me about. A sense of duchlas. It is about how we care for one another, especially those who are most valuable and in need of our support. I believe we can – if we are sufficiently adventurous honour that belonging through a social care system that is compassionate, innovative, and rooted in community.

Donald Macaskill

 

Next Wednesday, 29th October, is World Stroke Day, which gives us an opportunity to reflect not only on the global burden of stroke but on its deeply personal and local impact – particularly on older people in Scotland. The theme this year, “Every Minute Counts”, is a stark reminder that stroke is a medical emergency where time lost is brain lost. It is also a call to action: to educate, to advocate, and to care.

In Scotland, stroke remains one of the leading causes of death and disability. According to a report from Public Health Scotland published a couple of months ago in 2024 alone, 11,341 people received a final diagnosis of stroke. Of these, 84.9% were ischaemic strokes, caused by a clot, and 13.8% were haemorrhagic, caused by bleeding in the brain. These numbers are not just statistics. They represent lives changed in an instant, families thrown into crisis, and communities called to respond.

The Scottish Stroke Care Audit reveals that only 52.9% of patients received the full stroke care bundle upon admission. This bundle, comprising admission to a stroke unit, swallow screening, brain imaging, and aspirin is proven to reduce mortality and improve recovery. Yet not a single health board met the national standard of 80%.

Stroke disproportionately affects older adults. The incidence rate for those over 75 is 1,382 per 100,000 population, compared to just 126 for those under 75. Recovery in older age is often complicated by frailty, comorbidities, and social isolation. The Scottish Burden of Disease report predicts a 35% increase in cerebrovascular disease by 2044, equivalent to an additional 37,000 people.

Stroke is the leading cause of disability in Scotland, and older survivors often face long-term challenges in mobility, cognition, and emotional wellbeing. The risk of stroke is 62% higher in the most deprived areas, compounding inequalities and demanding targeted community support.

Recovery from stroke is rarely linear. It is a journey marked by small victories and profound setbacks. The Stroke Association reminds us that two-thirds of stroke survivors live with long-term disabilities. Fatigue, memory loss, and emotional distress are common companions. Yet, with the right support, namely rehabilitation, peer networks, and compassionate care, many do find a new rhythm to life.

In Scotland, organisations like Chest Heart & Stroke Scotland are pioneering Health Hubs in deprived communities, offering exercise classes, health checks, and peer support. These hubs are lifelines, helping older adults rebuild not just their bodies but their confidence and connections.

While acute stroke care often begins in hospital, long-term recovery is sustained in the community and this is where social care services become indispensable.

Care homes in Scotland are increasingly recognised as rehabilitation environments, not just places of residence. They can offer 24/7 clinical supervision, ensuring continuity of care and immediate response to complications. They also enable multidisciplinary coordination, with physiotherapists, occupational therapists, nurses, and care staff working together to support recovery goals. And critically they can foster social engagement, which combats isolation and apathy – two major barriers to stroke recovery.

In care homes, stroke survivors benefit from structured therapy programmes that are difficult to replicate at home. Group activities, peer support, and routine all contribute to improved outcomes in mobility, self-care, and emotional wellbeing.

For many older adults, home care services offer the chance to recover in a familiar environment. Scotland’s Intermediate Care Teams, including Early Supported Discharge and Reablement services bridge the gap between hospital and home. These teams can deliver stroke-specific rehabilitation at home, often at hospital-level intensity. They can also provide short-term support to relearn daily living skills and regain independence

However, home care is not without challenges. Space limitations, lack of equipment, and reduced therapy intensity can hinder recovery. That’s why integrated care planning, involving families, carers, and professionals – is essential.

As we look to the future, we must ask: are we investing enough in the social care and in its workforce in relation to stroke recovery? Are we recognising the expertise of care home staff and home carers in stroke recovery?

The economic cost of stroke in Scotland is projected to exceed £2.5 billion annually by 2025, rising to £4.5 billion by 2035. Much of this burden falls on social care. Yet, the sector remains underfunded and undervalued.

We need a national conversation about the role of social care in stroke recovery. We need to celebrate its contribution, support its workforce, and embed it fully in our stroke strategy.

To close, I offer a poem by Hannah Lowe, whose work in Magma Poetry captures the quiet devastation and enduring love that stroke brings into a family:

The Stroke

For days after the stroke, she laid bed-bound, misdiagnosed –

the Doctor said ‘Bells Palsy’ of her weeping eye and tilted frown,

her hand cold-numb below the eiderdown…

Her body was a blueprint, harbinger of duty, worry, pain…

And still my mother didn’t answer.

These lines remind us that stroke is not just a clinical event – it is a deeply human one. It touches memory, identity, and relationship. And it calls us, as a society, to respond with empathy, urgency, and hope.

Donald Macaskill

Today, October 18, is World Menopause Day.

When I was growing up, menopause was a word rarely spoken aloud. It was cloaked in euphemism and silence, even in health and care settings. Thankfully, in recent years, that silence has begun to lift. Thanks to the advocacy of women like Davina McCall and countless others, menopause is now part of our public discourse.

But awareness is only the beginning.

Menopause is not simply a biological milestone. It is a deeply personal transition, one that touches identity, dignity, and wellbeing. For many, it is a time of hot flushes and sleepless nights, but also of anxiety, loss of confidence, and changes in cognition and memory. It can be a time of liberation, but also of stigma and invisibility.

And in the world of ageing and social care, menopause is not something left behind in middle age. Its effects ripple forward into later life. Bone health, cardiovascular disease, mental wellbeing, and cognitive function – all are shaped by the hormonal shifts of menopause.

Recent research has shown that menopause, particularly the transition phase, is associated with accelerated biological ageing across multiple organ systems, with liver, metabolic, and kidney health most affected. Earlier menopause is linked to increased risks of osteoporosis, dementia, and heart disease.

This means that in our care homes, in our communities, and through our homecare services, we are supporting women who live with the long-term consequences of menopause. Yet too often, their discomforts are dismissed as “just age.” Their histories go unacknowledged. Their symptoms – urinary issues, sexual health concerns, mood changes – are rarely validated.

A truly rights-based approach to care demands that we take women’s health across the life course seriously – from puberty to post-menopause.

But menopause is not only about those we care for. It is also about those who care.

The majority of Scotland’s social care workforce are women. Many are in their 40s and 50s – precisely the ages when menopausal change is most present. The demands of care work are physical and emotional. Night shifts, lifting, relentless schedules. Add to this the brain fog, the sweats, the fatigue, the anxiety of menopause, and you begin to see why staff support is not a luxury – it is a necessity.

Recent guidance from Skills for Care reveals that 77% of women experience menopausal symptoms, with nearly a quarter reporting them as severe. 44% say their ability to work is affected. One in ten have considered leaving their job due to menopause. These are not statistics. These are stories of women who give so much compassion to others yet often receive little in return.

If we value care, we must value carers. That means creating workplaces where menopause is not whispered about but understood. Where adjustments are made. Where compassion is shown. Where women feel safe to speak, and managers are equipped to listen.

Menopause is not a footnote in the story of ageing. It is a chapter of transformation. And in a Scotland that values human rights, care, and compassion, it is a chapter we must no longer ignore.

World Menopause Day is more than awareness. It is a call for cultural change. A call to honour the contribution of women across the life course. A call to ensure that healthcare, social care, and workplaces are aligned in recognising the impact of menopause and offering practical, humane support.

This is not marginal. It is central.

To ignore menopause is to ignore the lives of millions of women – our mothers, our colleagues, our carers, our friends. Let us listen. Let us learn. Let us lead with empathy.

I leave you with a poem, shared by menopause advocate Tass Smith, which captures the emotional truth of menopause in a way that clinical language cannot. It speaks to the unpredictability, the loss of confidence, and the haunting repetition of symptoms that many women experiences. It is a reminder that menopause is not just a medical condition – it is a lived reality, and one that deserves to be seen, heard, and supported.

She Loves Me, She Loves Me Not

She loves me.

By day she sits, quietly, by my side.

My night cool and restful.

She loves me not.

She laughs mockingly in my face.

And it burns.

The fog descends, and with it, my capacity to think.

I’m a rabbit caught in the headlights.

I stumble, blindly through the day, tears pricking my eyes.

She’s packed away my self-esteem.

My courage fails me.

Meltdown.

The night brings no solace.

Her furnace stoked.

I lie awake, haunted by the nightmare of my day’s ineptitude.

I’m stuck on repeat.

Oh she tells me it’s just my age; a phase to go through.

That my hormones will, eventually, settle down.

Bring on that day.

 

Taken from https://lifenow.uk/blog/the-raw-truth-of-menopause

 

Donald Macaskill