Hopefully Something…

“What are you going to do with that?” The question my aunt asked me when I told her I was going to do a Master’s degree in Human Rights. “I don’t know,” I told her. “Hopefully, something.”

Something that will make a difference. I guess that’s what we all want to do really, just in our own, individual way.

My first experience of the difference a human rights based approach can make came after university. I moved to India to work for a Human Rights Charity called Shanti Bhavan or in English, Haven of Peace. The charity, the only of its kind in the world, supports children from the Dalit or ‘untouchable’ caste to fulfil their potential through human rights. These children, of which there are over 300 million, are considered to be worthless, unable to become anyone or anything or to contribute to society in any other way than sweeping the streets before sunrise.

Shanti Bhavan is a residential school which invites these children in and grants them their basic human rights from day one; the right to non-discrimination, the right to be treated with dignity and respect, the right to security and the right to education. The school provides, board, food, clothing, medical care and education from nursery through to university entrance exams. The charity started in 1997 and in 2010 saw its first batch of university graduates all of which secured jobs, lifting their families out of poverty, their villages in some cases and breaking the cycle of ‘caste.’ That’s the power of human rights, if we strive to treat everyone equally, with respect and dignity then we give everyone the opportunity to fulfil their potential.

In Scotland, we don’t have a caste system to contend with but we do have a system, a way of doing things, a way of seeing things which means that for some, human rights are not always realised. Older people are amongst these vulnerable groups. Sadly, Action on Elder Abuse estimated recently that 500,000 older people are subject to abuse at any one time. Our work at Scottish Care seeks to address this, to shape a care sector in which older people are respected, independent and equal members of society.

Over the past year, we’ve been working with older people in residential care and those receiving care at home or housing support to develop our Human Rights Conventions. We asked them, “What rights need to be protected to allow you to achieve your full potential?” They told us that they needed the right to privacy, to family life, to security, to freedom from inhumane or degrading treatment, to choice and to non-discrimination.

And, like Shanti Bhavan, in Scotland, there exists organisations and individuals who strive on a daily basis to promote and protect these rights. Carers who stay an extra hour after their shift to ensure that Jane feels secure and comfortable, who listen for hours on end to show Robert that he’s respected and important, who close the curtains to provide privacy. Nurses who take the time to explain things calmly and compassionately, who hold someone’s hand through a hard time, who ask, “are you ok?” to ensure dignity.

I guess what I’m trying to say is that the human rights we all entitled to and that we all need to flourish don’t change depending on where you live, what ‘caste’ you come from or what age you are. They are about how we treat people, how we make them feel and how we support them to achieve their potential as human beings. And, everywhere, there exists people who make these rights real. This blog is dedicated to them.

And, if anyone reading this needs a bit of motivation or positivity to get through today, take a look at this video of the children of Shanti Bhavan, I miss them an incredible amount.

[email protected]

 

 

Don’t walk away – a mental health challenge

 

One of the most interesting and yet challenging studies I have read recently was one published in the British Journal of Psychology last week. In an extensive European wide study researchers found many more elderly people than expected have or have experienced a mental disorder when evaluating them with a new, simpler screening technique. Indeed they discovered that nearly one-quarter of older people had a mental disorder in the previous year, and one-third had been treated for one in the previous year.

 

Traditionally it had been thought that the risk of mental disorders declined with age, but this new study suggests that is not true, raising concerns because of the greater effect depression, anxiety or substance dependence can have on health conditions for older people.

 

According to the researchers, older people struggle to remain attentive during traditional diagnostic tests and the questions may be too long or complicated, which makes their performance even worse. For the new study, researchers developed a new diagnostic method using a computer-based interview system with simplified questions and statements.

 

This research seems to underpin what I have been hearing and witnessing when I talk to staff who work in care homes, care at home and housing support services. The challenges facing services in Scotland are significant. It was therefore a positive measure to see proposals in the consultation on Scotland’s Ten Year Mental Health Strategy which have the potential to address the mental health challenges of our older citizens.

 

Scottish Care has made a response to the consultation. In it we highlight that many older people develop mental health challenges later in life, often when they are receiving care at home or care in residential settings.

 

We have come a long way in the last ten years with our work on dementia. However, there has always been a risk that the focus on dementia has taken our eye off other mental health and life enduring challenges faced by older Scots. I spoke recently to someone who had lived with chronic depression most of their adult life and had received good supports until that is they got to 65 years of age. Then almost overnight, he told me, it felt like the system was abandoning him and the supports he had been used to changed and disappeared.

 

“It was like standing at a window and seeing everything and everyone who had helped you live your life, especially in the down times, walk down the street and wave goodbye. I felt really alone.”

 

 

We have I believe to get much better at supporting people who have life enduring mental health challenges transition from adult to older people services. This will include properly resourcing the older people care sector to train and equip staff to deal with mental health issues and challenges and also to give greater priority to enable the development of new models of support which can cater for individual and particular mental health needs.

 

In addition, old age itself brings about a whole range of changes, many of which are positive and welcomed, but some are challenging and difficult. I do not believe, and the study quoted above highlights this, that we have sufficiently robust mechanisms in place for diagnosing and then supporting individuals who develop a whole range of conditions after the age of 65.

 

There is a real opportunity for Scottish Government, older people and providers to work together to improve the quality of mental health support. At times of vulnerability we need to give people the feeling and sense that people are there to support and guide, not that they are walking away from them.

 

Dr Donald Macaskill

18^th September, 2016

 

Greetings from Argyll and Bute.  We wanted to let you know about an exciting project that took place in Oban this summer.

One of the care at home providers, Carer’s Direct, took part in a pilot for a placement for physiotherapy students from Glasgow Caledonia University.  The placement was referred to as a split placement – the students time was split between the physiotherapy department in Oban, Lorne and the Isles District General Hospital, the Community Healthcare Team and Carers Direct.  This was an ideal project for us to work on together, as it built on improved partner relationships which had developed in Argyll and Bute over the last few years.  These relationships were forged against the backdrop of RCOP (Reshaping Care for Older People) and a workforce development project facilitated by IRISS (Institute of Research and Innovation in Social Services) and supported through the role of the Local Integration Leads.

The aim of the placement was to promote awareness of the move to more people being cared for at home and the implications for healthcare professionals (specifically physiotherapists) of supporting people in their own home.

The project was supported by a steering group with representatives from each of the agencies involved – Carer’s Direct, NHS Highland, NES, Care Inspectorate, Scottish Care, Glasgow Caledonian University so that learning from the pilot could be written up and disseminated.

Thanks to a lot of goodwill and hard work from all of the agencies involved in supporting the students during the placement it was a real success. We also have to mention here that the sun shone on Oban for the duration of the placement!  We are hoping that having worked and seen Argyll in it’s best light this might help with recruitment and retention!  Some of the students evaluation has been filmed and will be widely available soon – look out for the link on the Scottish Care website.  There will also be a link to the written evaluation and this includes lessons learned as well as the notable successes.

Of particular interest to care at home providers, development officers and local integration leads will be the students comments about how little time care at home staff are allocated to complete complex care tasks.  For the students this was at odds with promoting independence.  Care staff reported back that it was very helpful to have access to the physiotherapy students and to learn from how they worked with people to promote well-being and independence.  The care at home manager observed that care staff have gained transferrable skills and insight from working with the students.  We also recognised that the project helped cement relationships across the sectors within the partnership, promoted a better rapport and understanding of each other’s perspective and fostered a stronger team approach to delivering care.

Glasgow Caledonian University are keen to extend split placements for students to other providers and other areas of Scotland as a result of the outcomes from the pilot.  So if you know of any providers who might be interested in hosting a placement please spread the word.

 

Anne Austin & Susan M. Spicer,

Argyll and Bute Local Integration Lead, Scottish Care (job-share)

Anne’s email:  [email protected]   or, mobile: 07460898897

Susan’s email: [email protected] or, mobile:07771610728