The summer edition of the RSA Journal articles on care and the ‘crisis in care in the UK’ were both interesting and stimulating. As a Fellow who has achieved old age (79), I am particularly interested in the care of the elderly and believe that in Britain there are a number of community initiatives that do achieve what most older people want and need. Unfortunately, whilst they are very good at providing what older people seek they are not good at getting their message across effectively.
A great deal has been published about the increasing life expectancy and thus the proportion of the population that is elderly. However, this always seems to say that this means a massive increase in the numbers needing care in the years ahead. What it has not recognised is that there is a very positive side to this. It is those who have retired who provide the largest proportion of volunteers, the lifeblood of many charities providing support for those in greatest need. For example between now and 2035 it is estimated that the number of people over 85-years-old will have increased by about 2 million but those between 65 (retirement age) and 80 – the period when we might expect them to become volunteers – are estimated to increase by about the same number.
So there could be an extra potential volunteer for each extra person needing care. We need to make sure that we tap into this potential pool of community support. Many of us in our 70s are still very fit and able, and have found that there is great satisfaction to be had by contributing positively to our community. This resource should be positively promoted.
We are not only living longer than we did but also remain fit for much longer. Usually we are fine until we are in our 80s and have ‘lost’ our spouse or partner; often it is then that the problems start. So what can be done to prevent or alleviate these?
Most of us want to retain our independence, in our own home, and our ability to remain active with our friends in our community, whilst retaining our privacy. We need good food and the security of knowing that if we are taken ill, or have a fall, there is a way of getting instant help. We want to be safe from burglary or being abused in other ways. When we have lost our spouse or partner we want the companionship of friends, when we feel lonely; we do not want to have to cook meals just for ourselves. We do not want the worry of looking after a large family house and the uncertainty of unexpected bills. We do not want to have to spend too much of our pension and life savings on achieving the quality of life we desire and we do not want to have to move into hospital or nursing care until we are so unwell that it is essential to have 24-hour medical help.
Many of us now have much higher expectations than before: we want more space, separate bed and sitting rooms, en suite facilities, better services, and a better quality of life than we would have expected only a few years ago. Also more of us have a house worth quite a lot of money, though this is likely to reduce in future as less people can afford to buy and more have to rent the home they live in.
In over 400 towns and villages around Britain – and increasingly abroad – groups of local volunteers have got together to raise the money to buy, or build, large houses in the heart of their community, and to create, in them, apartments for local elderly people to lease. These apartments vary from self-contained two bedroom flats to single bedsitting rooms. Each house has a central kitchen, dining room and sitting room, car parking spaces, a spare room for visiting relatives or friends who tenants wish to invite to stay for a while, and a housekeeper to provide meals, and oversee the cleaning, laundry, and gardening. Each apartment has both an internal and external alarm systems and each tenant has a key for their own apartment, and for the house front door. If a tenant reaches the stage when they need help to get up, or shower, carers can be arranged.
Each tenant is notified of the planned monthly charge for the next 12 months well in advance of each year and has the chance to appeal or get help to find funding if they have a problem. The charge covers all the essentials: rent, food heating lighting, council tax, cleaning and laundry, water and sewage, building insurance, maintenance repair and decoration, staff, alarm systems and stair lifts (so there is no danger of an unexpected bill). This is very reasonable because the house is managed by unpaid local volunteers, is run for the community, is not-for-profit and the costs are shared between all the tenants. Each local house is usually registered as an independent social landlord and some, in the larger towns, have opened second or third houses or built larger apartment buildings to meet the local demand. Though they are each independent, they all share the same ethos of care in the community by local volunteers, and many pay a small fee into a central fund that employs specialist professionals to advise them, and to monitor the agreed standard that each house has to achieve.
That this approach does provide what most older tenants want can be confirmed by the frequent plaudits of the tenants everywhere, the number of tenants in such houses who are able to retain their independence into their late 90s and over 100. The impressive list of Patronage such organisations have attracted over the years, including the Queen Mother, the Prince of Wales, several Archbishops of Canterbury, Dames Judy Dench and Vera Lynn, Geoffrey Palmer, Marguerite Patten (so the food must be pretty good!), Patricia Routledge and many others.
If anyone is interested in finding out more, or considering getting a group of local volunteers together to start one locally for their town or village, they can find out more by looking them up on one of the following sites: www.abbeyfield.com, www.carrgomm.org, for the elderly based in the United Kingdom.