Help At Hand

2nd November 2012

The key to successful aging is to pay as little attention to it as possible, according to American talk show host Judith Regan – but the time will come for most of us when this advice, witty as it might be, wears thin and useless.

Becky Slack talks to one local couple who have had to pay full attention to the challenges of age, and finds out what services are available to assist older people.

John Mott is 89. His primary carer is his wife, Hazel, 87. John has needed round-the-clock support since suffering a series of strokes over the last two years. With her own health deteriorating and no family living nearby to help, Hazel has had to turn to others for assistance.

“I really was at my wits end to begin with. I didn't know how I was going to cope,” she says.

After many telephone calls and much form-filling Hazel now has the support of a live-in carer (paid for out of the couple’s savings) and carers provided by the local council who visit the house four times a day – services which are supplemented by free practical support from the charity WRVS, whose volunteers assist with transport and shopping.

“John is bed-ridden and has to be hoisted if he wants to move – I can’t do that on my own,” says Hazel. “It’s very miserable for him. The fact that I get help means so much to him as he’s always saying he wishes he could do more for me.”

Hazel and John Mott, who come from Rickmansworth, are not on their own. Demographic shifts and improvements in healthcare have increased life expectancy dramatically. The 2011 UK Census shows that the number of people aged over 65 is the highest on record at 16.4 per cent – or one in six. Meanwhile, the number of UK citizens aged over 90 has jumped from 13,000 to 430,000 over the last century. The Optima distribution area of north Middlesex and south Hertfordshire is fairly representative of these country-wide statistics; about 18 per cent of Hertfordshire is over retirement age, for example. As the age of our population increases, so too does the number of people reporting long-term medical problems, mobility issues and sensory disabilities.

In recognition of this ever-growing section of society, there now exists an array of useful services and facilities, laid on by councils, private providers and charities. This is good news for older people as it means that care is available. The challenge, though, lies in navigating this complex maze, particularly when it is accompanied by technical language and jargon. Harrow Council, for example, uses the term ‘enablement’ to describe its adult social care services – a term that will probably mean little to those who are new to the system.

The first step in the social care journey is to establish what sort of care is required – or even if it is needed at all

“It is important to respect the wishes of the individual,” says Marion Birch, chief executive at Age UK Hertfordshire. “Often it’s the case that people can still manage – they just do things at a slower pace. We had a man phone us recently to say that his mum needed to go into a home. When we looked into it, it turned out she was still doing the gardening…”

A residential home, be it owned by the council or a private company, is often one of the first things that people think about when considering care needs, and many are happy to make the move. However, although most providers offer excellent facilities – the Care Quality Commission has details of the options available in the area – not everyone is comfortable with the idea of leaving their home, as Hazel Mott says. “When it came to him being discharged we had the option of either a care home or coming home. It was a very difficult decision to make,” she says. “I visited some care homes, but I wanted him home with me. We’ve been married for 64 years – I didn’t like the idea of us being apart.”

For couples like the Motts who want to remain together in their own home, the local council should be the first port of call. It will have a suite of services it can offer, from basics such as meals on wheels and transport to hospital appointments, to on-going personal and medical care, such as help with washing, dressing and assistance with medicines. However, before it will agree to any level of care it will require two assessments to take place. The first is a Care Needs Assessment, aimed at determining what the need is and the best way to meet it. The second is to calculate how much financial support the individual is entitled to from the state. Unfortunately, in straitened times, not everyone will receive the help they want or need.

“We work within a set budget and cannot provide all the support we are asked for so we give priority to people with the greatest need,” Herts County Council website states. “We will fund support for adults who are considered to be at critical or substantial risk. But we cannot do this for people who are considered to be a moderate or low risk.”

These same principles are applied by all councils, which have to abide by the Fair Access to Care Services guidance issued by the Department of Health. However, judgement as to the extent of someone’s care needs is down to the individual who is reviewing the case and the information they are provided with, which can make it a bit of a lottery as to what care is granted. As Hazel Mott reflects, “There are endless forms to fill in, which don’t give the true picture – you just have to tick a box: yes or no.”

For those whose needs are not covered by statutory care there are two options available: pay for private care or access the services offered by local community groups and charities. There are a number of websites that direct people to what is available. Healthcare.co.uk, for example, is a website that provides details of all kinds of services aimed at maintaining a high standard of life for older people while independentliving.co.uk is another. Age UK also has a detailed website and a phone line manned by trained staff who can help identify what kind of help might be needed.

Mobility needs can be met by the ever-growing range of apparatus, from grab rails and walking frames to motorised chairs and stair lifts that can be borrowed on a temporary basis or permanently installed. The British Red Cross and the Disability Living Foundation can direct people to free or subsidised equipment.

Meanwhile, life can be made easier by the introduction of new technologies that will remotely monitor someone’s vital signs such as blood pressure, blood sugar and pulse, for example, with the aim being to reduce the amount of time spent in surgeries and hospital; measures such as these will ease both the financial and logistical challenges that older people may face when needing to travel frequently to and from medical appointments.
Even those who care for older people have options available to them.

“Many people don’t see themselves as carers. They see themselves as a husband or wife, or son or daughter, who’s helping their partner or parents. But if you are looking after someone and it’s having an impact on you, you are a carer and you could be entitled to some kind of benefit such as a discount on council tax or a grant from a charity,” says Steve McIntosh at Carers UK who adds that people should speak to charities such as his or the Citizen’s Advice Bureau about what is available and to who.

Making the decision to admit need can be difficult, but it is something that should not be ignored. There are people out there who can help and, as Hazel Mott says, support can have a really positive impact on an individual’s wellbeing. “A WRVS volunteer will give me a lift to the shops and help me with the trolley and packing,” she says. “It’s a tremendous help and he’s become a real friend. I don’t know how I could get on without him…”

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