Living well independently

The Cambridgeshire Insight website, run by the council, shows that Cambridgeshire has been the fastest growing county authority for more than a decade. And that by 2031 the population of those 65+ years old is due to increase significantly.

Many of these people will be able to live independently, with family and friends to support them without any intervention from the council at all. However many won’t. Not everybody has family, not everybody has friends.

Earlier this year the county was hit by quite a large storm, it was called Storm Doris and I remember it very well because it highlighted to me a huge problem we have with isolation. My wife and I were putting the kids to bed and just as I was heading upstairs I heard a strange scraping sound from my front door. I assumed something had blown against it but when I opened to check I found an elderly lady lying on my doorstep. She was soaked through, very shaken and unable to stand. Having tripped on the dark path outside my house she, with her jack russell dog, had been lying there for more than 20 minutes.

I helped her up and into our house where we dried her off and checked she was OK. She insisted she was and I said I’d walk with her back to her house. All she wanted to do was get back home which was only 100m or so away.

We asked if there was anyone we could let know, or who would come and help and there wasn’t.
No family, no close friends. “It’s just me”

So I started to walk her back to her house but after we were roughly halfway home she couldn’t walk even with my assistance. I phoned for an ambulance as I was concerned we’d make her injury worse but due to the storm they were extremely busy and the wait was going to be over 2 hours. Even for an 89 year old outside in the rain with a hip injury.

Throughout our conversation she kept telling me that she didn’t want to be a burden, or a nuisance. Eventually she said she did have some friends on our road and she had been out posting a birthday card through their door when the fall had happened. I then phoned my wife who went to their house and told them what was happening, and of course they rushed straight out to help me get her home.

Since that night I’ve done a lot of thinking about what can be done to help.

The thing is there is no such thing as a typical elderly person. They are just as diverse as younger people and whilst some are gregarious and seek company others prefer a quieter life.  Some will suffer health problems, others will be spritely well into their 80s. Some will be suffer memory problems by 70 and others be using learning new things at 90.

What I do think people have in common is a desire for safety, comfort and the feeling that if they needed company or assistance they could get it without feeling they were a burden or a nuisance.

So how can that be achieved?
Well the council has drawn up a list of priorities, briefly these are:
  • Developing new models for delivery including informal community networks
  • Better coordination with other organisations
  • Work with NHS to support earlier preventative intervention
  • Try to develop multi-skilled to deliver more than one service at a time
  • Better use of assistive and enabling technology
I want to set out a vision of well designed communities, supported by professionals and voluntary groups using technology as an enabler for making lives better.Anyone who has been involved in trying to find support for an elderly relative knows how
complex it can seem to outsiders to navigate the system.
It must be particularly difficult when you are the older person in need of help and you don’t know what to
do or who to call.

  • We already have the data within the public sector that would help us arrange the right help. So why not draw it all into one clear and easy to use system? Accessible by local authorities, GPs, NHS services, local charitable and voluntary organisations. It would allow us to identify where the people live, what support they require and allow much better coordination of services, both formal and informal.

  • The formal services such as health and care could be better coordinated to reduce travel times, the system could be updated so that everyone involved in care could easily interact with the system. A GP seeing a patient with concerns over signs of depression/loneliness could easily flag these up to all agencies with a simple reporting system. Seeing this report would flag this up to a volunteers group - like the community navigators service - who would pay them a visit and see what they can do to help.

  • There is a lot of cumbersome and terribly designed software in councils so this would have ease of use as a priority.

  • A single software system would also make the work of data analysts easier. They would be able to identify where the older people lived, the needs of the population and allocate resources in the most efficient manner. Travel time for care staff would be reduced allowing more time to be spent on each visit. Training needs could be identified so each small area of the county would have coverage for the specialist services required. Trends could be identified so we could better identify those who are showing signs of decline and ensure support is put in place quickly.There are many other things we could do too. We could insist on better design of public spaces. Too many developments lack public spaces suitable for older people. This might be as simple as more seating, sheltered areas, places to congregate safely with accessible facilities. There are great examples of architecture all over the world we should be borrowing from. It is far easier to design in level access, wide doorways and lift access then to retro-fit it. Developers should be obliged to provide a certain percentage of homes that contain these features.

  • We can also look to best practice elsewhere in the word, in the Netherlands there is a trend towards students being co-located with older residents. In exchange for providing company and keeping an eye on them the students receive a heavily subsidised rent. Again it wouldn’t suit everyone but in expensive cities like Cambridge it could work. Trials have also shown that locating childcare facilities within residential home has shown great promise in increasing levels of happiness for both the children and the adults. With so many new communities being developed in Cambridgeshire we have a great opportunity to design in the housing, facilities and social spaces we know work best.

  • Turning back to technology. We sometimes patronise older people by saying they couldn’t cope with learning new things, however I’ve met plenty of the current generation who can and subsequent generations will be even more used to working with technology. Today’s retirees will have had 10-20 years of using computers and mobile technology and subsequent generations will see tech as part of everyday life. So we should start using existing technology such as social media for example establishing hyper-local Whatsapp groups to put people in touch with others who live within walking distance so they can check up on each other in emergencies. A smartphone with unlimited data can be purchased for under £20 a month nowadays. If this provision, to those unable to afford it, even saved a month in a care home over the lifetime of the scheme it would be self financing.

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