Jean Townsend is a member of a research team at the University of Leeds, with a special interest in older people. Before working for the university, she worked in the voluntary sector with carers and for the NHS as chief officer of the Community Health Council.

Mary Godfrey and Tracy Denby are researchers at the Nuffield Institute for Health, University of Leeds.

"Having a safe, comfortable home, being close to friends and amenities in a safe neighbourhood, being able to take part in social activities, keeping busy, getting out and about and using transport, knowing how to find the way around the system and having good access to health services and to advice on how to stay healthy."¹

This is how a recent Audit Commission report summed up the factors that contribute to a sense of independence and well-being in older people. Many of them can be grouped under the heading "neighbourhood support".

Research for the Joseph Rowntree Foundation provides insight into the importance of neighbourhood support for older people.² Between 2001 and 2004, researchers at Leeds University worked with groups of older people to identify what makes for a good life in old age and what kinds of services and support can sustain well-being. The study took place in two localities and used in-depth interviews, focus groups and participant observation. Eighty-four people, aged 58 to 97, were interviewed individually.

Central to a good life in old age was securing interdependence, comprising the following:

• Being part of a community where people care about and look out for each other.
• "Not being a burden", especially on family.
• Maintaining reciprocal relationships.

In an ethnically diverse, inner city area of Leeds, our research partner was Caring Together, one of 37 neighbourhood schemes in the city that support and engage older people. Having their roots in community development, many of these schemes received recognition and support from Leeds Council in the 1990s as part of its strategy to foster "community care" at the neighbourhood level. They are now independent charities, managed by local people.

Caring Together provides advice, advocacy, support and befriending to older people, organises social, leisure and interest pursuits, and gives practical assistance with gardening, decorating and odd jobs. It has five staff and a membership of 370, nearly one-third of the local older population. In describing their relationship with the group, older people not only indicated how helpful the services were, they also demonstrated how the approach and method of working was central in promoting well-being. Key factors were:

• The search for ways to enable everyone to be involved - from active older people to those whose lives were increasingly restricted to the home and immediate area.
• The emphasis on finding creative solutions to maintaining social relationships, even in the face of restriction.
• The accessible, flexible support provided.

The opportunity to be involved was a key motivator for many members of Caring Together, with individuals engaged in different facets of work - as peer befrienders, fund-raisers, members of planning groups and the management committee, and as participants in social and interest-based activities. Ways were sought to enable older people who were mainly housebound to use their skills and expertise. One older woman spoke with pride of the knitting she had done for a group tapestry; another recounted how she had taught her Chinese student befriender to bake scones. Partnership and reciprocity was revealed in the way newcomers were drawn in. Some active older people were concerned about the perceived stigma of belonging to an organisation for older people. Knowing that they were helping others as well as enjoying themselves assuaged their concerns.

For those older people who are often excluded from social activities by limited mobility and ill-health, gentle exercise groups and small social groups were organised on a neighbourhood basis. Bringing together people who shared common experiences of working and living in the area facilitated the formation of new friendships and created a social structure of value to newcomers.

It also offered the opportunity for people to meet with long-standing friends and acquaintances. Intimate groups of four or five people allowed them to talk and reminisce, where larger groups were viewed as too demanding. A strong tradition of church "friendly visiting" was built upon, with many older members supporting those who were unable to get out and about.

Volunteering crossed generations. Students from the university were drawn in and it was clear that many firm friendships were established, continuing long after the students had moved on.

For older people involved in running Caring Together, there were two notable features of its way of working. First, the sheer pleasure and fun derived from doing things that were challenging and new. Second, the existence of paid staff offered freedom to participate in the group's work, without having to take on day-to-day responsibility. One older woman, a leading community activist in her younger days, talked about contributing her expertise without feeling the full weight of running a group, as in the past.

In marked contrast to statutory services, Caring Together was seen as accessible: older people did not have to consider whether their problem fitted agency-defined remits. Help-seeking had the character of calling on a good neighbour or family member for help and advice - for example, assistance when the smoke alarm malfunctioned or with preparing sandwiches when the home care worker was late.

People described the group as a safety net, "knowing someone is there for you". Even when Caring Together could not offer help directly, staff would try to put people in touch with someone who could. They acted as a link to housing, social care and health agencies: providing advocacy on housing repairs, liaising with district nurses or social services on problems of hospital discharge. The group opened out new opportunities for people by drawing on resources and networks within and outside the community: adult education for life-long learning, university and independent film-makers to produce a video celebrating older people's lives; and organising swimming and exercise groups with funding through health promotion initiatives.

How far could such a model be replicated elsewhere? Is it dependent on the existence of a cohesive community identity? In this respect, the study offers hope while acknowledging the challenges. Our Leeds locality comprised two distinct neighbourhoods. One had a long, rich history of community participation and a strong sense of local identity, the other was perceived differently. Here, there was little sense of attachment to the wider community, although people did reflect on neighbourly relations within their immediate street or close by. By supporting and reinforcing existing social networks and the values attached to neighbourliness, by using older people's experience and by working alongside community, faith and interest groups, Caring Together sought to draw upon the weight of social capital within the locality as well as extend its currency.

Neighbourhood groups that are rooted in the community and underpinned by values of neighbourly support, reciprocity and the engagement of older people at every level offer a significant contribution to the well-being of older people. The challenge is to ensure sustainability, given their often precarious financial position. As new services are developed, it is essential that what they do and how they do it reflect the values and priorities of older people and are in tune with the communities in which they live.

Abstract

This article looks at research into older people's well-being and the contribution made by neighbourhood groups. The research identified older people's key values - reciprocity, not being a burden and being part of a community. It offers guidance for future service developments by demonstrating that the way that neighbourhood groups operate, rooted in local communities and in tune with older people's values and priorities, is as important as the services they offer.

References

¹ Audit Commission, Older People - Independence and Well-being, 2004 

² M Godfrey, J Townsend, T Denby, Building a Good Life for Older People in Local Communities, Joseph Rowntree Foundation, forthcoming

Further information 

• Leeds Older People's Forum at www.opforum.org.uk or tel 0113 276 0999 
• G Wistow, E Waddington, M Godfrey, Living Well in Later Life: From prevention to promotion, 2003. From www.nuffield.ac.uk/ downloads/living_well.pdf 
• M Godfrey and T Randall, Developing a Locality Based Approach to Prevention with Older People, Nuffield Institute for Health, University of Leeds, 2003 
• Joseph Rowntree Foundation, at www.jrf.org.uk

Contact

j.townsend@leeds.ac.uk or tel 0113 343 6993  Contact details for publication j.townsend@leeds.ac.uk