My practice

As a social worker in the well-being service (which also has a district nurse and health visitor) I work with older people who may not meet departmental criteria for support or who are considered to be a “low priority”. Referrals for low level need uncovers many issues such as access problems, gaps in services, lack of information and negative experiences. Service users highlight their frustrations and lack of confidence when trying to gain support but are often being passed from pillar to post.

For example, why does an 84-year-old man have to phone six departments over a housing issue? Michael Dunn had a leak under his sink and became distressed at the not-so-merry-go-round of phone calls that he had to make. He was passed from department to department without being signposted by any. Finally, a community warden pointed him to the well-being team and one phone call to the housing manager sorted out his problem. Why should a worker be able to get things done, where an older person simply comes up against barriers and obstacles?

Research findings show that attending to apparent low level need prolongs an older person’s likelihood of remaining in the community. What older people view as importance to their independence shifts in line with changing capacities and other circumstances. They accept help but only for things they can no longer manage themselves. Service provision is not always responsive to such changes.

If you are to gain the trust of older people, you simply need to spend time listening to their histories, lifestyles and aspirations. But in today’s target-driven, performance-managed culture with limited resources and large case loads, do social and health care workers have the time to really listen any more?

The case of Mabel Saunders demonstrates the importance of time. This 85-year-old was referred to the accident prevention team after a fall, which carried out a full home safety assessment and offered equipment and access to health and social care services. They, in turn, referred her to our well-being team. Over a two-and-a-half-hour discussion Mabel revealed a loss of role after the death of her partner, an inactive lifestyle and lack of knowledge of available activities. She also showed anxiety about mixing with her peers on her own.

Time spent listening in this case led to counselling, membership of a gym for chair-based exercises and swimming, membership of a social club, and Senior Citizens’ Voice. She became a volunteer at the Wildflower Centre. Today she is leading a healthy, happy and active life with no input from statutory services.

It’s vital that we work with older people to develop low-level, preventive services which truly listen to their voices.

Elaine Pugh is a social worker in Knowsley.

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