Creating Care for the Whole person
by Mervyn Eastman
There can be little doubt that “a radical change of perspective is needed if public services are to meet the challenges of our ageing society” .
Older people now and in the future do not wish to continue being patronised by paternalism and a ‘we know best’ attitude to meeting needs and aspirations.
Maintaining independence and well being is not just about ‘prevention’ (whatever that might mean!) but is about constructing service responses that see beyond the labels of care, support, dependency, old age and ageing. A response that is underpinned by the promotion of a holistic approach embracing the concept of citizenship of ALL older people, whether they need care and support or not; their total engagement in decisions about their quality of life and above all moving away from choice and independence to CONTROL and INTER-DEPENDENCE.
Much of our past and current responses to care and support promotes a distinction between those older people who are active and those who require varying levels of support. Social inclusion must include those in residential care, hospitals, nursing homes, day centres and supported accommodation. Such social inclusion promotes the notion that all older people are contributors and not recipients.
As society ages and offers opportunities far beyond those of previous generations, there needs to be a fundamental shift in how we think about older people and ourselves as growing older. Medical advances, improved living conditions, greater opportunities to engage within the communities in which we live and greater life expectancies challenge politicians, professionals, age-sector organisations and older people alike to rethink attitudes about how best to meet the aspirations of a population that, by 2025, will exceed the number of children by two million!
I am now 56 years old, a so-called ‘baby boomer’ of the first cohort and, alongside millions of others, am “redefining middle age and beyond” . I am not going to be interested in politicians and professionals providing me with services I do not want, and certainly not interested in them telling me they know best about what I need. It will be I who tell them. I am not going to be interested in welfare but well being – opportunities to exercise my citizenship, my human rights, my control and my agenda across all aspects of public policy. If and when I require support or become frail and enter a time of long term dependency, my expectation will be that in such dependency I will be viewed as a contributor, not a service user or patient. I will be more than simply a passive recipient of a so-called health and care system that, to date, holds power over who and what I am.
Such will be the challenge facing public policy providers and commissioners of services. The challenge too will be for age-sector organisations (large and small) to work in partnership with government at all levels and with older people themselves to stop seeing older people and their care needs as “somebody else” or as a health and social care responsibility.
We have already begun the journey to the WHOLE person, system and community approach that most underpin social care provision . ‘Opportunity Age’, the UK Government’s White Paper that seeks to prepare effectively for the age shift between now and 2050, was issued days after the publication of their Green Paper on a ‘Vision for the Future of Social Care for Adults in England’. Both share the same rhetoric and aspirations – control over our lives and making a contribution. The Welsh Assembly Government has already embarked on its national older people’s 10 year strategy. All recognise citizenship and engagement as key outcomes.
The future does indeed look bright but the rhetoric will only become a reality when public sector structures of decision-making become ones of partnership with older people – all older people – and by ridding ourselves of decision-making structures that keep power in the hands of those who believe older people are “somebody else” – not us, simply older!
Mervyn Eastman, UK Director