By Pauline Ashworth
Over the past 20 years, government and media attention has increasingly been drawn to the rising numbers of elderly people in our society and the consequent spiralling costs of health and social care for this section of the population. At the same time, the pressures on the NHS and local authorities, specifically financial pressures, have been widely documented and worried over. With mounting costs and reducing governmental input, the NHS and local authorities have been squeezed to a point where they are faced with invidious choices about where to prioritise their efforts and target their funding.
The number of people aged 85 and over has risen by almost a third since 2007 and is set to double in the next 20 years, according to an Age UK report published in February, while care providers suffered a £160 million cut in spending in real terms in the decade between 2010/11 and 2015/16. Further, nearly 1.2 million people aged 65 and over are not receiving the help they need with essential daily living, a 1.7% increase on 2016 and a 48% increase since 2010.
In this environment of rising demand and cuts to statutory services’ funding, the voluntary sector is becoming increasingly important. A King’s Fund Report in September 2016 noted how the voluntary sector is “keeping services going even when funding [has been] curtailed”. However, there is evidence that the voluntary sector is doing much more than keeping services going; in one area at least, it is significantly enhancing the experience of older age for thousands of local residents who would otherwise be at best struggling and at worst isolated, ignored and ill. The local Neighbourhood Elders Team (NET) in Garforth, Leeds is providing much more than a stop gap, as a recent piece of research has demonstrated.
The NET was founded in 1995 with the initial aim of providing a place for older people to meet, share experiences and get help with practical day-to-day matters. Since then, as demand has mushroomed, NET has grown and developed into a major provider of support for local elderly people, becoming an independent charity in 2001. Over time, staff at NET have developed extensive links with local health and care professionals. So much so that local GPs, social services and care providers have come to rely on NET as a point of referral and, often, initial assessment.
More than that, NET has developed a network of facilities throughout the local area to provide social activities and contacts for elderly, isolated, bereaved, infirm and able bodied people. These activities include chair yoga, Pilates, dance exercise, luncheon clubs and coffee mornings, as well as events and groups for specific conditions such as a dementia café, falls clinic and stroke group.
As part of a bid for funding earlier this year, NET commissioned a small piece of research to investigate the anecdotally held belief that involvement in NET activities and support generally meant that older people would have less recourse to the services of the NHS. In this way, it was hypothesised that involvement in NET would save the NHS money and contribute to the health and well-being of people in the later stages of their lives. The findings exceeded even the most optimistic expectations.
Cost savings and improved wellbeing
Over the 12-week research period, expenditure on the health and care needs of a group who had no contact with or input from NET was, on average, more than seven times as much as for those who attended no more than one NET activity a week – £138.26 a week compared to £18.59. Attendance at two or more NET activities reduced average expenditure to a mere £7.06. Moreover, over the 12-week research period, while the non-NET clients showed no change in expenditure, NET clients saved a weekly average of between £49.96 and £53.74 depending on how much involvement they had with NET.
Of course, when assessing quality of life, it is not enough to focus solely on financial outlay. The research project also looked at what elderly people felt about themselves and their lives. Again, the results demonstrated clearly that involvement with NET enhanced quality of life; with just minimal involvement with NET, elderly people reported feeling much more positive about themselves and optimistic about their futures. Using the Warwick-Edinburgh Mental Well-Being Scale, the scores given by clients of NET were consistently higher and, on many of the factors, more than double those given by non-NET clients.
‘It’s like being reborn’
As a final aspect of the research, a number of clients were interviewed to gain a fuller picture of their feelings about NET and what they believed they gained from being part of it. The responses were unanimously positive with comments such as “it’s a lifeline for me”; “NET is like being in a big family”; “it’s like being reborn”. Several said that, without NET, they would be “lost”, “just sat at home watching the telly”, “feeling sorry for myself”, “all alone”, “stuck inside doing nothing”. Two said they “probably wouldn’t be here without NET”. Most spoke about the fun and laughter they had, and how they looked forward to going there to meet friends they would otherwise not have had.
As the researcher who conducted the interviews, it was humbling to listen to the struggles that many of the elderly people were dealing with on a daily basis; yet, they had all found a new lease of life at NET, they felt they could be useful again and that life had some purpose.”
They were able to forget, for a while at least, their aches and pains, their loneliness and worry, and share their remarkable histories and experiences. Their testimonies made it easy to understand just why NET was able to achieve so much and in ways that local health and social care agencies could not, whether because of lack of resources or because they weren’t drawing on the remarkable healing power of elderly people themselves.
Overall, the research findings are compelling and, in these times of stringent cuts in NHS and social care provision, surely it would make sense for the funders to consider directing some of their resources to responsible, well-managed agencies such as NET which can provide critically needed support for a fraction of the cost.
Pauline Ashworth is an independent researcher and retired lecturer in social work, University of York