How should we look after our ageing population and who should bear the weight of responsibility? Norman Lamb in his interview in The Daily Telegraph and Sarah Dittum in her response in Comment is Free, The Guardian both tackle the view that communities are neglectful of their ageing neighbours but with opposing answers
At The Young Foundation we’ve been doing a lot of thinking and work on this issue over the last couple of years, through our work on ageing, resilience and health.
The main body of his interview deals with Lamb’s argument that a better “partnership between state and society” was needed to help care for our ageing population. Lamb sees this partnership as being based on neighbourly resilience, which would stop people needing to go into care homes. As families become increasingly dispersed and fragmented, some of the challenges of adapting and supporting ageing adults should be absorbed by people within their community.
This doesn’t appear to be a very contentious argument. However, in her response, Dittum notes that as a nation we are doing more caring now than we did 10 years ago and challenges the view that we are neglectful neighbours. Dittum argues that this is a result of government cuts to services, which threaten to undermine notions of neighbourly resilience. As the NCVO has pointed out, the recession and resulting government cuts have forced the third sector to do more with less.
To expect volunteers and communities to rise up to replace the government in tackling major issues such as these does seem misguided. However, we believe that there is a role for the third sector in not just replacing what the state used to do, but rather helping to guide the state to improve its offer.
That we have become a more atomised and less homogenous society seems true but the result is not completely negative. In addition, we must recognise that how we define our networks is not confined to familial or neighbourly ties, but can consist of the various communities that we operate in. The freedom for people to live how they wish has certainly added to the wellbeing of those who 40 or 50 years ago might have been stuck in a community that failed to understand them. It is important to recognise and as Dittum states give value to, the informal care that takes place in neighbourhoods. At the same time, more can be done to tap into the informal networks in which people operate.
Many people feel stretched by the need to care for ageing relatives who live far away. Unable to afford paid services or to move closer to them due to work and other family commitments, these people are trapped by these competing demands. Care4Care, a Young Foundation venture, seeks to mitigate these problems by providing greater incentive for neighbours to help out those in need. It is limited to comfort care – cups of tea and chats – and we see it as complimenting existing statutory services rather than replacing them. It seems Lamb is encouraging schemes such as Care4Care in his interview, which of course we welcome. However more is needed than simply support- action must be taken.
In a recently published Young Foundation blog, ‘The resilience illusion’, we made the point that neighbours do find innovative ways of supporting the more vulnerable members of their communities. They can be the first to spot when someone is not well, or needs a hand with their garden. Understanding resilience in communities will mean a greater focus on what is happening within a neighbourhood, at a granular level. By identifying and working with the existing informal and formal support structures, we can start making better use of them. Yet without the benefit of an outside structure, these activities can be episodic and irregular, resulting in vulnerable people falling through the gap.
Neighbours and communities need state and third sector support to give structure and resources to interventions or activities that support ageing residents. This means valuing what can appear to be messy and sporadic and supporting interventions such as Care4Care, which promote the exchange of time, and tap into a demand for care and a desire to strengthen local networks.
We need to move to a system that is proactive rather than reactive; a system that works with people, not one that works on people. We need to reduce isolation among older people, which causes many more health and social care related problems towards one where there is a network of support – which will include the state, the third sector, as well as family and friends. It is too simplistic to believe that one of these groups will take sole responsibility for our care.