‘Older carers: invisible but invaluable’ by Antony Smith

  • There are 2.8 million people aged 50 and over providing unpaid care in the UK, including 5% of people aged 85 and over.
  • A quarter of all carers aged 75 and over provide 50 or more hours of informal care each week.
  • Carers save the UK economy an estimated £87 billion a year.

At Age UK we hear from many people in later life who are caring for a spouse, partner, relative or friend. Although many find caring rewarding and an expression of their relationship, carers also tell us that they feel invisible and undervalued. Many are stressed and exhausted. Here is an excerpt from one of those personal stories.

Jenny and James

“James and myself were both looking forward to spending our retirement together, but four months after I retired, James became ill and was diagnosed with memory loss caused by depression. Five months later he became ill again, almost overnight, and was hospitalised. He was 71.

“Eventually I was told, because James had Lewy Body dementia, I’d never be able to look after him and that he had to go into residential care. With a nursing background, I thought I could care for James at our home and believed this would be better for his mental wellbeing, but no one listened.

“Once a social worker was assigned to our case, he said he would try and enable a care package where James could live at home with me. However once our financial assessment was done, and we weren’t eligible for funding support, we were left to get on with things ourselves. I set about arranging a care package, but it was a complicated task to do with no guidance. Luckily, I’m able to use the internet, but I dread to think how I would have sorted anything without it.

“After nearly three months in hospital, James finally came home in Feb 2011.

“Being a carer is exhausting – from the moment James wakes up he needs help with everything from moving and getting dressed to washing and going to the toilet. When I don’t have night cover I’m up about four times a night and can’t sleep during the day as James needs someone with him all the time. Because we hired support workers independently we have the same ones nearly every time. I think that’s really beneficial to James, as changing faces can be particularly disorientating for someone with dementia and they perform very personal tasks.

“I take James to a day centre twice a week and this is welcome relief for me. Unfortunately we’ve just been informed that because of local authority funding cuts the centre will close next year. There are about 20 of us who use the centre, and James really enjoys his time there.

“Every six weeks I also put James in respite care for a week, to give me a complete break. Unfortunately on his most recent trip when I went to collect him he had no shoes on, his glasses were missing and he was wearing someone else’s clothes. I could tell he was frightened and he had bruises on his body. When I got him home I discovered he’d lost 8lbs in seven days. I’ve made a formal complaint and am waiting to discover the outcome, but things like that shouldn’t be acceptable and obviously I haven’t felt like I could put him in that respite home since.

“I feel I have managed to come to terms with my feelings of loss and bereavement concerning James, which were overwhelming at the start, and I just have to get on with things. I try not to think about the future. James is getting weaker, and I’m getting older so I don’t know how long I’ll be able to manage and I don’t know what will happen when our money runs out.”

Age UK Is calling for more support for older carers – from government, local authorities and health professionals – such as a Carer’s Allowance for pensioners, a choice of appropriate services and regular carers’ health checks. You can find out more about our work to highlight the support older carers need, as well as the recognition they richly deserve, on Age UK’s website.

Antony Smith is Development Officer for Equalities and Human Rights at Age UK Antony.Smith@ageuk.org.uk

Care in the first two years of life: OXPIP and the emerging discipline of parent-infant psychotherapy

By Adrian Sell, Executive Director, OXPIP: The Oxford Parent Infant Project

OXPIP is one of the organisations pioneering parent-infant psychotherapy. Founded in 1998 we have been working in Oxfordshire to provide support to parents who are struggling to form a secure attachment to their baby. In the last three years we have worked with over 900 families and consistently improved mental health and the quality of the parent-infant relationship[1]. We work with babies up to the age of two and their parents, normally the mother but we have worked with many fathers as well.

Parent-infant psychotherapy is distinguished by the attention it brings to the mother’s mental health, the baby’s mental health and, crucially, to the quality of the relationship between parent and baby. This focus on the quality of the care that comes from this early experience is critical to our success in addressing intergenerational cycles of disadvantage. We all have a tendency to default to parenting our children as we were parented, even if those relationships were withdrawn, unpredictable or harmful.

Our clinicians are skilled at enabling parents to build and sustain closer relationships with their children. One of the therapeutic tools for achieving this is through modelling thoughtful, empathic ways of relating within the therapeutic relationship. For some of the parents we work with this is the first time they have really experienced being thought about and related to in this way; it can be a powerful tool for change, opening up new possibilities for how they in turn can relate to their babies.

Our team of psychotherapists come from a range of backgrounds including Child Psychotherapy, Adult Psychotherapy and Clinical Psychology as well as including prior qualifications in Health Visiting, Nursing, Midwifery, Social Work and Teaching. All have undergone Infant Observation training, and are trained in the use of video through the (NICE approved) Video Interaction Guidance approach. This mix of backgrounds and approaches gives our work a strength and rigour that forces us to constantly challenge our own preconceptions and viewpoints.

We are part of a growing national movement of people and organisations who are bringing greater focus to the first years of life. Our Executive Director, Adrian Sell is a trustee of PIP-UK a new national charity seeking to support similar services to develop elsewhere. We have backing from Impetus – The Private Equity Foundation where we are one of twenty-five organisations they see as critical social game-changers supporting disadvantaged children to develop to their full potential. We are a member of the Centre for Social Justice Alliance where we are recognised for our effectiveness in tackling the root causes of poverty and disadvantage. We are supporters of the All Party Parliamentary Group for Conception to Age 2 – the first 1001 days

We all instinctively know that the first few years of our life are formative. There is also considerable neuroscientific evidence that has emerged to support this. OXPIP are now at the forefront of developing an evidence base for the positive impact that parent-infant psychotherapy can have. If you want to find out more then please look at our website, get in touch or leave a comment below.

OXPIP: The Oxford Parent Infant Project
Suite J
The Kidlington Centre
Kidlington
OX5 2DL
T: 01865 371080 or 01865 778034
info@oxpip.org.uk
www.oxpip.org.uk

 

‘The interface between care politics and corruption’ by Renu Addlakha

A most shocking event has taken place in the Indian state of Bihar involving the state run midday school meal programme resulting in the death of 23 children who had consumed insecticide laced rice and curry (http://news.in.msn.com/national/government-to-probe-mid-day-meal-scheme-after-23-children-die), The Midday Meal Scheme is the world’s largest school feeding programme involving 120 million children in India. The programme is run on a public-private partnership with NGOs and local contractors and the scheme involves giving hot nutritious freshly cooked food to children. It is envisaged as a means of reducing malnutrition and increasing school retention of children coming from poor households, particularly in rural areas.

In the present case the food had been cooked on the school premises and preliminary investigations suggest unintentional poisoning. The oil in which the food was cooked had been put in an empty pesticide container and the two substances had got mixed. This oil had then been used for cooking the meal. The food was prepared in the house of one of the teachers whose husband was grocer. So conspiracy theories are also rife.

From a care perspective, this case raises several issue to my mind.Firstly, how can such carelessness take place and what does it tell us about the attitude of those managing the programme? What does this tell us about the contemporary state as it moves from a paradigm of social welfare to neo-liberalism wherein it sub-contracts core care functions to private stakeholders? What is the value being placed on the lives of young children in such a context? How is that the rage which such an event should have generated has turned more into a storm in a teacup? What does this event tell us about the interface between care politics and corruption?

I would love hear how others view this event from a care perspective.

Renu Addlakha
Professor
Centre for Women’s Development Studies
New Delhi, India.

Why we should care about the menopause

A couple of months ago I was telling a younger woman about some of the problems I was experiencing with the menopause. She appeared to be listening with what has to be called grudging tolerance, at best, until I came to the bit about hot flushes. I was only mentioning them in passing, while explaining about some new medication that was helping. But when I said ‘hot flushes’ she sniggered. Yes, sniggered is the only word for it. She sniggered as if there was something really absurd and ridiculous about hot flushes. She sniggered in a conspiratorial way as if I should snigger too. I did not. For me, there is no sniggering about hot flushes.

I have discovered that there is still silence, stigma, and  taboo, about the menopause that is both widespread and, most worryingly, prevalent among women, even right-on feminists. If you broach the subject, women ten years younger – fellow lesbians, or bi or straight –  hastily do the maths to work out how long before it is their turn, and then, with anxious relief (or concern), tell you. Women two decades younger look uncomfortable, as if you’ve just broken wind. Older women seem reluctant to discuss the menopause, once over, either declaring breezily ‘Oh I sailed through mine’ (never has such a less empathic thing been said between two women, in my view) or, with a slight shudder, ‘it will pass’ as if half-remembering horrors now consigned to memory. Then there are the women who point out that in Japan there is no word for menopause, or the marvels of HRT (not mentioning its risks and that it is contra-indicated for some women, including me), or who helpfully suggest some homeopathic remedy a friend of a friend said was ‘simply marvellous.’ There is always the sense that there is something I could, and should, be doing to fix my menopausal symptoms.

There is no public space for menopause, apart from  books and magazine articles usually exhorting, ‘successful ageing’- style, women to enjoy our menopause (preferably ‘naturally’). ‘Enjoy’ is another way of saying ‘cope with it discretely and don’t complain about it’ and is a view not shared by all. Other than that it is privatised, hidden away. There is no place – apart from jokes, or self-help websites or conspiratorial chats between fellow menopausal women – for the impact of the menopause, particularly chronic sleep deprivation and effects on concentration and memory, to be recognised. Not at work, not in education, not in the provision of goods and services (beyond medicine). ‘Pregnancy and maternity’ is a protected characteristic under the UK Equality Act, because of discrimination pregnant women and mothers (especially nursing mothers) can experience. Perhaps ‘Menopause’ should be too, not simply as a gender discrimination issue.

The marginalisation is undoubtedly rooted in ageism – in mainstream society and between women – and sexism, the menopause being inextricably linked to loss of fertility and women’s (heteronormative) reproductive social value. If I hear anything more about the ‘male menopause’ I shall scream, and not because of hormonal changes. Heterosexual men going through the ‘male menopause’ often trade in their original wives for younger models, starting a family all over again. Women going through the (real) menopause are saying goodbye to their chances of ever having any (more) birth children, whether they want them or not.

In the 1970’s a man shop assistant said, when I was being mildly assertive, ‘don’t worry about her, her period’s probably due.’ And this menopause issue feels somehow similar, something very sexist, but with the added dimension of ageism. It feels like social exclusion from/by a world geared up for young, virile, things who have no limits, and don’t want anything to do with someone who reminds them that there are limits, that our bodies change, and that, in the end, we die. It feels like another aspect of the false (masculine) denial of vulnerability as part of the human condition.  All (cisgender) women go through the menopause, for now at least. While for some it is plain sailing, for others it is not. We should embrace each other in care and solidarity before, during and afterwards, not leave women to go through the menopause silently, on the margins, and alone.