Bringing it all together – re-valuing older people by combining research, training and practice

Valerie LipmanValerie Lipman is a Postdoc Intern at the Social Care Workforce Research Unit in the Policy Institute at King’s College London.

Here’s a challenge for learning institutes in the UK: how can they deliver on-site direct services for the vulnerable groups whom they’re studying and promoting? I talked to Dr Indrani Chakravarty, the founder and Director, of the Calcutta Metropolitan Institute of Gerontology (CMIG) about her experience of doing just this and how she marries research with real practice. Continue reading

Ageing and India

Valerie LipmanValerie Lipman is an honorary Postdoc Research Fellow at the Social Care Workforce Research Unit, the Policy Institute at King’s. (926 words)

Just as the British TV-watching public was being captivated by the start of a three-part reality-style programme, ‘The Real Marigold Hotel’, showing eight familiar-faced senior citizens set up home in Jaipur north India, I was on my way to West Bengal in east India to take part in a gerontology conference. While the show raised some big questions about realistic retirement choices, including enjoying India’s many splendours, India is coming to terms with its own vast and growing population of older citizens. Continue reading

Men? Have your circumstances changed?

Valerie LipmanDr Valerie Lipman is Honorary Post-Doctoral Research Fellow at the Social Care Workforce Research Unit. (553 words)

We don’t see much about the lives of older men in the field of social care. The focus tends to be on older women, partly because women’s life expectancy is longer and perhaps, because in the care field, women are more visible in the traditional care settings, such as day centres and care homes. Have your circumstances changed?’, a triptych of duets between an ageing man and a boy of about 10-12 years of age, stages the daily routine of a single older man.

The three short pieces, about 15 minutes each, are set in sequence in a kitchen, living room and bathroom, showing a different older man managing life on his own. The performance takes place in the windows of a former furniture shop in a former shopping mall in Islington, north London. There’s no dialogue but just a series of noises of daily living. In the kitchen the man accidentally tips his rice crispies all over the floor, the sink gurgles, he thumps his knife into an onion, and butter splutters in a frying pan on the cooker all against the background of Radio 2. In the living room the TV blares out quiz shows, football and the Generation Game. And in the bathroom we hear the toilet flush, medicines fall out of the cabinet and imagine the scraping of shaving and the sizzing of false teeth in the glass. Continue reading

Following a pathway to impact

Valerie Lipman

Valerie Lipman

The Social Care Workforce Research Unit is part of the Policy Institute @ King’s, which is furthering the cause of evidence-informed policy and practice. Valerie Lipman, a social gerontologist and a postdoc Intern at the Unit, reports on an event which examined the questions that arise where academia, funders, policy-makers, and practitioners meet.

I went to a great panel discussion last week: ‘The impact of impact: who are we researching for?’. The event, the last of the year organised by KISS-DTC* was moderated by BBC journalist Mark Easton. Lots of talking about the history of research, its purpose, why do we do it, what’s meant to happen to it when done, and who cares? And that for me is the critical question. Who cares, or rather who do I want to care about the research I’ve done? Why would you bother doing social science research unless you wanted something to be different as a result? This view has been the order of the day for some time now, and the proof is in how money is made available for research, and the ability of those carrying out the research to disseminate and inform others.

From their different perspectives three panellists presented the case about why impact matters. In the academic corner we had Dame Janet Finch, chair of the social sciences panel for the REF, arguing a strong moral case that researchers have a responsibility to make their research available and that the ‘impact’ element of the REF is here to stay. Aileen Murphie, Director, DCLG & Local Government VFM, promoted the need for evidence-based policy, though as members of the audience argued this can result in favouring government priorities occluding an openness to new ideas. And representing a position between the academic and government worlds was Anthony Tomei, former Director of the Nuffield Foundation: the voice of independence, risk taker in what research to support and an advocate of the importance of quality research that can effect change.

The time when research was allowed to be an expression of freedom and a search for the new—an opportunity to delve into the unknown and emerge with the prize that would change the thinking and actions of others to make a better world—seems to have passed. On the other hand I’ve worked with people in university research departments who’ve never thought about what the purpose of their research was. It was the job of others to interpret the findings and take it further. Obviously, you shouldn’t know the answers to the questions before you start the research or skew your questions to meet what you want it to show—’policy-based evidence’ as someone at the meeting described it. But there must be a way of deciding at the start that you’ll want the results of the research to matter, so how about building in processes at the outset that stimulate debate as you go along … following a ‘pathway to impact’, as Janet Finch said, not merely waiting till the obligatory conference and a couple of academic papers at the end?

Valerie Lipman was recently awarded a PhD by the Centre for Ageing at the University of Southampton. She is a postdoc Intern at the Social Care Workforce Research Unit, developing material from her doctorate for publication here at King’s.

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*KISS-DTC = King’s Interdisciplinary Social Science Doctoral Training Centre

 

Letter from Sarasota: support services for older people

Valerie Lipman

Valerie Lipman

Dr Valerie Lipman is a social gerontologist and independent researcher. She reports here on support services for older people in Sarasota, Florida and particularly on the growing trend there toward ‘board-and-care’ arrangements in private homes. Could we see more of this in the UK?

I’m in the old age capital of the world. Sarasota on the Gulf Coast of Florida, USA boasts a total population of 386,147 of whom 32.5% are over the age of 65 years. And a third of that grouping is over 85 years. In the UK, the equivalent would be a town such as Christchurch in Dorset where 30% of residents are aged 65 and over. The national figure for the 65+ population in the USA is about 13%, and just under 18% for the State of Florida as a whole. This makes Florida fairly similar to the UK where the equivalent figure is just under 17%.

Older people come to Florida from across North America, and some from Europe to live here*. The sun shines most days, though it’s been a bit like England lately—teeming, non-stop rain and colourless skies. But freak days aside, it’s mostly a pleasure to wake up to.

With such a large older population the scope for delivering and trying out new support services feels almost endless. The general aim is to encourage ‘ageing in place’ and there are scores of home agencies, as well as ‘homemaker companion’ services, providing friendship and support. The former are registered services, the latter are not.

But just the same, many want or need the certainty and security of residential care. From continuing care retirement communities (CCRCs) to nursing homes there are innumerable private registered bodies in the Sarasota area offering services to older people. CCRCs offer a full range of housing choices and services on one campus—from independent living to assisted living to skilled nursing in an attached facility. The skilled nursing option costs $4,000-$8,000 per month in addition to entrant fees ranging from $150,000-$600,000. Assisted living facilities (support centres are called ‘facilities’ here) and memory (dementia) facilities/homes average around $3,000-$4,000 per month. There are also State-run services. Classically these are nursing homes, for which you have to demonstrate income below a certain level to qualify for what’s known as the Medicaid waiver.

But what do you do if you find yourself caught in the old eligibility trap of being too rich for Medicaid and too poor for the private homes? You could take a risk at one of a growing number of ‘private care homes’—also known as board-and-care homes. They are not the private homes of the UK that can serve any number of older people. Homeowners offer long-term personal and less regimented residence in a family friendly environment for one or two elders as a home business. These homes are not, however, regulated by the state.  They don’t have to meet any of the rigorous requirements that apply to group homes and assisted-living facilities (see Barbara Peters Smith, ‘Private-home care could become more common for elders’, Sarasota Herald Tribune, 23 January 2014).

They do, however, fill a huge need when it comes to cost. People will tend to hand over their pension to the homeowner to take care of them. No one knows how many of these homes exist. Most operate by word-of-mouth referrals and are private-pay only, but they are on the increase in an area where there is pressure on affordable places for the growing 80+ population. And like any other home the residents are dependent on the good will, attitude and behaviours of the owner/manager. Without family or friends to check out what’s going on, the scope for abuse is endless—at every possible level.

Yet, with some regulation and light-touch inspection, could this be added to the options of support for older people in the UK? It may be that Shared Lives is our take on this—an adaptation of what used to be called adult placement or adult fostering, but with the critical difference that Shared Lives arrangements are registered and regulated.

Sarasota is dealing with the complexities of an ageing population that we will have to meet in the UK in time. How to provide sufficient and varied enough facilities capable of offering security, safety and care in a homely environment that are not strangled at birth by hide-bound bureaucracy or slip into becoming exploitative ‘senior farms’?  Watch this space!

Dr Valerie Lipman is undertaking an investigation of how recent government changes in public services in the UK are impacting on BME elders. You can contact Valerie on valerielipman2003@yahoo.co.uk


*Projections from the University of Florida’s Bureau of Economic and Business Research (BEBR) show the percentage of the 65 and over population increasing to over 35% by 2020, and almost 40% in Sarasota County by 2030 BEBR, Florida Population Studies, Volume 44, Bulletin 159, June 2011.