One of my friends was complaining about his neighbour to me yesterday. They were going to watch a football match together but his neighbour’s resistance to accepting help meant that they could not get the best seats for him. ‘He’s so independent he won’t admit he’s disabled. He can’t walk more than five steps. If he said so we could get disabled tickets. He’s 86,’ he complained.
Why is it that some older people are reluctant to accept help? Or to even use the aids and technology that would make their life easier? We all have an anecdote to tell, about an older relative or friend who will not do the thing that to us seems to be of obvious benefit. Move to retirement housing, get their bathroom adapted, use a walking stick, wear their alarm pendant. Even hearing aids can get shunned.
Unfortunately for them, and the wider community too, they have internalised the ageism that permeates our society. Ageism is perpetuated by workplaces, healthcare systems and families by subtle discrimination. From childhood, people encounter jokes, media and comments portraying ageing as decline and irrelevance, which older adults eventually believe about themselves. Youth is equated with beauty, productivity and value, hence some older people distance themselves from people who seem ‘old’, for example judging peers who use mobility aids or receive care, because they do not want to be associated with the negative stereotypes. To their detriment, they even reject the very adaptations that can help them to stay independent.
This is bad news for Wes Streeting. The policy of prevention, which aims to target ‘upstream actions’ – stopping health issues before they become crisis – not only means investment in services that may not pay off for years, but it often requires attitudinal change on the part of clinicians and behavioural change on the part of individuals. Wrongly, depression and chronic pain are often regarded as an inevitable part of ageing.
Suicide risk in older men is often under acknowledged. Policy and service design may not include older people’s voices, leading to systems that do not meet their needs. ‘Digital-first’ NHS services can exclude older people who may lack access or skills. Services such as falls prevention, continence and dementia care are under invested despite rising demand. Is the NHS serious about making a shift in its priorities?
When it comes to investing in social care, which by its very nature is all about supporting people to live well outside of hospital, we do not seem to be getting a look-in. I was heartened to hear that over half of the people who were arrested during the demonstration relating to Palestine Action in London were aged over 60. Nearly 100 of those detained were in their 70s and 15 were in their 80s. People may think of protesting as a young person’s game but the participants on this demo were smashing ageist attitudes if nothing else.
Whether Wes Streeting’s (or Labour’s) policy of prevention will succeed depends on several factors. The idea is sound; investing in prevention can improve public health and save the NHS money in the long run. If it is to reduce demand for more expensive treatments it requires investment in access to GPs, mental health support and healthy environments. However, its success depends not just on delivery but on overcoming real-world obstacles, not least of which is ageism.
Has ageism been discussed in your workplace? If so, what was the outcome? Leave a comment on this column or join the conversation to share your thoughts.
Sara Livadeas is a social care expert and Founder of Social Care Works. Email: [email protected] X:@saralivadeas