When I grow up

by Suzanne Iuppa, Community Connector — Llanidloes (2nd from left)*

I grow old … I grow old … 

I shall wear the bottoms of my trousers rolled. 

Shall I part my hair behind? Do I dare to eat a peach? 

I shall wear white flannel trousers, and walk upon the beach.

The Love Song of J. Alfred Prufrock, by T.S. Eliot

    

What do you want your older age to feel like, sound like, look like?

I’ve spent much time thinking about this on my long drives working around the very beautiful countryside of Powys. I’ve worked for Powys Association of Voluntary Organisations (PAVO) now for six months as a Community Connector, linking older people in the county with services to improve their health and wellbeing. 

I moved here from Flintshire in September 2016, where I lived for 25 years and raised all three of my children as a single mother. My boys now live in the four corners of the planet and we joke (well, it is my favourite fantasy) that when I get older I will wing in with my Mary Poppins umbrella, all sprightly and fun, right when my beloved daughters-in-law can’t face another meal prep or load of washing, to look after my many grandchildren in turn, in different countries. My loving offspring will have a very small but beautiful granny flat in each of their houses for me to make magic in during my regular, seasonal visits. When I am not on Nainey duty I will be in my stunning but tiny (ie: low maintenance) cottage with the view at the edge of the Snowdonia National Park. I’ll have dinner parties, write stories, make crafts, feed the birds, and still make the long walks to the pub or garden centre. Or perhaps even take my trusty bike. I’ll thrive. I’ll be happy.

That’s if: if in future I’ll be able to travel easily to see my family, if I develop no long-term health conditions which sap my energy, if my children do indeed have children, and if my daughters-in-law will want my help on a regular basis.

I’m good at being flexible, but, with my family living at a distance and most of my friends being a good ten or fifteen years older than me (I was a young Mum, and my friends and I raised our children together) chances are, if my fantasy does not play out, my older age could be at risk of feeling lonely. In Powys there are plenty of places like my village, small tight-knit rural communities where children are living at a distance from parents and many people are of an aging population, all developing complex health problems as their age advances, in tandem. We might all want to be social! But for one reason or other, it may be hard to do. 

I help many people in Powys whose friends are not able to assist and whose family are not present, by linking them to befriending groups or ‘good neighbour’ schemes. It’s very important these schemes are well supported with funding and volunteers. Because — loneliness is not a condition we want to allow in our communities. The Older People's Commissioner for Wales, Sarah Rochira says: "Loneliness is a major Public Health problem here in Wales. We can all help — one day it could be us."

Loneliness has an effect on mortality that is similar to that of cigarette smoking. It is associated with poor mental health and conditions such as cardiovascular disease, hypertension and dementia.

Loneliness has a much wider Public Health impact too: it is associated with a number of negative health outcomes including mortality, morbidity, depression and suicide, as well as increased health service use.

Most of my work is centered around helping people feel listened to, and responding to people’s individual needs, particularly older people living with a sensory loss, cognitive impairment or dementia, those who are carers or who have mobility issues. It seems in Powys these older people are most socially isolated. In addition, the people I have worked with have reported:

• Loss of trusted relationships.
• Loss of privacy and dignity.
• Being a full-time carer with little social mobility.
• Poor access to a car or public transport.
• Not being able to run a home by oneself anymore.

The answer is not the NHS to any of these problems; either primary or secondary care. But… quite often that is where lonely older people end up. If we think of primary healthcare, we can also think of primary health and social services for older people. These should be first in line for funding and support for to prevent hospitalisation. These are: appropriate housing (including residential and nursing care) day centres, personal care, befriending, community transport, practical services such as shopping, cleaning and gardening, and social links.

We need to listen better to older people’s life stories and their wishes to create an enabling environment for all, so we can work together to provide the primary social services. Understanding the sense of loss would be a start. Veronica Jarman, day hospital sister at Llanidloes Day Hospital and a Wales Nurse of the Year, explains: "It’s grief — loss of partner, social position, income, friends… the grief can be overwhelming."

Active and reflective listening are keys skills in grief therapy, and could be an early response to people asking for help with loneliness, before accessing NHS services at a crisis moment.

The Royal College of Speech and Language Therapists, for example, has emphasized the link between the ability to communicate clearly with an individual’s ability to make informed decisions, to access services, enjoy their rights and overall, the dignity and respect that they experience.

Of course the older people in our society have lived through unprecedented change. For all the developments in communications and technology, the needs at the start and end of life are still best met through personal interactions. 

Our society is ageist — the only people really admired and in the driving seat in our society are from age 25 — 60 years. Like puberty, older age is a time of radical transformation for many; complete change. Whereas in previous societies elders had specific roles as guides, healers, mediators, correspondents, even dispute resolution specialists, because their amassed life experience was held in great esteem, now we tend to disrobe older people of roles and responsibility, in our families and in society generally. I’ve no doubt this disengagement has an effect on cognitive function. What would happen if we were able to advertise for older people to fill specialist roles in our community — designers, garden and horticulture, childcare, farming practices with wildlife conservation, flood prevention, town planning, holistic healing, dance events, history projects, clothes manufacture, community transport, language classes? What if people 65 years+ were the only ones to fit the bill, because of their wealth of experience, their time and their care?

Perhaps the Nainey duties and the dinner parties could keep me at the top of my game, for longer. I’m joining some craft guilds just in case — oh and my local town choir! I’ve even started an online course in herbal medicine. Still, I wonder if my daughters-in-law will be able to recommend a really good hairdresser in each country? I hope so!

To contact Suzanne for further information about her work as a Community Connector, please email suzanne.iuppa@pavo.org.uk or ring 01597 828649.

* The photograph also features (L-R) Carla Rosenthal — Community Connector in Knighton, and Melissa Townsend — Volunteer Officer PAVO.