Big Society: How can older people with high support needs contribute?
David Cameron envisages the Big Society as one where people 'feel both free and powerful enough to help themselves and their own communities'. That sounds very appealing, both in its emphasis on empowerment and self-help, and in its potential for cost savings in this time of public spending cuts …
But can we all be involved, at whatever stage of life and however 'high' our 'needs'? When we reach old age, will we continue to be seen (even to see ourselves) primarily as 'vulnerable', our needs framed as a 'burden' caused by the 'demographic time bomb'? Or will we be enabled to share with others our wealth of skills, wisdom and lifetime experience, to contribute to family, social, community and communal life, and to be valued for what we do – as older people in a recent JRF study have called for? As the debates around the Big Society and public spending cuts gather steam, we want to find out what it could all mean for 'them' – or rather, for 'us', because, after all, we’re all heading in that direction!
One of our recent Viewpoints argued that current debates about transforming social care must consider 'the wider networks and dynamics involved in providing and receiving support through family, friends and community'. In the early stages of our new programme 'A Better Life', we have come across many intriguing examples of schemes and settings, across the UK and in the wider world, where people who have 'support needs' actually support each other. Many of these have been around for a while, and some are almost mainstream in other parts of the world. The recent HAPPI report showcased some examples of senior cohousing. Already well-established in Scandinavia, the Netherlands and the US, this at last seems to be taking off in this country too, spearheaded by small but persistent groups such as OWCH and Vivarium. They are now supported by a network and organisations (such as Hanover) with the clout and resources to turn their visions into reality.
There is also growing interest in applying to older people the principles of other models originally developed with and by people with learning or mental health difficulties, or as intergenerational approaches. I’m thinking, for example, of arrangements such as KeyRing, and Homeshare, both of which, although they do need an infrastructure to sustain them, depend crucially on the support members give each other. There's a myriad of other mutual-support type schemes which seem to have real potential too – Shared Lives , Southwark Circle, 'Adopt-a-Granny' schemes, telephone and internet support groups, micro-enterprises, collectives and care co-ops, communes and communities …
It's true that such approaches are incredibly varied in terms of their scope, history, financial arrangements and regulatory framework. But what they do share is the common thread of mutual support – and a way of meeting needs which is fluid, negotiable, non-stigmatising and based round real relationships rather than on set tasks or time slots. It's this common feature – together with their potential for building communities, and their focus on people actively contributing instead of being passive receivers of services – that could challenge the boundaries of more conventional service commissioning and provision. It could also offer learning for more mainstream services in the sector as a whole.
There is also undoubtedly a perception that these kinds of approaches may have real potential for cost savings in our new age of austerity and demographic change. It has certainly been suggested that they can actually reduce needs (and therefore costs) by empowering those involved and possibly by delaying the onset of higher dependency.
But most of these models and schemes have evolved locally, individually and organically, and there has been comparatively little research around them. Certainly the jury is still out as to whether they can work for – and enhance the quality of life of – those in the later stages of life with high support needs (as opposed to other groups and more able and active older people). Is there likely to be enough enthusiasm and demand from the public, and could they ever be replicated, rolled out or scaled up sufficiently across the UK to become viable mainstream options? And last but not least – could they really save money, by replacing, complementing, or reducing/delaying the need for, other services?
What do you think? We are commissioning a major new project on 'A Better Life' – if you want to apply, be quick … the deadline is 5 October!
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