Background

With improved living conditions and better health care throughout life, life expectancy in Cwm Taf Morgannwg continues to increase. However, for many people, getting older may bring new challenges such as loneliness, isolation or more complex health problems.

We know older people value their independence and ability to live in their own home for as long as they are able. Our role is to ensure older people get the help they need to live healthy, happy and independent lives. It’s important they feel they have a voice and that their voice is heard.

How we involved older people.

We held two events to look at what is needed to improve services for people living with dementia and our older population.

Our tea dance at Cynon Linc, Aberdare, was a fantastic opportunity to meet over sixty people aged over the age of 50 and have meaningful conversations around health and social care.

We followed this up with a hack-a-thon, looking at the priorities identified for older people in our Population Needs Assessment and discussed what actions we can take to improve services.

Themes explored included:

• Loneliness and isolation
• Living independently
• Home from hospital
• Community services and support
• Good dementia care

How can services be improved?

In summary, older people and people living with dementia would like to see:

• Integration needs to be defined, understood and implemented effectively so individuals are able to access care and support at the right time to maximise positive outcomes and promote delivery.
• Face to face support for older people due to levels of digital exclusion and the increase of loneliness and isolation experienced throughout the COVID-19 pandemic
• Accessible communication and information so those who are digitally excluded can be included and informed
• Meaningful co-production with older people and people living with dementia that values their different experiences, views and opinions
• People living with dementia and their carers to be listened to, valued and supported in a holistic way

You can read a more detailed summary around each area below. 

Loneliness and isolation

“When you’re housebound you’re not only stuck in one room for hours or days – it could be years.”

Ideas for positive change include:

• Providing more support to unpaid carers, who are vulnerable to loneliness and isolation. This includes recognising and valuing the sacrifice and contribution they make to support health and social services across the region. You can read more about our unpaid carers hack-a-thon here. 
• “Telephone services don’t work for everyone” and therefore it is important that there are a range of community based face-to-face solutions for individuals can easily access to help them have community contact and feel less lonely and isolated
• Ensure there is a continuous level of care to build and sustain relationships, so users of services feel heard, understood and valued. This will reduce the potential of individuals falling through the cracks, and will help professionals to get to know the person better in a way that will aid better care
• “Telephone services don’t work for everyone”  – provide a range of accessible community activities – particularly intergenerational options – so people can have community contact and feel less lonely and isolated
• Review and improve crisis support by co-evaluating and co-designing opportunities with people who use services and frontline staff. This will create better services based on lived experiences and identified needs.
• Invest in befriending services to overcome loneliness and isolation, especially for those who are housebound or restricted due to caring responsibilities

Living independently

“I live in supported housing and my networks of support are brilliant”

Ideas for positive change included: 

• Increased befriending services that can offer face-to-face support and help older people to build their confidence around travelling in their community using public transport, accessing activities and trying something new
• Housing support to help people live independently longer. This includes house modifications to help with mobility issues and sensory loss, in addition to improving home security to help older people feel safe at home
• A range of supported housing options for older people to decrease the stigma and fear associated with moving into supported living accommodation.
• Provide options for older people to access primary care services, such as GP appointments. Digital exclusion can be a barrier for older people, resulting in them not being able to access relevant information; send photographs of symptoms or issues and attend virtual appointments.

Home from hospital

“How will I find the support I need?”

Ideas for positive change included: 

• Early intervention support that may stop people needing to be hospitalised. This includes mental health and wellbeing support,  hoarding support and tackling loneliness and isolation. Collaboration with the third sector is vital, valuing the role they can play in supporting people and building relationships with individuals
• Investing in patient advocates and befrienders within hospitals to help individuals feel less lonely. This will help take pressure away from busy ward staff, and create better experiences for patients while in hospital and will help to support the discharge process
• Provide accessible information so older people can understand what services and support is out there and available to them, before reaching crisis point
• Ensure time is spent with patients to understand their needs and desires for when they are discharged. This will ensure the necessary plans are in place, including ensuring the right food is in the house, and the bed is ready with preferred bedding. This is particularly important if someone is not returning to their home, but instead being placed into supported accommodation/ a care home
• Ensuring prevention services can be tailored to support the needs of the individual to keep them well at home as long as possible, rather than waiting until crisis point or hospitalisation

Community services and support

“We started with health and social care, and then turned on its head, and looked at community resilience around us.”

Ideas for positive change included: 

• Regenerating and building a sense of community resilience, pride and belonging. This can be achieved by offering more community based face-to-face support at dedicated hubs.
• Helping older people feel safe in their communities by breaking down barriers between generations – more intergenerational activities can support this
• Greater investment in social care to overcome staff shortages and burnout, which will better support people living in our communities

Good dementia care

“Not everyone has a good experience and people’s feelings need to be validated.”

Ideas for positive change included: 

• Accessible information so that people understand what support and activities are out there for people living with dementia and their carers. People also want to understand their rights and advocacy services are important to help people living with dementia and their carers exercise them effectively
• Safe environments with accessible housing to build communities that care and can support people living with dementia. This includes improving the quality of community services and raising awareness of dementia within our communities.
• Looking after the physical and mental health of carers so they can continue to look after their loved ones. This includes providing accessible and adequate respite services so carers have time to have a “real break” and time for themselves
• Using accessible language so that people living with dementia and carers can participate in conversations and activities
• Ensuring we create adequate time for people living with dementia and their carers so they can process information, and take time to ask questions. There also needs to be an appreciation of when is the most appropriate time of day for appointments as it may take longer to prepare them to attend.
• Co-producing meaningfully with people living with dementia and their carers – this involves equipping organisations and services with the knowledge and skills to share power and responsibility effectively
• Ensuring continuity of services across the region. Individuals should be confident they will receive a quality service wherever they live.