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JSNAA

Older people (JSNAA)

  • PHE suggest that there is no agreed definition of older or old people and people differ widely in what they consider to be old. Members of each age band are a very heterogeneous group and age is a very unreliable indicator of state of health or mental or physical capacity of any individual. Ageing can be equated with the onset of health conditions such as heart disease, stroke, cancer and respiratory disease as well as heralding increased sensory impairment.
  • However, the medicalised premise that successful ageing is purely the avoidance of ill-health is challenged by qualitative studies of older people which consistently asserts that social, spiritual, cultural and artistic outlets are valued far more as indicators to 'good health'. Perceptions of older people and ageing can therefore be inverted and viewed as an asset, pointing to the promoting of programmes that support a framework for such outlets as key features for local commissioning.
  • Older people make a huge contribution to the life of their local area through the taxes they pay, contribution to the labour market, their spending as consumers, the contribution they make to childcare and the care of loved ones and friends, as well as through voluntary, political, cultural and community based activity.
  • Older people have the opportunity to become critical drivers in economic development and regeneration of South Tyneside if they are given sufficient support to contribute and actively participate in society.
  • People aged 65 and over in the UK contributed £61 billion to the economy last year through employment, informal caring and volunteering, according to a new report by Age UK. That's equivalent to 4.6 per cent of gross value added, and six times more than the money spent on social care by local authorities in England.
  • The Age UK Chief Economist's report found that £37 billion of the total amount came from employment and £11.4 billion from informal caring. Child care contributed £6.6 billion. Nearly £6 billion came from volunteering.
  • For the first time there are now more than eleven million people in the UK aged 65 and over. A growing number of them - more than a million - are working. Although some will be doing so from financial necessity many others want to work for longer because they are in good health and because what they achieve at work is valuable and worthwhile.

Age UK Chief Economist's Report  Spring 2014
Based on analysis of ONS Labour Force Survey,  ONS Annual Survey of Housing and Caring,  ONS Economic Accounts, Understanding Society, Pacey Annual Survey of Child Minding Fees

Key Issues

  • Demographic and population - dramatic increase in ageing population suggests future pressure on community, primary and secondary care.
  • Dementia - increasing prevalence of dementia in people aged 75+.
  • Economy and income - South Tyneside is an area of high deprivation with many older people remaining asset rich due to increasing land values and property prices, yet relatively cash poor leading to less available money to support a healthy lifestyle or adequately fuel their home. Pensioner benefits have been protected due to changes in government legislation. Pensioner reforms could lead to boom in consumption and financial pressures once assets are exhausted.
  • Access to good quality information and advice is crucial now and will grow in importance as society ages. The ability to plan and prepare for later life is fundamental to promoting the health and wellbeing of older people. Finance, housing and care options in later life are inextricably linked. Access to integrated, impartial good quality information and advice is vital to informed decision-making and a central component of Care Act 2014.
  • Health and long-term conditions - An ageing society has led to the prevalence of long-term conditions. Prevention, delaying onset and slowing progression of long-term conditions and encouraging older people to self-care and manage their conditions will alleviate pressure on the health and social care system.
  • Housing - a key contributor to people's sense of wellbeing particularly if their quality of housing is high and there is local community support. Quality of housing is important to quality of life throughout life but maybe critical in later life and needs to be reflected through social housing policy, sheltered housing as well as the Local Development Framework and considering wider implications, for example dementia friendly communities.
  • Transport and access - although South Tyneside is an urban area with established transport links, some wards have limited access to transport, which could prevent older people from living as independently as possible.
  • Falls - the impact of a fall can affect older people's confidence and ability to retain their independence and remain an active citizen in their local community. The implications of repeat falls also have an impact on people and their ability to cope and live independently as well as on hospital admissions.
  • Physical disabilities and sensory impairment.
  • Black and Minority Ethnic (BAME) - people from diverse cultural backgrounds may not engage with statutory or existing local provision and often have fewer opportunities to access services due to language or cultural barriers.
  • Social isolation, improving older people's independence and quality of life.
  • Fuel poverty and cold homes - detailed in future needs assessment.
  • Excess Winter deaths - detailed in future needs assessment.

The Leaders and Elected Mayors Group for the North East asked areas to focus on two aspects that are regularly cited as being critical to health and wellbeing of older people: promoting a healthy old age and tackling loneliness and isolation. The report states preventative services are key to supporting increasing demand to reduce pressure on services. (Association of NE Councils)

High Level Priorities

1.  Reducing loneliness and social isolation.

There is growing recognition that loneliness is a serious problem, with far reaching implications, not just for individuals, but also for wider communities, which merits the attention of local authorities. Whilst in the past, loneliness was sometimes viewed as a trivial matter; it is increasingly understood to be a serious condition which can affect a person's mental and physical health very detrimentally. Acute loneliness has been consistently estimated to affect around 10-13 per cent of older people. Apart from the general imperative for public services to do what they can to alleviate personal suffering and distress, there is also very strong evidence that loneliness can increase the pressure on a wide range of council and health services. It can be a tipping point for referral to adult social care and can be the cause of a significant number of attendances at GP surgeries.

Loneliness is a significant and growing issue for many older people. Its impacts are devastating and costly - with comparable health impacts to smoking and obesity. Loneliness is amenable to a number of effective interventions, which are often low cost, particularly when voluntary effort is harnessed. Taking action to address loneliness can reduce the need for health and care services in future.

http://www.local.gov.uk/documents/10180/7632544/L15-431+Combating+loneliness+-+a+guide+for+local+authorities/b4b88757-2623-4696-ae04-565892a58909

2.  Improving independence and quality of life.

3.  Digital inclusion to evolve as a cross-cutting theme in supporting older people to ensure they are aware of the positive health benefits of getting online in communicating, shopping, ordering prescriptions, making appointments, comparison sites, banking or job applications.

4.  As society ages, health and social care services become even more important. The Government must fund and integrate them properly so councils can ensure they meet the needs of older people and that users experience a seamless and coordinated response to reduce demand for expensive reactive, emergency or institutional services. (Ageing: The Silver Lining. June 2015)

5.  South Tyneside should maintain commitments to addressing fuel poverty, falls prevention and reducing excess winter deaths evident in the 2013/16 JSNA. Falls prevention promotion needs to be emphasised across the system including supporting people to discuss falls at primary care level and encouraging the wider disclosure of falls. Investment in warm homes initiatives aimed at vulnerable older people in socially and economically disadvantaged households should be maintained to reduce fuel poverty and avoid increase levels of excess winter deaths.

Those at risk

  • Aging Population
  • Older people in poverty
    • The Institute of Fiscal Studies recently reported that the average income of pensioner households (£394 per week) exceeds that of the rest of the population (£385 per week). However, there are still a substantial number of older people in poverty.
    • In October - December 2010, 2.7% of older people (over 65) worked full-time and 6.1% worked part-time, an increase from 1.2% and 3.4% in 2001. Improving recruitment, retention and enabling over 50s and early 60s to remain in the workforce after state-pension age to improve the financial health and social wellbeing of individuals into later life is important for our economy. Retiring at 55 instead of 65 could reduce an average earner's pension pot by a third - they would also have to spread this over a much longer retirement. (Government Policy. Older People. 2010-2015). As more older people live and work longer, further health inequalities emerge in that older people may be unable to do more physically demanding roles or need to upskill into different vocational areas such as digital skills.
  • Volunteers: the House of Lords Select Committee on Public Service and Demographic Change found that 30% of people over 60 volunteer regularly through formal organisations, 65% of people over 65 regularly help older neighbours, and one in three working mothers rely on grandparents for childcare.
  • Loneliness and social isolation
    • Living arrangements will be much more varied with more people living on their own and increasing number of childless older people. More people having to go into private rented sector and therefore do not carry a large capital asset with them into later life. 51% of all people aged 75 and over live alone.
    • Loneliness and social isolation can arise from a combination of personal risk factors (such as sensory loss, mobility loss, lower income etc) and factors in wider society (poor transport, lack of toilets, lack of seating, shortage of housing that meet older people's needs, fear of crime etc.). ONS have identified people 65 or over who are single, widowed, divorced or separated and thus at higher risk of isolation. Statistics show 6 - 13% of older people say they feel very or are always lonely; 17% of older people are in contact with family, friends and neighbours less than once a week and 11% are in contact less than once a month.
  • Older people's families: families are worried about their ability to offer the care needed if their parents are admitted to hospital in future. Although many families have strong family support networks, over 30% do not. With existing cuts and restrictions on social care, Home from Hospital services are likely to be needed more than ever. (Help Them Home. Royal Voluntary Service. 2015)
  • Carers: increasingly older people are becoming carers and they represent a sub-group of carers with special needs that are not necessarily met by present service provision (Age UK 2010). For instance, they are more likely to have health needs of their own such as long-term conditions; they may be caring for someone that shares a lifelong relationship such as parents or siblings with a disability; they may also be caring for a relative with dementia. It can be accurately assumed that this group is expanding though the size locally is not defined. Flu clinics in GP practices are being considered in some areas as offering opportunities to identify unknown carers, especially those who don't consider themselves carers who could ultimately be added to the Practice carer's register. The flu vaccine is routinely offered free of charge to anyone aged 65 or over South Tyneside enjoys good rates of take up. (Carers JSNAA cross reference)

Level of need

South Tyneside Older People's Health and Wellbeing Profile

  • Our ageing population is experiencing greater inequality. Socio economic differences are growing and they have a very significant impact on older people's experience of life, especially as it affects their health and wellbeing. For example: male life expectancy in a deprived area is nine years shorter than in an affluent area.
  • Male and female life expectancy is lower in South Tyneside than the England average. Male life expectancy is 9.9 years lower and female life expectancy is 8.6 years lower in the more deprived areas of South Tyneside. (Public Health England. June 2015)
  • 18.1% of the population were economically inactive due to retirement in South Tyneside between October 2014 - September 2015 in comparison to 15.1% in the North East according to ONS Annual Population Survey.
  • 18.8% of deaths from respiratory disease in persons aged 85+ - higher than England average.
  • 55.85% hospital deaths in persons aged 75-84 - higher than England average.
  • 60.8% hospital deaths in persons aged 85+ - higher than England average.
  • 10% excess winter deaths (3 years, aged 85+) - better than England average.
  • Fuel poverty is worse than England average (11.3%). This is based on the percentage of households that experience fuel poverty based on low income high cost methodology.
  • Excess weight in adults - 71.9% population considered overweight or obese.
  • Percentage of physically active and inactive adults is worse than England average, with 32.9% population disclosed as inactive and 49.2% population disclosed as being active.
  • 2035 per 100,000 injuries due to falls in people aged 65 plus.
  • 12.7% people have had an emergency readmission into hospital within 30 days of discharge from hospital.
  • Health related quality of life for older people is worse than England average with 0.677 being the average score for people aged 65 plus.
  • 2,331 per 100,000 hip fractures for older people aged 85+ - worse than England average.
  • Excess winter deaths for older people is similar to England average.
  • South Tyneside is 15th out of 32,844 LSOA's for risk of loneliness in older people 65+ therefore in the top 20 most at risk areas

In order to support older people to contribute and actively participate in society we must consider and embrace all of the areas which affect older people's lives which extend beyond health and social care including housing, transport, culture and leisure and built environment to improve their health and wellbeing and reduce health inequalities. All of these areas have a role to play in improving the health and wellbeing of the older population and thereby reducing the demand for expensive reactive, emergency or institutional services. (Association of North East Councils. April 2016)

Unmet needs

Normative Needs - what experts define as need based on some standard

From NICE Guidance - Older People with social care needs and multiple long-term conditions (November 2015):

  • Identify and assess social care needs. Consider referral for a specialist clinical assessment by a geriatrician or old-age psychiatrist to guide social care planning for older people who social care needs are likely to increase or who may need to go into a nursing or care home.
  • Telecare to support older people with social care needs and multiple long-term conditions.
  • Care planning - Coordinate and plan care collaboratively. Ensure care plans are tailored to each person giving them choice and control and recognising the inter-related nature of multiple long-term conditions. Develop care plans in collaboration with GPs and representatives from other agencies. Ensure older people with social care needs and multiple long-term conditions are supported to make use of personal budgets, continuing healthcare budgets, individual service funds and direct payments.
  • Support carers.
  • Integrate health and social care planning.
  • Deliver care through provision of support and information, support self-management and ensure continuity of care and links with specialist services.
  • Care in care homes. Ensure care plans include ordinary activities outside the home for example shopping or visiting public spaces. Include activities that reduce isolation because this can be particularly acute for older people with social care and multiple long-term conditions and build people's confidence by involving them in their wider community, as well as with family and friends.
  • Prevent social isolation.
  • Training for health and social care practitioners to ensure they are able to recognise, consider the impact of, and respond to common conditions such as dementia, hearing and sight loss; common care needs such as nutrition, hydration, chronic pain or falls, common support needs such as bereavement and end-of-life and deterioration in someones health or circumstances.
  • As a result of pressures in the social care system, managers and practitioners often prioritise meeting older people's essential personal care needs over their wish to live a 'normal' life. The NICE guideline for older people with social care needs and multiple long-term conditions recommends that there must be a change in perceptions and that social care managers and practitioners:
  • Review current provisions of information and advice to ensure it covers all aspects needed to enable people to choose and manage their own care and support
  • Draw an awareness and understanding of the impact of social isolation
  • Work with older people locally who already use personal budgets, continuing healthcare budgets, individual service funds and direct payments to review the support they need.
  • To support older people with social care needs and multiple long-term conditions, health and social care practitioners need to have skills and knowledge about a range of conditions, care needs, support options and legislation.
  • Traditionally, health and social care services that support older people with social care needs and multiple long-term conditions focus on managing separate health conditions and the system is complex to navigate. Systems and structures need to change to help professionals to work across service boundaries and specialisms.

Felt Need and Expressed Need - what people say they want and request of services

  • A large percentage of older people living in South Tyneside are considered to be at risk of loneliness and social isolation. Befriending and enabling support is currently provided by Age UK South Tyneside, St Clare's Hospice, Happy at Home and the Carers Association. There is a significant demand for befriending services to support older people.
  • Age UK South Tyneside's Get Going Together project has identified a need to expand the number of physical/social activities and enabling support to older people. Statistics from Public Health evidence need to increase physical activity amongst adults in South Tyneside and encourage people to self-care. NICE Guidelines recommend that older people with multiple long-term conditions will benefit from physical activity and being involved in the wider community. Get Going Together provides The Interim Independent Evaluation Report for the Get Going Together project states early findings indicate that the project is improving the physical health of older people - mobility in particular with survey respondents scores from SF-36 suggesting the involvement of GGT has reduced their experience of pain and energy/fatigue and increased emotional wellbeing.

Projected Need and Demand

  • Our population is ageing. The number of people aged 65 or over in England will increase by 65% over the next 25 years. Within this, the number of people over 85 years old is due to increase significantly.
  • The Office for National Statistics (ONS) projections suggest that between 2012 - 2032, the national population of 65-84 year olds will increase by 39% from 7.8m to 10.9m. Over the same period, the national population of over-85s will more than double from 1.26m to 2.61m. By 2039, more than one in 12 of the population will be aged 80 or over.
  • The North East is projected to be one of the fastest-growing English regions in terms of percentage of the population aged 65 and over, with a rise from 17.2% in 2010 to 23.6% in 2030.
  • Recent research by Public Health England (February 2016) confirms continuing upward trend in life expectancy among older age groups in England. For males in 2014, the life expectancy figures at ages 65, 75, 85, and 95 are the highest ever recorded. The same is true for females at ages 65, 75, and 95. Male life expectancy has increased to nearly 80 and women is already at 83.
  • Our ageing population is becoming more diverse. By 2026 it is estimated that the older population from black and minority ethnic communities will make up 28.4% of the population compared to 21.2% today.
  • Our ageing population will be more open to diversity in sexuality with a significant growth in the number of older people who are openly gay, lesbian or bisexual
  • Health and long-term conditions - The prevalence of long-term conditions is strongly linked to ageing and the number of people with multiple long-term conditions in England is projected to rise to 2.9 million by 2018 (Department of Health, 2015).

Community Assets and Services

www.wellbeinginfo.org.uk

There are a wide range of services available to support older people their families and carers. Voluntary and community sector organisations such as Age UK South Tyneside, Alzheimer's Society, Carers Association, as well as services to support older people with specific issues or conditions including Women's Health in South Tyneside, Tyneside Mind, Sight Service, Blissability and many more can provide information and advice, health and wellbeing activities, support to get online or practical assistance.

Evidence for Interventions

Views

South Tyneside CCG are hosting an Engagement Event specifically for older people on 8 September 2016 in partnership with Age UK South Tyneside. This would be a great opportunity to engage older people for their views to contribute to development of the JSNAA

Additional Needs Assessments Required

  • BAME and Sexual Preference
  • Loneliness and Social Isolation
  • There is currently no data collected to understand population or demographics relating to older people from Black and Minority Ethic Groups or sexual preferences of older people in South Tyneside.

Key Contact

Key contact

Sean Galdwin

E-mail

info@ageuksouthtyneside.org.uk

Job Title

Chief Officer , Age UK South Tyneside

Phone Number

0191 456 6903

 

References

Ageing: The Silver Lining. June 2015. Local Government Association.

Public Health Profiles. Public Health England. April 2016. http://fingertips.phe.org.uk/

Association of North East Councils: Report on the Impact of an Ageing Population. April 2016.

WRVS, Gold age pensioners: valuing the socio-economic contribution of older people in the UK. 2011, WRVS

SQW, Valuing the socio-economic contribution of older people in the UK: Economic Model. 2011, WRVS

Help Them Home: The challenges facing families and older patients. Royal Voluntary Service. 2015.

Age UK Digital Inclusion Evidence Review 2013 http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/Age%20UK%2

Local Strategies and Plans

Ageing Well. Local Authority - South Tyneside, CCGs - NHS South Tyneside. Public Health England. April 2016.

National Strategies and Plans

Governments Digital Strategy. December 2013.https://www.gov.uk/government/collections/government-digital-strategy-reports-and-research

Campaign to End Loneliness and Age UK. Testing Promising Approaches.http://www.campaigntoendloneliness.org/wp-content/uploads/Promising-approaches-to-reducing-loneliness-and-isolation-in-later-life.pdf

 

Last updated: March 2016

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  • Joint Strategic Needs and Assets Assessment (JSNAA)
  • South Shields Town Hall
    Westoe Road
    South Shields
    Tyne & Wear
    United Kingdom
    NE33 2RL

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