Socially Excluded And Too Old To Help?

A critical report launched this week by Age UK and The Salvation Army shines a light on the specific challenges experienced by people who are socially excluded in later life. The report explores the issues facing people living with poverty, homelessness, drug or alcohol addiction, severe mental illness and/or who are ex-offenders.

The report ‘Too old to help’ found that while social exclusion was incredibly difficult at any age, ageing magnifies the challenges and the stigma which socially excluded people already face, while at the same time often reducing the support which is available.

The qualitative research by Britain Thinks which forms the basis for the report comprises interviews with nine socially excluded people between the ages of 50 and 73 years, and seven professionals who work in this specialist field.

The outcomes of the report were discussed at an online parliamentary event this week (16 June) by charities, MPs and service providers.

The report highlights the numbers of socially excluded older people and the fact that services too often lack the specialist skills and resources to meet their needs.

For instance:
• Health services not asking older people about their alcohol consumption or drug use because they presume that these problems are an issue experienced by younger people.
• Services are not adapting to meet the needs of people living with cognitive impairment. For example, communications can be long and complicated and support isn’t provided to help people to remember their appointments.
• Older people are expected to attend services in the same spaces as younger adults, which can be intimidating, particularly if people are being disruptive or violent. When accessing group services, they may also find it hard to relate to younger people or feel ashamed and embarrassed if they are older than other service users.
• That many services that support socially excluded people often centre on finding employment, which isn’t necessarily relevant for people who are state pension age. Rehabilitation services may also offer distraction activities which aren’t suitable for older people living with long-term conditions or in poor health, for example sports.
• Or staff who may be ill-equipped to support older people with long-term health conditions, or disabilities, and similarly for those who require personal care, such as help with washing or toileting.

Sadly, the research found that ageist attitudes and assumptions also play a role. It found some professionals were deterred from providing support for older people as they felt they were ‘too old to change’, or because they believed that resources were better invested in helping younger adults.

“There’s lots of support for the under 25s. There’s beds for the kids. There’s nothing directed at my age at all. I think there will be even less as I grow older. I understand why. You’ve had 50 years and you’re f***** up. They don’t want to know.” Sarah, age 51.

“The thing is, you get to an age where you know that you’re destined to be alone.” Stuart, age 56.

“I contacted the GP as I have a list of things that I wanted to check in about, but they told me the only way was to go online. I can’t do that at the moment so there’s no way around it for me now.” Nehala, age 60.

Andrew Wileman, The Salvation Army’s Assistant Director of Older People’s Services, said: “Many older people who The Salvation Army works with have struggled to get the support they need whether that be accessing mental health support, help with debt, help to tackle addictions to drugs or alcohol, or assistance to find a permanent home. For many, this is exacerbated by financial difficulties which can mean they don’t have access to the internet or a phone. For some, the social isolation imposed by lockdowns due to the pandemic has made this even worse.

“Across the board more tailored services are needed to help older people who are socially excluded, local authorities and health services need to ensure their programmes and support is accessible and inclusive of all age groups. A one size fits all approach simply doesn’t work.”

The recommendations in the report call for:
• More tailored services to help older people who are experiencing social exclusion.
• For local authorities and health service systems providing services to improve their understanding of older populations.
• Stereotypes to be broken down to make sure services are accessible and inclusive of all age groups.
• To provide high quality information and advice so that older people with complex needs have access to independent information and advice.
• Offer greater financial support for groups approaching State Pension age who are unlikely to be able to work again.

Caroline Abrahams, Charity Director at Age UK, said: “Our new report shows how tough life often is for someone in their fifties and beyond who is challenged by poverty, addiction, housing, or mental health issues – or a combination of these problems. The fact that the support available to them is often single issue in nature doesn’t help. We also know that age tends to exacerbate the difficulties socially excluded people face, but it was depressing to discover some ageist attitudes among professionals and a sense that it was not worth investing scarce resources in an older person who they felt was incapable of positive change. We need to do more to persuade professionals that while it is certainly never too early to help someone who is socially excluded, equally it is never too late.”

Worryingly, the numbers of people at risk of social exclusion in later life appear to be growing. Pensioner poverty is now at the highest level for 15 years, with 18% - (equivalent to 2.1 million) of pensioners living in poverty after housing costs. This increase represents 200,000 more pensioners in poverty compared to the previous year .

“They stopped my disability allowance for 28 weeks, and I knew I was going to be in too much debt with my housing association. I did not want to cause trouble or be evicted, and so I just thought I’m leaving. And one day I just left.” Rudy, age 64.

The report found that many of the people interviewed were living ‘hand to mouth’. They also said that support housing in later life was temporary, insecure and often poor quality.

Even before the pandemic was happening Age UK analysis of ONS data shows that 39% of homeless people who died while sleeping rough or in emergency accommodation were aged 50-74 in 2019 , and it’s still too early to have official data on what happened in 2020’.

Regrettably, the data also show a significant increase since 2011 in deaths directly attributable to alcohol amongst people aged 55-79, and in 2019 the highest alcohol-specific death rates were among those aged 55-69 and 60-64 .

“Why would I stop using [heroin] now? To be some little old lady in some random flat on my own with nothing…I’m too old to sleep in shop doorways. I’m out of my head with anxiety about it… I’ve only got old age and death ahead of me anyway. So if I’m homeless again, I’ll just kill myself.” Sarah, age 51.

In 2018-2019 there were 1.3 million estimated admissions to hospital where the primary reason for admission or a secondary diagnosis was linked to alcohol. Of those patients admitted for an alcohol-related reason, 47% (nearly half) were aged between 54 and 74 .
There is similarly a rise in admissions to hospital for poisoning by drug misuse where there was an increase of 36% among people aged 45 and over between 2012/13 and 2018/19. In comparison, admissions for people aged 45 and under dropped by 8% .

Nickie Aiken (Con) MP for London and Westminster, who sponsored/hosted yesterday’s briefing event, said: “Some older people who have experienced challenges in their lives, including homelessness, substance misuse, or experience of the criminal justice system, can’t always access the support they need. Services designed for older people sometimes struggle to cater for those with complex needs, while all-age services are often unable to cope with the added complications that come with ageing. As a result, these older people are likely to have a harder time.

“Our health and support services have been doing sterling work in what has been a difficult year, but as they change to become fit for the future, they should consider some of the practical ideas in this report to include those who may become socially excluded in later life.”

Caroline continued: “The report paints a stark picture of the grim reality for thousands of pensioners in the UK who through no fault of their own have become socially excluded. With an ageing population it seems that those figures look set to keep rising, unless something is done to address the issues older people face now or could face in the near future.“

Download and read the report here: 
https://www.ageuk.org.uk/our-impact/policy-research/reaching-those-who-are-socially-excluded/

The Salvation Army runs 12 residential care homes and one regulated adult day centre across the United Kingdom and Ireland, with a person-centred approach that recognises that every resident is going to have different needs and wishes and encourages them to make their own choices.

As well as this, The Salvation Army runs thousands of programmes for older people through its churches and community services such as lunch clubs and befriending schemes. These activities aim to help unlock the opportunities later life can present to a person and their families. The church and charity’s support for older people has adapted during the pandemic, for example, through Salvation Army volunteers and members calling dozens of older people in local communities each week, collecting and delivering prescriptions, and even walking guide dogs.

Age UK offers support through our free advice line on 0800 678 1602. Lines are open 8am-7pm, 365 days a year. We also have specialist advisers at over 140 local Age UKs. With the right support socially excluded older people have much better prospects:

“David from Age UK was a godsend. He would come cycling up this hill every week without fail and just listen. I’d say I was interested in something and as soon as you like he had his phone in his hand Googling groups or events or something else. And then the next day, I’d get leaflets and printed pages from these websites through my door.” Nehala, age 60.

“I am the fittest, healthiest, cleanest I’ve ever been. My treatment is really working.” Stuart, age 56.

“The help I received from Age UK was just fantastic…they practically did everything, getting in touch with doctors and writing a medical report. I would never have been able to appeal without them, it’s like having a whole legal team behind you. When the letter came through that I got [the PIP] back, I phoned the Age UK lady up and she come and see me and that – just to congratulate me and for me to say thank you.” Bob, age 64.

[1] Telephone interviews were conducted with professionals from organisations including Age UK, RECOOP, King’s College Hospital homelessness unit, and the Single Homeless Project.

[1] Definition: People socially excluded when they are unable to access the rights, resources, or opportunities which are available to most members of society.

[1] Since 2003/04

[1] In 2019/20 18%- equivalent to 2.1 million pensioners were living in poverty (below 60% of median household income after housing costs)

[1] In 2018/19 - 16% of pensioners were living in poverty.

[1] Office for National Statistics, ‘Deaths of homeless people in England and Wales: 2019 registrations’. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/

[1] Office for National Statistics (2021), ‘Alcohol-specific deaths in the UK: registered in 2019: deaths caused by diseases known to be a direct consequence of alcohol misuse by sex, age, religion, and deprivation.’ Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare

[1] NHS Digital (2020), ‘Statistics on alcohol, England 2020: alcohol-related hospital admissions’. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-alcohol/2020/part-1

[1] NHS Digital (2019), ‘Statistics on drug misuse, England, 2019: hospital admissions related to drug misuse’. https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-drug-misuse/

Notes to editors

While 50 may appear relatively youthful, many who are socially excluded are subject to premature ageing and have a shockingly low life expectancy due to lower average life expectancy we define older people experiencing social exclusion as those aged 50+.

About Age UK

Age UK is a national charity that works with a network of partners, including Age Scotland, Age Cymru, Age NI and local Age UKs across England, to help everyone make the most of later life, whatever their circumstances. In the UK, the Charity helps more than seven million older people each year by providing advice and support.  It also researches and campaigns on the issues that matter most to older people. Its work focuses on ensuring that older people: have enough money; enjoy life and feel well; receive high quality health and care; are comfortable, safe and secure at home; and feel valued and able to participate. Age UK’s subsidiary charity, Age International, supports older people globally in over 30 developing countries by funding programmes such as vital emergency relief and healthcare and campaigning to raise awareness and change policies. Age UK is a charitable company limited by guarantee and registered in England (registered charity number 1128267 and registered company number 6825798). Charitable services are provided through Age UK and commercial products are offered by the Charity’s Community Interest Company (CiC) (registered company number 1102972) which donates its net profits to Age UK (the Charity).