Priority 3 - Ageing Well

Health and Wellbeing Board member Dr Sunil Gupta explains what we mean by ageing well and our aims for this priority:

Keeping active is important as we get older for both physical and mental health. This is because the older you are, the more activity you need. The more long-term conditions you have the more activity you need too. Yet people tend to become less active as they get older.

Just over half of adults aged 55-74 in Castle Point are physically active, compared to almost 7 out of 10 adults aged 34-54. This is similar in the Rochford District. Nearly 7 out of 10 adults aged 34-54 are physically active compared to nearly 6 out of 10 55-74-year olds (Active Lives data, Sport England 2019-20)¹⁸.

To help people remain independent, and support good physical and mental wellbeing, we aim to help and encourage more people to be physically active, and to stay active as they get older.

Nadia, 36, is a single parent. She has two young children and is just about managing. She wants to make some positive lifestyle changes but cannot afford gym membership, so she has started doing Couch to 5K.

Nadia’s dad Ravi, 65, has recently retired and is feeling at a loss. He enjoys keeping active and has started doing some gardening for one of his neighbours. He is looking for other activities to fill his free time. 

Identity and Purpose: challenging perceptions and valuing people’s contribution

Ageing brings a time of change as well as opportunities. It’s important that we look after ourselves and each other as we age and as our circumstances change.

Older people have a resilience brought about by common life events. The learning and life events we experience as we age give a rich and thoughtful insight to share across all generations. Not just within families but wider within our communities too. How we respond to these life events can also affect our physical and emotional wellbeing. 

Our statutory services have a responsibility to provide health and social care services, whilst our VCFSE organisations provide extra support and volunteering opportunities. Through these we can capture a person's skills, knowledge and expertise and pass them on to younger generations. This helps people retain a sense of purpose.

Social interactions are an important part of ageing well. They help people to maintain health and wellbeing through our communities. For example:

• a walk in the park
• visiting the library, post office or local shops
• going to a café or place of worship
• chatting to a neighbour

Loneliness and Social Isolation in Ageing

There is a link between later stages of life and a decline in mental health. This can be due to loneliness and / or isolation or for other reasons, such as stopping work, having less money or the time of year. Most older people cope well despite these challenges; however, depression can affect 1 in 5 older people living in the community, and 2 in 5 living in care homes.

Older people are especially prone to loneliness and social isolation. It can have a serious effect on health. Older people should have the support and opportunity to make and maintain meaningful connections and participate in meaningful activities so that they can enjoy life as much as possible for as long as possible.

According to Age UK, more than 2 million people in England over the age of 75 live alone, and more than a million older people say they go for over a month without speaking to a friend, neighbour, or family member. No one should have no one. 

People can become isolated and lonely in later life for a wide range of reasons. These can include:

• loss of loved ones
• ill health
• lack of local services
• poor public transport
• poor physical environment

You can be isolated without being lonely and be lonely without being isolated. Research shows that loneliness is linked to poorer physical and mental health and wellbeing in older people. It can make them unhappy and lower their self-confidence and ability to cope.

Older people with a high degree of loneliness are twice as likely to develop Alzheimer’s disease compared to those with a low degree of loneliness. Someone who is lonely may also find it hard to reach out. There's a stigma surrounding loneliness and older people tend not to ask for help. We aim to reduce this stigma by raising awareness about the effects of loneliness on health and encourage more people to seek the help they need. We want people to know what help is available to them locally to support their mental health as they age and as their circumstances change. 

Maintaining independence

Castle Point and Rochford have a higher proportion of older people compared to Essex as a whole. According to the Office for National Statistics, approximately a quarter (25.5%) of people in Castle Point and 23% of people in the Rochford District are aged 65 and over. In the next 20 years, our older adult population is projected to grow. By 2043, there will be around twice as many people aged 90+ living in Castle Point and Rochford¹⁹.

¹⁹Data obtained from Population projections for local authorities: Table 2 - Office for National Statistics

As people live longer, they are likely to need more care and support. This is because older people are more likely to live with multiple and complex long-term conditions, which can impair quality of life.

The role of carers is hugely important to maintain independence. We will ensure they are supported to continue in their caring role, should they choose to. We also want to make sure they are aware of opportunities to support them. The Essex All-Age Carers Strategy will be key to supporting this.

Dementia

Most parts of the body tend to work less well as people get older. This is also true of the brain. It happens differently for everyone due to genetic, lifestyle, and environmental factors. The number of people aged 65+ with dementia is projected to rise by nearly 50% in the next 20 years in Castle Point and Rochford²⁰. Therefore, we must have the capacity to support the increasing number of people that will be living with dementia. The new Southend, Essex and Thurrock Dementia Strategy (*currently being updated*) will aim to enable local communities to support people affected by dementia, and their carers, to live well.

Brian, 62, lives in Rayleigh with his wife Valerie. Brian was recently diagnosed with dementia; He works full time and his employer of 10 years has been very supportive and accommodating. Brian is not sure how much longer he will be able to carry on working. He is usually very sociable; however, he has become more forgetful and now struggles with word finding, particularly when he is tired. He now avoids all social interaction.

Valerie, 60, also works full time and provides emotional support for Brian. They don't have any family nearby. Valerie is worried about how to pay the bills if Brian has to stop working. She is also worried about her and Brian being isolated.  

Brian was referred through Live Well Link Well to a local service for an assessment. He was referred to Citizens Advice for advice around employment support, benefits, and budgeting. A Dementia Navigators referral was completed for Brian. He and his wife Valerie were given advice on local social support groups and charities that could help, including Alzheimer’s Society. Advice was also given about some technology that may help support Brian with his forgetfulness and keep him safe.

Frailty

Frailty is a term that may be used to describe a person’s state of health. Frailty is a long-term condition that can take away a person’s independence and health. Whilst it is common in older people, it is not an inevitability of ageing. Being described as 'frail', having 'frailty' or 'living with frailty' may occur when the body loses its natural reserves. This may be due to a range of factors such as illness, disability, or aspects of the ageing process.

Those living with frailty are at an increased risk of falls. Falls can also be a symptom of undetected frailty. According to the NHS, around 1 in 3 people aged 65 and over, and half of people aged 80 and over are likely to fall at least once a year²¹.

Rates of emergency hospital admissions due to falls in people over 80 are higher in Castle Point than in Rochford (6364 per 100,000 people compared to 5679 per 100,000 people). This is significantly worse than the national average (5644 per 100,000 people)²². This is an issue that we want to address, which is why we are making falls prevention one of our priorities within ageing well. 

Anne, 58, lives in Hadleigh. She is a carer for her 82-year-old father who has dementia. She is stressed and exhausted and has lost weight recently. She was referred to the Dementia Community Support Team and Dementia Navigators for support and advice for her father, and for Anne as his carer. They told her about Smart Minds, a weekly group for people living with dementia and their carers to attend together.

Preparing well / Future planning

Another important consideration for people as they get older is end of life or palliative care. End of life care is support for people who are in the last months or years of their life. It helps them to live as well as possible until they die and to die with dignity. As people near the end of their life, Advance Care Planning (ACP) including Lasting Power of Attorney (LPA), Wills services, and access to wellbeing and emotional support are important elements of the end of life care process. Not just for patients, but their families and carers too. Palliative care is support for people who have an illness that cannot be cured. It aims to make them as comfortable as possible by managing pain and other distressing symptoms. 

Impacts of COVID-19

COVID-19 affected the way we all live, learn and work. It impacted on jobs, finances, education, families, caring responsibilities, and social life. It also placed immense pressure on essential workers. Some groups have been affected more than others. For example, carers and older people's physical and mental health has declined. Health inequalities have widened too as a result. This means we need to focus more of our efforts towards those whose needs are greatest.

We want to remedy this as best we can as we recover. We know that this will be a challenging task, but it is an important one to prevent further deterioration in health among these groups. We want to help people to recondition; this means supporting them to reengage and reconnect with the activities that they enjoy. This will help people to feel more connected to each other and their local communities. In turn it will also bring benefits to their physical and mental wellbeing, particularly among people living alone.

Connecting through technology

Digital aids have transformed many aspects of everyday life to help older people stay safe and independent at home. Since the pandemic, the way that people connect to each other and to services has changed too. They learnt new skills that enabled them to stay connected to others and take part in activities. Services have also adapted. This has provided more opportunities for people to access help and support and manage aspects of their own health. For example, through managing prescriptions and booking GP appointments online.

In the video below, Health and Wellbeing Board member Dr Sunil Gupta explains some of the ways we can empower people to age well: