Tag Archives: people

As a GP I feel powerless to help elderly people struggling to survive

Recently a patient brought home to me how inadequate the help I can provide my elderly patients as a GP can be. Among more than 50 phone calls I fielded one day as one of the GPs dealing with urgent requests, there were two from a patient in her 80s who is the main carer for her husband who has dementia. She also has health issues and he is unaware of the problems they face. The receptionist learned far more about the difficulties they were having from the woman’s phone calls to the surgery and from observing them in the waiting room, than I did from my snatched telephone conversations and the scrawled note left for me. I found out later that the only way she could get to the surgery to bring the sample I requested was by locking her husband in the car outside. I knew that things were difficult, but this was a new low.

Over the last year I have been increasingly involved in the care of a man who is in his 80s and moved into my practice area to be nearer to his family. He enjoys telling me about his past when he gets the opportunity and I recall how his eyes sparkled as he told me that adopting his daughter was the best decision he and his late wife ever made. He knows his dementia is worsening and was the one who recognised the initial symptoms, well before these signs were noticed by others around him. He looks crestfallen as he recounts to me how he sees the frustration and sorrow in his daughter’s eyes when he asks the same question another time. He is annoyed by his failing health and memory and feels he is a burden to those around him. At times he is too proud to ask for help.

The population is ageing, with the number of older people with care needs likely to increase by more than 60% in the next 20 years. One in three over 65s will die with dementia, and it is the leading cause of death of women in the UK, yet dementia research is poorly funded, with combined charity and government research significantly lower than cancer research. Every day as a GP I see patients in difficult situations, where an elderly person is struggling to care for themselves and their spouse, with implications to the health of both. I see families trying to maintain their jobs and daily activities, while providing increasing support for their elderly relatives. At the end of a long day yesterday a son called me in distress; his mother was already an inpatient and he was left to look after his father, but felt getting involved in intimate personal care was a step too far.

As a GP I am the person that people often turn to, but at times I feel I have little power to make positive changes for these patients. I can only provide brief intervention, refer and signpost to over-stretched services – this is not the level of care and support that they need. Those that come to me are often at crisis point, having struggled without any input from outside services until they cannot continue any longer. There are undoubtedly those that I’m not aware of perhaps until an emergency admission or mishap alerts me. These patients may come into contact with many services; as health professionals we often see an aspect of their lives, dealing with high blood pressure, an arthritic knee or continence issues, but do not realise the enormity of the situation or assess it properly.

Older people’s mental health services and social care are limited. Yes, I can refer, but these services are overloaded and don’t provide much help. We need more resources, more time, more services, more people available to provide assessment, listen and support. We need to start focusing on ageing and older people and encouraging planning for the future, or this situation will only get worse.

*Some details have been changed to preserve patient anonymity

Join us on 23 May to discuss how the public and voluntary sectors, retail and service industries can recognise and support people with dementia.

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Tory manifesto: more elderly people will have to pay for own social care

More elderly people will have to pay for their own social care in the home and lose universal benefits under a new Conservative policy which, Theresa May will say on Thursday, is difficult but necessary to tackle the crisis in funding.

Introducing the party’s election manifesto, the prime minister will say it is the “responsibility of leaders to be straight with people about the challenges ahead” as she unveils a controversial policy that would reduce the value of estates that many people hope to pass on to their children.

The policy will be a flagship measure in the Tories’ election manifesto, which the prime minister will pitch as a programme for solving some of the challenges facing Britain. It means wealthier people with more than £100,000 in assets will have to pay for their own elderly care out of the value of their homes, rather than relying on the council to cover the costs of visits by care workers.

The Conservatives will attempt to soften the blow by promising that pensioners will not have to sell their homes to pay for their care costs while they or a surviving partner are alive. Instead, products will be available allowing the elderly to pay by extracting equity from their homes, which will be recovered at a later date when they die or sell their residence.

Labour responded to the announcement by saying that people could not trust the Tories’ promises on social care. Barbara Keeley, shadow minister for social care, said: “In their last manifesto, they promised a cap on care costs. But they broke their promise, letting older and vulnerable people down.

“It’s the Tories who have pushed social care into crisis; their cuts to councils have meant £4.6bn axed from social care budgets between 2010 and 2015, leaving 1.2 million people struggling to get by without care. And NHS bosses have recently said that the money the Tories promised them won’t help alleviate the problems.”

To provide a more immediate boost in funding for social care, the government will also end universal winter fuel payments of £100 to £300 a year for pensioners, bringing in a means-tested system instead. The Conservatives declined to say how much they would raise from this, or what limits they would place on who is eligible for the benefits, but the payments currently cost the government around £2bn a year.

The manifesto is set to have a markedly different in tone from Labour’s, which promised a populist programme of mass nationalisation, more spending on the NHS, the abolition of tuition fees and an end to the public sector pay cap.

May billed it as a “declaration of intent: a commitment to get to grips with the great challenges of our time and to take the big, difficult decisions that are right for Britain in the long term”.

“People are rightly sceptical of politicians who claim to have easy answers to deeply complex problems. It is the responsibility of leaders to be straight with people about the challenges ahead and the hard work required to overcome them,” she will say.

Other measures expected to be included in the manifesto are:

A pledge to scrap free school lunches for infants to pay for free
breakfasts for all primary pupils, saving around £650 a year per pupil, which will be used to increase schools funding by about £4bn over the parliament.

Extra charges for businesses that employ workers from overseas and higher charges for foreigners who use the NHS.

A ditching of the triple lock on increasing the state pension, as
signalled by May and other ministers during the campaign.

The care policy is an attempt to meet the cost of looking after the elderly in their homes, which councils across the country are struggling to fund in the face of severe budget cuts. In turn, this has been putting unprecedented pressure on the NHS.

At present, people have to pay for their social care at home if they have wealth of more than £23,500, excluding the value of their residence. Under the new policy, people will have to pay for their social care only if they have wealth of more than £100,000 – but the value of their homes will be included as well. As a result, more homeowners will be liable to pay for the cost of home helps and carers provided by the council.

It is better news for the elderly in residential care, whose homes are already included in calculations of their assets. It means they will now only have to pay for their care until they have remaining assets of £100,000, instead of £23,500. There are no details on when the policy would be implemented, but it is likely that it would require consultation and legislation.

The Conservatives will also say they plan to do more to integrate the NHS and social care, stop unnecessary stays in hospitals, and examine how to make better use of technology to help people live independently for longer. An additional measure to help family carers will be a new right to request unpaid leave from work to look after a relative for up to a year.

May will hope the measures address deep concerns about the long-term costs of funding social care, which have been having a knock-on effect on the NHS as more elderly people stay in hospital.

May said at a press conference on Wednesday that the manifesto would seek to address five major challenges in an echo of social reformer William Beveridge’s five “giant evils”.

The social care announcement is likely to get a mixed reception, as some Conservatives will worry about it going down badly with middle-class voters who want to pass on the value of their homes to their children.

Voter confronts Theresa May over disability benefit cuts – video

May is already under pressure from some on the right of her party over interventionist policies, such as her pledge to cap energy costs for households. Previous attempts to reform the funding of social care have met with deep hostility from the rightwing press, who branded Labour proposals for a levy on estates a “death tax”.

Her decision to include a measure that could be unpopular with middle-aged and elderly voters is likely to be taken as a sign of confidence in winning the election, given the Tories’ double-digit lead in the polls over Labour. Strategists also hope it will paint the prime minister as a realist and pragmatist in contrast to Labour’s manifesto promising more spending on public services paid for by higher taxes on companies and high earners.

Other measures in the manifesto are likely to include proposals on improving skills and apprenticeships, and a promised expansion of workers’ rights, which Labour has dismissed as spin.

The document is also likely to retain the Conservative commitment to bringing down immigration to the tens of thousands from hundreds of thousands. That approach was challenged on Wednesday by a leader in the Evening Standard newspaper, edited by the former chancellor George Osborne, which claimed that no senior cabinet ministers support May’s desire to keep the target.

In a leader column, the newspaper said there had been an assumption at the top of the Conservative party that May would use the election to “bury the pledge” made by David Cameron before he was elected in 2010 because it was unachievable and undesirable. “That’s what her cabinet assumed; none of its senior members supports the pledge in private and all would be glad to see the back of something that has caused the Conservative party such public grief,” the newspaper said.

Editorials are written anonymously as the voice of the newspaper, but Osborne tweeted a link to the column and the front page of the Evening Standard, which attributes a squeeze in the cost of living to inflation caused by Brexit.

Theresa May to unveil policy of making older people pay for social care

More elderly people will have to pay for their own social care in the home and lose universal benefits under a new Conservative policy which, Theresa May will say on Thursday, is difficult but necessary to tackle the crisis in funding.

Introducing the party’s election manifesto, the prime minister will say it is the “responsibility of leaders to be straight with people about the challenges ahead” as she unveils a controversial policy that will reduce the value of estates that many people will have hoped to pass on to their children.

The policy will be a flagship measure in the Tories’ election manifesto, which the prime minister will pitch as a programme for solving some of the challenges facing Britain. It means wealthier people with more than £100,000 in assets will have to pay for their own elderly care out of the value of their homes, rather than relying on the council to cover the costs of visits by care workers.

The Conservatives will attempt to soften the blow by promising that pensioners will not have to sell their homes to pay for their care costs while they or a surviving partner are alive. Instead, products will be available allowing the elderly to pay by extracting equity from their homes, which will be recovered at a later date when they die or sell their residence.

Labour responded to the announcement by saying that people could not trust the Tories’ promises on social care. Barbara Keeley, shadow minister for social care, said: “In their last manifesto, they promised a cap on care costs. But they broke their promise, letting older and vulnerable people down.

“It’s the Tories who have pushed social care into crisis; their cuts to councils have meant £4.6bn axed from social care budgets between 2010 and 2015, leaving 1.2 million people struggling to get by without care. And NHS bosses have recently said that the money the Tories promised them won’t help alleviate the problems.”

To provide a more immediate boost in funding for social care, the government will also end universal winter fuel payments of £100 to £300 a year for pensioners, bringing in a means-tested system instead. The Conservatives declined to say how much they would raise from this, or what limits they would place on who is eligible for the benefits, but the payments currently cost the government around £2bn a year.

The manifesto is set to have a markedly different in tone from Labour’s, which promised a populist programme of mass nationalisation, more spending on the NHS, the abolition of tuition fees and an end to the public-sector pay cap.

May billed it as a “declaration of intent: a commitment to get to grips with the great challenges of our time and to take the big, difficult decisions that are right for Britain in the long term”.

“People are rightly sceptical of politicians who claim to have easy answers to deeply complex problems. It is the responsibility of leaders to be straight with people about the challenges ahead and the hard work required to overcome them,” she will say.

Other measures expected to be included in the manifesto are:

A pledge to scrap free school lunches for infants to pay for free
breakfasts for all primary pupils, saving around £650 a year per pupil, which will be used to increase schools funding by about £4bn over the parliament.

Extra charges for businesses that employ workers from overseas and higher charges for foreigners who use the NHS.

A ditching of the triple lock on increasing the state pension, as
signalled by May and other ministers during the campaign.

The care policy is an attempt to meet the cost of looking after the elderly in their homes, which councils across the country are struggling to fund in the face of severe budget cuts. In turn, this has been putting unprecedented pressure on the NHS.

At present, people have to pay for their social care at home if they have wealth of more than £23,500, excluding the cost of value of their residence. Under the new policy, people will have to pay for their social care only if they have wealth of more than £100,000 – but the value of their homes will be included as well. As a result, more homeowners will be liable to pay for the cost of home helps and carers provided by the council.

It is better news for the elderly in residential care, whose homes are already included in calculations of their assets. It means they will now only have to pay for their care until they have remaining assets of £100,000, instead of £23,500. There are no details on when the policy would be implemented, but it is likely that it would require consultation and legislation.

The Conservatives will also say they plan to do more to integrate the NHS and social care, stop unnecessary stays in hospitals, and examine how to make better use of technology to help people live independently for longer. An additional measure to help family carers will be a new right to request unpaid leave from work to look after a relative for up to a year.

May will hope the measures address deep concerns about the long-term costs of funding social care, which have been having a knock-on effect on the NHS as more elderly people stay in hospital. On Thursday, doctors’ leaders will accuse ministers of a “callous disregard” of the NHS and putting its funding into “deep freeze”. The British Medical Association will call on ministers to plug “the enormous funding gap” in healthcare spending between Britain and other major European countries.

May said at a press conference on Wednesday that the manifesto would seek to address five major challenges in an echo of social reformer William Beveridge’s five “giant evils”.

The social care announcement is likely to get a mixed reception, as some Conservatives will worry about it going down badly with middle-class voters who want to pass on the value of their homes to their children.

Voter confronts Theresa May over disability benefit cuts – video

May is already under pressure from some on the right of her party over interventionist policies, such as her pledge to cap energy costs for households. Previous attempts to reform the funding of social care have met with deep hostility from the rightwing press, who branded Labour proposals for a levy on estates a “death tax”.

Her decision to include a measure that could be unpopular with middle-aged and elderly voters is likely to be taken as a sign of confidence of winning the election, given the Tories’ double-digit lead in the polls over Labour. Strategists also hope it will paint the prime minister as a realist and pragmatist in contrast to Labour’s manifesto promising more spending on public services paid for by higher taxes on companies and high earners.

Other measures in the manifesto are likely to include proposals on improving skills and apprenticeships, and a promised expansion of workers’ rights, which Labour has dismissed as spin.

The document is also likely to retain the Conservative commitment to bringing down immigration to the tens of thousands from hundreds of thousands. That approach was challenged on Wednesday by a leader in the Evening Standard newspaper, edited by the former chancellor George Osborne, which claimed that no senior cabinet ministers support May’s desire to keep the target.

In a leader column, the newspaper said there had been an assumption at the top of the Conservative party that May would use the election to “bury the pledge” made by David Cameron before he was elected in 2010 because it was unachievable and undesirable. “That’s what her cabinet assumed; none of its senior members supports the pledge in private and all would be glad to see the back of something that has caused the Conservative party such public grief,” the newspaper said.

Editorials are written anonymously as the voice of the newspaper, but Osborne tweeted a link to the column and the front page of the Evening Standard, which attributes a squeeze in the cost of living to inflation caused by Brexit.

Air pollution kills more people in the UK than in Sweden, US and Mexico

People in the UK are 64 times as likely to die of air pollution as those in Sweden and twice as likely as those in the US, figures from the World Health Organisation reveal.

Britain, which has a mortality rate for air pollution of 25.7 for every 100,000 people, was also beaten by Brazil and Mexico – and it trailed far behind Sweden, the cleanest nation in the EU, with a rate of 0.4.

The US rate was 12.1 for every 100,000, Brazil’s was 15.8 and Mexico’s was 23.5, while Argentina was at 24.6.

The figures are revealed in the WHO World Health Statistics 2017 report, published on Wednesday, which says substantially reducing the number of deaths globally from air pollution is a key target.

The report reveals outdoor air pollution caused an estimated 3 million deaths worldwide, most of these in low- and middle-income countries.

Wealthy European nations had high levels of air pollution from fine particulate matter. The UK had an average of 12.4 micrograms of fine particulate pollutants (PM 2.5) for each cubic metre of air, which includes pollution from traffic, industry, oil and wood burning and power plants in urban areas. This is higher than the pollutant levels of 5.9 in Sweden, 9.9 in Spain and 12.6 in France. Germany had higher levels of particulate pollution than the UK at 14.4 and Poland’s was 25.4.

Dr Penny Woods, chief executive of the British Lung Foundation, said the report confirmed that deaths from air pollution were higher in the UK than many other comparable countries.

She said: “It is deeply tragic that around 3 million lives are cut short worldwide because the air we breathe is dirty and polluted. In the UK, air pollution is a public health crisis hitting our most vulnerable the hardest – our children, people with a lung condition and the elderly.

“Yet, we are in the fortunate position of having the technology and resources to fix this problem. It’s time to use what we have to sort this problem out as a matter of urgency and clean up our filthy, poisonous air. The next government needs to bring in a new Clean Air Act to protect the nation’s lung health.”

The worst countries for toxic air included India, where 133.7 deaths for every 100,000 people are attributed to air pollution, and Myanmar, where the rate was 230.6 deaths.

WHO said: “Outdoor air pollution is a major environmental health problem affecting everyone in developed and developing countries alike.

“Some 72% of outdoor air pollution-related premature deaths were due to ischaemic heart disease and strokes, while 14% of deaths were due to chronic obstructive pulmonary disease or acute lower respiratory infections, and 14% of deaths were due to lung cancer.”

The World Health Organisation said it was up to national and international policymakers to tackle the toxic air crisis

“Most sources of outdoor air pollution are well beyond the control of individuals and demand action by cities, as well as national and international policymakers in sectors like transport, energy, waste management, buildings and agriculture,” the WHO said recently.

LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away from | Alexander Leon

I almost didn’t write this. It wasn’t from not wanting to. I cradled my head in my hands, desperate to contribute to the reams of social media positivity I had seen surrounding Mental Health Awareness Week.

I almost didn’t – couldn’t – because I was depressed.

There came a certain point in my experience of being LGBT where I accepted that I had to be strong and uncompromising in the face of disapproving glances and withering remarks. I made a pact to throw myself into my community with zeal, no matter how exhausting, and to make full use of the privileges I was afforded in the tolerant metropolis I’d landed in.

And yet, for some reason, I find this an incredibly difficult attitude to transfer over to my struggle with depression. I will share with my co-workers that I am going on a date with a man or going to an LGBT-themed event with an almost belligerent pride, but am overwhelmed with fear in having to admit to those same people that I’m leaving slightly early to see my therapist or that I need to take some time off due to another episode.

Indeed, the word “depression” still has a bite to it, in the way that the word “gay” did when I first dared to say it to someone else in reference to myself. The tone of my voice takes on an odd quality as I approach it in a sentence, to the point where I sound intolerably meek by the time “depression” tumbles out.

The thing is, in many cases, mental illness and being queer go hand in hand. It’s an uncomfortable but important reality that LGBT youth are four times more likely to kill themselves than their heterosexual counterparts. More than half of individuals who identify as transgender experience depression or anxiety. Even among Stonewall’s own staff, people who dedicate themselves to the betterment and improved health of our community, 86% have experienced mental health issues first-hand. It’s a morbid point to make, but it makes perfect sense that we, as a community, struggle disproportionately.

At a recent event I attended, set up to train LGBT role models to visit schools and teach children about homophobia, no one explicitly mentioned their struggles with mental illness. We told one another stories of how we had come to accept ourselves in the face of adversity, talking in riddles about “dark times” or “feeling down” or being a “bit too much of a party animal”. But these problems have other names – depression, anxiety, addiction – that we consistently avoid, despite being in a community in which a large percentage of us will have undergone similar experiences.

And this phenomenon replays itself over and over. Despite there being a common understanding between me and my queer friends that we’ve probably all been vilified in the same way and made to feel a similar flavour of inadequate, we will rarely acknowledge, even within the safe boundaries of friendship, that this has had a lasting impact on our ability to maintain a healthy self-image.

But part of being proud of who we are as LGBT people is being able to be open about the struggles we’ve faced. It’s in naming and wearing the uncomfortable badges of anxiety, depression and addiction that we take the first step towards fully accepting mental illness as an important part of our collective identity. After all, how can we be true role models to the next generation if we refuse to tell the whole story?

And so, this Mental Health Awareness Week, I’m issuing a challenge to my community. If you are LGBT and suffer from a mental illness, be defiant in your acceptance of it in the same way that you would about your sexuality or gender identity. Bring it up, speak it out and feel sure that your voice, however seemingly small or insignificant, is a valid one. After all, we have been, and will always be, a community of fighters – it’s about time we dared to show our battle scars.

Social media and bullying: how to keep young people safe online

For all the benefits to mental health a digital world can bring, such as a sense of belonging and information and support for those with problems, there are also myriad dangers associated with online activity. In the very worst cases, people have live-streamed their suicide and had people cheer them on in the comments section.

Meanwhile, cyberbullying and trolling, along with communities and groups on social media that foster, glamorise or even encourage self-harm are pervasive. Stephen Buckley, head of information at the charity Mind, acknowledges these risks: “It is vital to recognise the huge danger created by any site or social media trend that promotes self-harm, suicide or eating disorders. They can be hugely damaging and possibly dangerous to someone in a crisis.”

This has come to the forefront over the past decade as more and more children use smartphones and tablets. A Young Minds report, Resilience For the Digital World, says half of Europe’s nine- to 16-year-olds now own a smartphone; the vast majority go online at least once a week, and most daily.

Buckley says that people are now used to following their friends on social media and sharing news of a new job, relationship, or a holiday presented in the best possible light. But this can have an impact on individual self-esteem. “While low self-esteem is not a mental health problem in itself, the two are closely linked. If lots of things are affecting your self-esteem for a long time, this may lead to depression or anxiety,” says Buckley.

Pressure on young people may also come from situations where they are being bullied in daily life that then cross over into their digital lives, says Marc Bush, chief policy adviser at Young Minds. “For instance, victimisation in the school playground is replicated on their Facebook pages or their WhatsApp or Snapchat groups, so they relive the distress they’re experiencing in real life on the digital platform.”

So, what’s to be done? Bush says industry has an important role to play. Today, if you search certain hashtags on Instagram, for example, a helpline pops up. He also cites the report from the House of Lords communication committee, Growing Up With the Internet, which calls for a national digital champion who can look at the rights of young people online, educate parents and teachers on how to look out for warning signs, and support young people to understand the consequences of bullying someone online.

The greater part of the solution, though, lies with young people themselves. “Ultimately,” says Bush, “young people are active in the creation, consumption and distribution of these images or forms of behaviour, so they have to be part of the solution.”

Tamanna Miah: ‘I developed severe anxiety after being bullied online.’

Tamanna Miah


Tamanna Miah is now a prominent anti-bullying activist

Tamanna Miah, 23, is a campaigner and public speaker from Kent. She describes how she coped with being bullied on social media and what it has been like to grow up in a digital world.

“I grew up in Sevenoaks, Kent, which is a very conservative, middle-class area. I suffered from severe bullying and racism from primary school to my all-girls secondary school until university. When I went home, the abuse continued online. It happened on my social media networks – Facebook, Bebo and MSN. People would comment on photos, status updates, anything that I was doing. Sometimes it was racist or Islamophobic, or attacking my appearance or the way I acted – anything. People would find a fault and take advantage of the situation.

I was a very shy, quiet child, I couldn’t stand up for myself, or look people in the eye. I would be bullied at school, come home and log on to the laptop and it would continue. You wake up in the morning to check again and it’s never-ending torment and hate. I couldn’t escape. I hated school and my time in education. I was never happy.

I developed severe anxiety and depression as a result. I tried to get support from my school and was unsuccessful. I visited my GP and they dismissed me and didn’t take me seriously. They said nothing was wrong and told me to do some exercise. It wasn’t until university that I was diagnosed.

Now I try and be careful when using social media, but I also use it for networking and meeting people. I’ve been through bullying online and offline, but I’ve also had a wealth of opportunities through social media.

I make sure that my personal activity, photos and comments are restricted, to avoid anyone attacking me publicly or harassing me. I don’t want to experience more abuse so I’d rather keep personal things private. I’d say to others in similar situations to always be careful about what you post and where.

Your online life is always going to be present. Google yourself to see what’s out there so you can check your settings and change them if needed. If someone is bullying you, always tell a responsible person as soon as possible. Make sure you have evidence of everything. Take screenshots or make audio recordings.

Whatever happens, don’t give up – just keep going. We absolutely need to speak about these issues, because if we don’t, who will?”

Loneliness among older people: a new epidemic

A weekly phone call or visit from a volunteer are among the solutions to help ease the loneliness epidemic affecting 1.2 million older people in England, according to campaigners.

Age UK, says that 1.2 million older people are chronically lonely and that this has an adverse impact on mental health, and the challenge will increase as our population ages. In the next 20 years, England’s over-85 population is set to rise from nearly
1.3 million people to just under 2.8 million.

Caroline Abrahams, Age UK charity director says: “Loneliness can have an impact on older people’s health and wellbeing. And this is particularly true when it comes to mental health, with older people’s depression often brought on by, or exacerbated by loneliness.”

NHS figures reveal that depression affects around
22% of men and 28% of women aged over 65 in England, but, according to the Royal College of Psychiatrists,
85% of older people with depression receive no NHS help at all. The spotlight on older people initiative – a group of nine older people’s organisations led by the Jo Cox Commission on Loneliness – says that more than half the users of over-50s social networking site Gransnet who say they are lonely have never discussed loneliness with anyone.

But solutions do exist, says Abrahams: “There is no quick fix or single policy solution to eradicate loneliness but there are reasons to hope that we can change things for the better.” An Age UK and Campaign to End Loneliness 2015 report, Promising Approaches to Reducing Loneliness and Isolation in Later Life, reveals good practice. For example, it says interventions involving help with transport or technology “can be the glue that keeps people active and engaged”.

The report highlights successes such as face-to-face or telephone befriending projects, including the Royal Voluntary Service’s Dorset Befriending Service, offering home visits to older people. The project began after a local GP’s concerns that older patients would visit the doctor primarily because they were isolated. Another initiative, The Silver Line, is a 24-hour, free helpline for information and companionship. In addition, British Red Cross community connectors are volunteers who identify and attend local activities with lonely older people.

The Campaign to End Loneliness is developing a national initiative to tackle loneliness through community collaboration. Laura Alcock-Ferguson, the campaign’s director, adds: “At a local level across the UK, health authorities should be developing clear plans to reduce loneliness and social isolation in their local areas.”

Dr Amanda Thompsell, chair of the old age psychiatry faculty at the Royal College of Psychiatrists, says organisations developing support projects must also include older people and carers as well as psychiatrists, GPs, and the social care sector. Thompsell suggests awareness of loneliness could also be incorporated into the school curriculum: “Inter-generational contact has been shown to be particularly effective in combating loneliness and we often forget how much children can learn from older people.”

Ignoring the challenge is not an option, as Thompsell says: “Failure to tackle loneliness will lead to more pressure on services which are already overwhelmed.”

Roy Warman: ‘I met the daughter I never had through a telephone befriending service. It changed my life’

Roy Warman


Warman credits Age UK with helping to turn his life around Photograph: Amanda Searle

Roy Warman’s wife, Phyllis, died in January 2015. Buoyed by well-wishers in the first few weeks of bereavement, the visits and telephone calls gradually dwindled, and he felt increasingly alone. Many of his friends have passed away, he does not have any family nearby and the couple never had children. He explains: “The longer it goes without speaking to someone, the harder it gets.” He describes loneliness as “one of the hardest things that you will encounter in life”, likening feeling low to “living in a void”.

The 84-year-old from Wiltshire spotted information about Age UK in a local magazine a few months after Phyllis’s death. He got in touch and was referred to an Age UK telephone befriending service that matches older people with like-minded volunteers for friendship or phone calls.

He recalls the first time he spoke to a companion on the phone: “It opened a new door. It was so nice to think that someone might listen … a voice at the other end who could sympathise.” Today he has weekly phone calls with a volunteer he describes as “like the daughter I never had” and he also has regular visits from another volunteer as part of Age UK’s face-to-face befriending scheme.

The impact has been extraordinary, says Warman, describing the experience of support as “like being in a desert and coming across an oasis”. He has joined a singing group and developed his IT skills: “I think it partly affected my decision to join a local choir. And Age UK introduced me to the tablet, it’s like a giant library.” Crucially, he senses his self-confidence has returned: “I feel good about myself and feel able to cope now.” SS

The government must not force me and other disabled people out of our homes | Tessa Bolt

I have Down’s syndrome and I live in supported housing. Today a parliamentary select committee has put out a report on the government’s planned changes for supported housing that could force people such as me with a learning disability out of our homes.

Last year the government said it wanted to make changes to funding for supported housing that would limit payments to the local housing allowance rate and let local councils have control over the extra money needed to give people supported housing. This would mean people such as me could lose our right to have our housing paid for and that there could be a lot less supported housing available.

Both these changes would obviously be really bad. Thankfully today’s report agrees, which is good to hear as it is what me and other people in supported housing have been saying for a long time. But I’m still very scared the changes could happen.

In March I gave evidence for this report. It was a historic event as I was the first person with Down’s syndrome ever to give evidence to a select committee. I was very proud to be taking such a big step for people with a learning disability, especially as I know these changes could mean that thousands of people like me lose their homes and independence. As a society, we’d be going backwards.

Before supported housing, people with a learning disability had to live with their families or live in institutions. Most care professionals think institutions are not the best place for people with a learning disability; in some cases people end up having to live far away from everyone they know, and sometimes too, without proper support, people can even be in danger of abuse and neglect. I don’t think that’s a life anyone would choose.

I moved into supported housing when I was 30. Before then I had lived with my parents. I love them but I wanted to be independent. Nobody wants to still be living with their parents at 30! After a lot of talking, my parents agreed and I now live in a house run by Golden Lane Housing, with Elizabeth and Katie, two other ladies who have a learning disability. I love living with them – we’re like family.

I couldn’t live on my own without support, but I don’t want full-time care, because I’m not a child. Supported housing means I can be independent but have day-to-day support from Mencap. My support worker Jeanette helps me get out and do the things I love, which include volunteering at Oxfam, my local bookshop and the Cancer Trust. I make my own choices and I get to live the life I want, something everyone has the right to do.

But this will all change if the government’s planned changes happen. A cut could mean that I couldn’t afford to pay my rent any more. I wouldn’t be able to live with Katie and Elizabeth and I might lose my day-to-day support. It makes me scared for my future because I’d have to move away from my home, my friends and my voluntary jobs and go and live with family. It could change my whole life in a way that I don’t want.

But I’m lucky. A lot of people with a learning disability don’t have family who can support them, so they could be forced to live in an institution, where the support and accommodation might not be right for them. They could away from everything they know and they would lose all their independence. This would be a huge step back for everyone with a learning disability.


I make my own choices and I get to live the life I want, something everyone has the right to do

It is a scary thought and I think it’s clear the government isn’t thinking about all the people who use supported housing. So I’m glad that the select committee report has said that these changes could lead to a really bad situation. This is also what a lot of supported housing providers and Mencap have said and it’s what I think as well. But I don’t know if the government will listen to this new report.

I think things would be very different if people such as me had more of a voice, more power. I don’t think changes like this would be happening. That’s why it’s important that the government listens to us.

I would say to the government: “Stop and think about what you are doing!” It’s good to save money; I am not against changes. But things have to be fair for everyone, and until you can guarantee that changes won’t take away people’s homes, independence and happiness, then these are changes that the government can’t afford to make.

Nearly 40 million people live in UK areas with illegal air pollution

Nearly 40 million people in the UK are living in areas where illegal levels of air pollution from diesel vehicles risk damaging their health, according to analysis commissioned by the Labour party.

The extent of the air pollution crisis nationally is exposed in the data which shows 59% of the population are living in towns and cities where nitrogen dioxide (NO2) pollution breaches the lawful level of 40 microgrammes per cubic metre of air.

Labour says the air pollution crisis is a “national scandal”. Sue Hayman, shadow secretary of state for environment, food and rural affairs, said a Labour government would bring in a new clean air act to tackle what was a public health emergency.

“Labour will not allow the Tories to use the snap general election or Brexit to kick this issue into the long grass or water down standards that would put millions of UK adults and children at risk,” said Hayman.

She said the party was committed to putting in place a network of clean air zones across the UK where there are high emissions, and would act at an international level to close loopholes in emissions testing of vehicles.

The analysis published by Labour shows more than 38 million people, representing 59.3% of the UK population, are living in areas where levels of nitrogen dioxide pollution are above legal limits.

Local authorities including Aberdeen, Birmingham, Bournemouth, Burnley, Derby, Chelmsford, Leeds, Northampton, Richmond and Sheffield – among many others – have NO2 levels above the legal limit.

The new figures were revealed as the government made a last-minute application to the high court to delay publication of a new tougher air quality plan to tackle the pollution crisis.

On Friday at 7pm, ministers lodged the court application – too late for it to be considered.

Judges had ordered them to come up with a tough new draft air quality plan by 4pm this coming Monday – 24 April – after judges said the original measures were so poor as to be unlawful.

James Thornton, CEO of legal NGO ClientEarth, which successfully took the government to court over its air quality plans, said the Labour data showed that air pollution was a national problem which required a national solution.

“Our court case forced the government to come up with new plans to bring down illegal levels of air pollution across the country,” said Thornton.

“Those plans must include a national network of clean air zones to keep the dirtiest diesel vehicles out of pollution hotspots, if we are to stand any chance of dealing with this public health crisis.”

ClientEarth condemned the government’s application to the high court to delay the plans being published.

Thornton said: “This is not a political issue but a public health issue. Whichever party is in power, the British public need to see an air quality plan which relies on good scientific evidence and which ensures that people no longer have to breathe toxic air and suffer the grave consequences to their health as a result.”

ClientEarth will be able to raise objections if the new draft plan – when it is eventually published after the election – does not fulfil the NGO’s five clear lines in the sand.

These are:

  • The need for robust modelling and roadside, not lab-based, emissions testing.
  • Proper funding to make sure cities and towns can delivery the necessary changes.
  • Mandated clean air zones in every town and city with illegal levels of air pollution.
  • A diesel scrappage scheme or other form of compensation for drivers who bought their cars in good faith as successive governments favoured diesel over other fuels.

The Guardian revealed earlier this month that tens of thousands of children in schools and nurseries across England and Wales are being exposed to illegal levels of damaging air pollution from diesel vehicles.

The joint investigation with Greenpeace, which examined the government’s most recent air pollution modelling, showed 2,091 schools, nurseries, further education centres and after-school clubs are within 150 metres of a road emitting illegal levels of nitrogen dioxide.

European data shows modern cars emit 10 times more noxious fumes than trucks and buses – which are subject to a much stricter testing regime.

Research consistently shows exposure to traffic fumes is harmful for children and adults. Children are more vulnerable because their lungs are still developing and exposure to nitrogen dioxide reduces lung growth, produces long term ill-health and can cause premature death.

Children are more vulnerable because their lungs are still developing


Children are more vulnerable because their lungs are still developing. Photograph: Alicia Canter for the Guardian

Nitrogen dioxide emissions from diesel traffic cause 23,500 of the 40,000 premature deaths from air pollution each year, according to figures from the Department for Environment, Food and Rural Affairs (Defra). In April last year, MPs said air pollution was a public health emergency.

In London, Labour mayor Sadiq Khan will force polluting cars to pay up to £24 a day to drive into the city when he creates an ultra-low emission zone in 2019. The price will comprise the existing congestion charge of £11.50 per day, which applies to all cars entering inner London, plus an extra amount.

The government’s original air quality plan involved clean air zones in five cities and an ultra-low emission zone in London – but these were rejected by the high court.