Report for Southside Partnership and Dun Laoghaire Rathdown Network for Older People A Profile and Needs Assessment of Older People in Dun Laoghaire Rathdown from Liz Chaloner and Wendy Cox independent researchers and consultants June 2009 Older people in Dun Laoghaire Rathdown: profile and needs Acknowledgements The researchers would like to warmly thank the following people who contributed in their different ways to the outcomes of this research project about and with older people in Dύn Laoghaire Rathdown: The Chair, survey sub-committee members, members of the main committee of the Dύn Laoghaire Rathdown Older People’s Network and their administrative staff member, for their hard work and good humour in working with the researchers to plan and implement a very successful survey. Thanks too to the County Council for support in kind to the survey process. All of the 291 members of groups in the Dύn Laoghaire Rathdown Older People’s Network who took the time and trouble to complete the survey questionnaire. The individuals consulted in statutory agencies and voluntary organisations who made time for questions and discussion, contributing valuable information and insights. Finally, sincere thanks to the Manager and staff of Southside Partnership for support and advice throughout, and for their help in providing temporary office space for the survey work. We hope that the resulting report will be of value to everyone concerned. Liz Chaloner and Wendy Cox June 15th 2009 2 Contents Acknowledgements page Preface: The Role of Southside Partnership 5 Chapter 1 Introduction 7 1.1 Aims and tasks of the study 1.2 Structure of the research and the report 1.3 Summary of main findings Chapter 2 Context 20 2.1 Global ageing trends and the Irish situation 2.2 International policy on older people 2.3 The national context: Irish policy and strategy 2.4 Local policy and strategy: Dún Laoghaire Rathdown County Chapter 3 Older people in Ireland and older people in Dún Laoghaire Rathdown: demographic and statistical information 36 3.1 Older people in the national demographic picture 3.2 Older people in Dún Laoghaire Rathdown 3.3 The contribution of older people 3.4 Older people as residents of Dún Laoghaire Rathdown 3.5 Older people: income and employment 3.6 Older people and health: national level information 3.7 Older people, security and safety 3.8 Older people and education in Dún Laoghaire Rathdown Chapter 4 Survey: Contributions and Needs of Older People in Dún Laoghaire Rathdown 88 4.1 Background: the Network for Older People in Dún Laoghaire Rathdown 4.2 Designing and implementing the survey 4.3 Survey findings Older people in Dun Laoghaire Rathdown: profile and needs Chapter 5 Consultations with Key Informants 112 5.1 Themes and topics 5.2 Organisations and agencies consulted 5.3 Findings of consultations Roles, remits and services Definitions of ‘older people’ Aims of organisations and services The older population of Dún Laoghaire Rathdown Older people’s participation in decision-making Contributions of older people Positive developments service and older people’s wellbeing Challenges and gaps in services Older people’s information needs Identifying the disadvantaged and excluded Suggestions for new services and supports Chapter 6 Conclusions and Recommendations Appendices: 132 137 1. Bibliography and references 2. Relevant policy documents: international, national and DLR 3. The older population of Dún Laoghaire Rathdown by age, 2006 4. List of those consulted in the course of the research 5. Outline of topics for consultations 6. Network for Older People in Dún Laoghaire Rathdown: questionnaire 4 Older people in Dun Laoghaire Rathdown: profile and needs Preface The Role of Southside Partnership Southside Partnership is the local development company for Dún Laoghaire-Rathdown (DLR) and implements the Local Development Social Inclusion Programme (LDSIP). The Partnership is in the process of extending the LDSIP to the whole County of Dún Laoghaire-Rathdown and is undertaking a number of key actions to support this objective. A key facet of this process is to undertake the development of a detailed profile of new areas and vulnerable groups, and the mapping of needs of new target areas and target groups in the County. This will build on work already undertaken by the Partnership. Supporting key target groups revolves around providing development supports to groups at risk of and experiencing social exclusion. A central tenet of this role includes building the capacity of target groups to play a meaningful part in local efforts to promote their social inclusion. These structures include those related to Southside Partnership and other structures of importance which may not be under the remit of Partnership directly, such as the CDB, RAPID, the Local Drugs Task Force and so forth. This also includes providing a particular focus in their work on those geographic areas in which there are clusters of disadvantage and thus target groups such as in areas of social housing. Current programmes and activities In the context of the role and thrust of the Partnership, it is worth outlining the current work of the Partnership. This current work is based around a number of Programmes, each of which includes a number of strategies that in turn inform a number of actions. The three central programmes are those that are set out in the LDSIP, namely: Services to the Unemployed Community Development, Education, Youth and Childcare Work with older people During the first Southside Partnership Programme of Action older people were not named as a target group but were very involved in consultation on the plan. Later on, Pobal identified a number of target groups including Older People. However work with other groups (Travellers, Ethnic Minorities and People with Disabilities) took centre stage. Given the demographic profile of Dún Laoghaire Rathdown as one of the oldest in the country, it was clear that Southside Partnership should take a targeted approach to understanding and responding to the issues faced by older people in the area. In 2007, Southside Partnership provided training for carers through the Local Employment Service. This provided FETAC certified training for lone parents and unemployed persons to qualify them for work providing care services in the home to older people and people with disabilities. 5 Older people in Dun Laoghaire Rathdown: profile and needs In 2008, the Partnership provided formal training to the Dún Laoghaire Network for Older People on how to conduct a survey of older people in the area and to begin the process of bringing these issues to the attention of key decision makers in the County. This established a strong connection between Southside Partnership and the formal representative structure for older people in Dún Laoghaire Rathdown and has led to further opportunities for collaboration, including this research project. In 2009, Southside Partnership working with Age and Opportunity and the HSE Older Service Programme will deliver the 'Ageing with Confidence’ programme which will provide an opportunity for older people in the area to reflect on aspects of ageing, challenge stereotypes and develop a pool of activists on ageing issues in the area. Southside Partnership is also preparing an application for Interreg funding which, if successful, will see Southside Partnership engage with a number of academic and practice partnerships in Ireland, Northern Ireland, Belgium and Luxembourg to explore opportunities to develop social enterprises serving older people. This promises to be an exciting project that will have definite positive outcomes in improved services at a time of significant cut backs. Throughout this time, Southside Partnership has been actively involved with older people in their role as staff, members of boards of management and volunteers in community groups and organisations around the County. The Partnership recognises the invaluable contribution that older people make to civic life in Dún Laoghaire Rathdown. This research will provide important guidance on how Southside Partnership can support older people in making that contribution. *** Marie Carroll, Manager, Southside Partnership, June 2009 6 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 1: Introduction 1.1 Aims and tasks of the study The research on older people in Dύn Laoghaire Rathdown County which was the basis for this report was commissioned by Southside Partnership, together with the Dύn Laoghaire Rathdown Network for Older People. It was carried out during the period November 2008 to April 2009 by two independent researchers and consultants, Wendy Cox and Liz Chaloner. The primary purpose of the research was to inform and strengthen the Partnership’s planning processes in relation to work for and with older people, who will be a new ‘target group’ in the forthcoming Strategic Plan, as indicated in the Preface. In addition, the Network hoped that results from a survey would strengthen their work in representing older people’s issues at county level and with local TDs and County Councillors. As set out in the Terms of Reference, there were three linked strands to the research: o To review recent statistical and demographic data, in order to provide a profile of older people in the county; o To carry out a series of ‘key informant interviews’ with statutory and voluntary service providers; o To design and implement a questionnaire-based survey, working collaboratively with the Dύn Laoghaire Rathdown Network for older people, which would focus on the needs/issues of older people and on their contributions to community life. The Partnership also requested that the information be linked to the national and local policy contexts in relation to the older population. 1.2 Structure of the research and the report The three main strands of the research were potentially complementary, but in the event there was no straightforward way to match the findings from all three to each other in order to provide a thematically-structured report. It was therefore decided to present the results of each strand separately, making links where possible between them, and clearly ‘signposting’ themes and topics in common. The report is structured as follows: Chapter 2: Policy context In recent years, in the context of an increased awareness of Ireland’s changing demography, there have been significant developments in national policy in relation to the older population. The opening chapter first contextualises them by reference to international framework documents on ageing and older people, then outlines the main developments and the commitments that have been made to date, based on a study of the relevant documents. 7 Older people in Dun Laoghaire Rathdown: profile and needs Research also included identifying relevant policy statements and strategy documents at a more local level. These are also outlined in the chapter, as they form part of the context in which the Southside Partnership is developing its increased focus on older people, their needs and contributions. Excerpts from the main documents cited are included in Appendix 2 of this report. At the time of writing (mid-2009), it is uncertain how the impact of Ireland’s current economic situation and the inevitable adjustments in expenditure that are under way will affect the implementation by both government and local authorities of the policies and strategies they have already put in place, and on those which have been promised, of which the National Positive Ageing Strategy is a good example. Chapter 3: Statistical/ demographic context One of the two researchers concentrated on the elaboration of a profile of older people in DLR. This was carried out through secondary data analysis, primarily using the following recent sources available for investigation: o CSO data from Census 2006; o Small Area Population Statistics (SAPS) relating to Dύn Laoghaire Rathdown, drawn from Census 2006; o GAMMA report for County Development Board: Demographic and Socioeconomic Profile of Dύn Laoghaire Rathdown (2008) and GAMMA statistics provided to Southside Partnership; o Social Inclusion Profile of Dύn Laoghaire Rathdown: report by Niall Watters of Unique Perspectives, for Southside Partnership, 2009 (unpublished at the time of this research); o The CSO publication Ageing in Ireland, published in 2007. Definitions of ‘older people’? In recent years, official statements and documents have generally abandoned the term ‘elderly’ as a description of the older part of the population in favour of ‘older people’, but the meaning of this term can vary from one context to another. The majority of statutory service providers, including the HSE, designate age 65 (the conventional retirement/ pension age) as the point when a person becomes ‘older’ and therefore eligible for particular services. For the purposes of this study it was decided, in consultation with Southside Partnership, that the term ‘older people’ should where feasible encompass everyone of 55 years and over, since this generation will in due course become part of the more conventionally defined older age group. Outline of chapter 3 The chapter uses the available statistical information to look first at the general profile of the over-65 and over-55 populations in Dύn Laoghaire Rathdown, and compares them to the picture for the Greater Dublin area and for Ireland as a whole, to show that the county is unusual in demographic terms because of its older age profile overall, and hence its higher ‘age dependency ratio’. 8 Older people in Dun Laoghaire Rathdown: profile and needs The following sections of the chapter cover important aspects of their lives and experiences, although the balance of national and local information available varies a good deal across the different topics covered: o Older people’s contributions to society, through volunteering, caring work and voting habits; o Older people as residents of the county: housing circumstances; age profiles of different areas; older people living alone in DLR; and the different types of accommodation available to them; o Income and employment: employment/ retirement status and the risk of poverty; state pension recipients; pre-retirement occupations; o Health and disability: income, social class and health; exercise and nutrition; mental health and social well-being; national provision for care at home; o Security and safety, including safety in the home, older people and road safety; elder abuse; o Older people and education. Difficulties encountered in carrying out this statistical/ demographic research Several challenges were met regarding the construction of an accurate and comprehensive picture of the situation of older people living in DLR County. A principal difficulty is that the geographical boundaries of differing service providers and authorities are not coterminous. For example, the relevant HSE administrative area (Dublin - Mid-Leinster) comprises a much larger geographical area than that covered by Dún Laoghaire-Rathdown County Council, and the areas covered by Local Health Offices include parts of the county as well as areas beyond it. Geographical areas covered by Garda divisions likewise do not follow county boundaries. Further detailed investigation thus remains to be done in order to obtain some specific health and social services-related information for the Southside Partnership area. There was a particular difficulty in relation to obtaining detailed information on the economic circumstances of older people living in Dύn Laoghaire Rathdown. Confidentiality is naturally a key concern in this regard, and, although some information was available to the researchers via the Unique Perspectives Social Inclusion Profile, a more detailed picture was not possible. This is regrettable, as data from national sources show some groups of older people – such as older women living alone on state pensions – to be ‘at risk of’ poverty, although this may not necessarily be the case in Dún Laoghaire Rathdown for these or other potentially vulnerable groups. The demographic profile of Dύn Laoghaire Rathdown as a whole is unusual compared to most other parts of the country, because of the greater preponderance of older people. This means it is not possible to deduce the local situation from the national figures when local statistics or national age-disaggregated statistics are unavailable. This is true of such important factors as economic circumstances (the Census form does not include a question on income), experiences of crime, levels of volunteering, caring, and other contributions. 9 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 4: Survey of Network for Older People in Dún Laoghaire Rathdown Background The other researcher took primary responsibility for working with the Network for Older People on the design and implementation of a survey focused on issues in three areas that the Network itself had earlier identified as central to its members’ concerns: transport; security and safety; health and health services. (More information about the Network itself is provided in Chapter 4.) In summer 2008, members of the Network’s Committee had obtained funding from Age and Opportunity, and benefited from general training by the Partnership in research principles and practice. They had concluded – alongside their decision on the areas of focus – that their preferred strategy was to work with an appropriate researcher on a questionnaire-based survey of older people. The survey process Over a four-month period, beginning in November 2008, the researcher met with a survey sub-committee nominated by the main Network committee, carried out work on behalf of the sub-committee, and took part in the Network Committee’s monthly meetings, where the survey was a major agenda item. She worked closely with the Network Chair and office on practicalities such as printing, distribution and collection of the questionnaires, and arrangements for the preparatory meeting. All of this work was seen as a contribution to building the Network’s capacity and confidence for future projects, and so interactions were as far as possible carried out as peer-to-peer support and development work, rather than as expert interventions. It was not decided at the outset whether the survey would be limited to Network members, or have a wider reach. Consideration was given by the Partnership and the researchers to the feasibility of including in the survey’s scope a small number of older people’s groups in somewhat different settings, such as a residential care home and a Travellers’ project. Eventually, for reasons of practicality and time constraints, it was concluded that the survey would have greater coherence if it was straightforwardly ‘of the Network, by the Network and for the Network’, and work proceeded on this basis. A survey questionnaire was designed, covering the chosen topics as well as relevant demographic information, and taking care that its length, language and format were appropriate to a range of older people. A small number of older people were asked to take part in a pilot survey, and their accounts of the experience were taken into account in producing the final version. The Network’s groups were briefed and invited to participate, and a preparatory meeting was organised for ‘contact people’ from each of the groups, to familiarise them with the questionnaire itself, and support them to introduce it effectively to their own groups, so as to ensure maximum participation. It also turned out to be a lively and interactive networking meeting for those who attended! 10 Older people in Dun Laoghaire Rathdown: profile and needs Outcomes Results of this careful preparation were positive: there was general enthusiasm for the project and 30 of the 34 groups listed as members of the Network participated, returning 291 completed forms to the Network office by the due date. Data entry was then undertaken during the month of March and analysis of the data began in April. Chapter 4 of the report presents and comments on the main findings from the 44 questions in the survey. It also includes information about the Network itself, based on its published material and on interviews conducted with the Network’s Chair and the staff member of Dύn Laoghaire Rathdown County Council who is responsible for that body’s support to and liaison with the Network. Chapter 5: Consultations with key informants A list of key informants, from statutory and voluntary bodies providing services and supports to older people and including HSE, Gardai, VEC, County Development Board, Irish Association of Older People, and St Vincent de Paul Society, was provided to the researchers by the Partnership. All of these individuals were contacted, and face to face interviews were successfully carried out with most of those listed, and with one or two others to whom the researchers were referred. A small number of additional informants were contacted but in the event it was not possible to hold discussions with them or obtain relevant data from them. The semi-structured interviews lasted generally for an hour or an hour and a half, and were conducted on the basis of a ‘topic guide’ agreed in advance with the Partnership, which covered areas including: o Role and responsibilities of the person consulted and their organisation; o Organisational definitions of ‘older people’; o Services provided by the organisation; aims, achievements and challenges of these services; o Views on the overall situation of older people in the county, and any gaps identified in services generally; o Views on the contribution of older people to their neighbourhoods and communities; o The question of which older people are most at risk of being marginalised or socially excluded, and suggestions about new services or programmes to address this and benefit older people generally. All those who were interviewed were very helpful, and generous with information and views. Some of them also kindly suggested other people to contact. Given the time constraints of the overall project, consulting this group of key informants could be seen as an important first step, but only a first step, towards gaining a full 11 Older people in Dun Laoghaire Rathdown: profile and needs grasp of the broader picture of older people’s needs and contributions in the county, and to assessing how far the range of services and supports provided responds to the needs and wishes of the older population. A more extensive consultation – perhaps based on the new comprehensive listing of services which was about to be published at the time of writing – will be needed to provide the full picture. Difficulties in the way of obtaining a comprehensive overview, which were identified in the course of the research, included the very different geographical reaches of different organisations and agencies, which by no means respect county or electoral division boundaries, and the fact that some do not identify ‘older people’ as a specific target group’ for services, so do not collect data or record activity/ services on that basis. Assumptions about organisations supporting older people in particular were tested when it transpired that the particular local charitable society approached (a parishbased chapter of St Vincent de Paul Society) had almost no older clients, so were not in practice service providers to older people – although a high proportion of their volunteers are ‘older people’ themselves. In addition, an expectation that further detailed and informative statistical information could be provided as a result of several of these interviews was not fulfilled in practice, not least because the extremely varied boundaries and ‘catchment areas’ of the different organisations made county-based data difficult to identify and retrieve. Nevertheless, the information provided by those consulted in this part of the research exercise provides valuable insights from those working ‘on the ground’ in relation to a number of topics including: o Challenges for service providers, and gaps in present range of services; o Suggestions for new services and supports, based on providers’ local knowledge; o Older people’s information needs; o Identifying the ‘most excluded’ older people; o Older people’s participation in decision-making. Chapter 6: Conclusions and recommendations Finally, the report offers some conclusions and recommendations based on the findings of the research. ------------------------------------------------------------------------------------------------------------------- 12 Older people in Dun Laoghaire Rathdown: profile and needs 1.3 Summary of main findings (i) Policy context This research project has been situated within the context of existing policy statements and strategies on ageing and older people, from international, national, and local county sources, and it has referred briefly to major new research and policy initiatives now taking place in Ireland. Contextualising it in this way shows clearly that any new initiative which Southside Partnership, the County Development Board, or any other body concerned with older people in Dún Laoghaire Rathdown might take, can draw on a solid and extensive body of documentation and existing expertise relating to the well-being of older people, which has already had considerable influence on policy and provision here. The internationally-agreed United Nations Principles for Older Persons (1991) and Madrid Declaration (2002), establishing the right to full equality and the best possible quality of life, as well as underlining the key principles of independence, participation, care, self-fulfilment, and dignity in older age, were drawn on by the Irish government, when it set out its vision for older people in Ireland in Towards 2016. And it is noteable how the themes of the World Health Organisation in its Age Friendly Cities Guide and accompanying Checklist (both 2007) resonate with the topics and issues emerging at grass-roots level from the project’s survey of older people in Dún Laoghaire Rathdown. It is appropriate that the current study, growing out of the Partnership’s determination to bring older people more clearly into focus in its work, has taken place in 2009, as older people (and in fact all who hope to become ‘older’!) wait for the realisation of the government’s stated ambition for a National Positive Ageing Strategy, a comprehensive framework for policy and provision, which will finally replace The Years Ahead: a Policy for the Elderly (1988). Consideration of the wider context of thinking, at national and local levels, about the needs and contributions of the growing numbers of older people in Ireland, can only lead to the conclusion that the emphasis now needs to be: First, on creating and putting in place this vital strategic framework; Second, on devoting resources to implementation – of the Strategy’s major provisions, and of existing sectoral and specialised policies and plans addressing specific aspects of older people’s lives; Third, underpinning all of this has to be a whole-hearted commitment to an ongoing process of wide-ranging and serious engagement and consultation with older people themselves. These are the elements that will ensure that Ireland, and the county of Dun Laoghaire Rathdown itself, can become great places for everyone to grow old in. 13 Older people in Dun Laoghaire Rathdown: profile and needs (ii) Demographic profile: older people in Dún Laoghaire Rathdown Background: Dύn Laoghaire Rathdown has conventionally been seen as an affluent county with few areas of disadvantage. This perception has recently been challenged by Watters (2009) who argues, in his Social Inclusion Profile of Dύn Laoghaire Rathdown, that traditional measurements of deprivation, based on percentages, have seriously under-estimated deprivation levels in the county. His study shows that the absolute numbers of those within Dún Laoghaire Rathdown experiencing or at risk of deprivation are considerably higher than in other areas of Dublin and the country as a whole, which have traditionally been associated with high levels of deprivation. In endeavouring to highlight aspects of the demographic profile of older people in the county, which could be the starting points for further research and action, this report took cognisance of these important findings, as well as the detailed statistical data provided by GAMMA to the County Development Board and the Partnership. Its main findings are as follows: Population profile Census 2006 data showed 25,987 people over 65 in Dύn Laoghaire Rathdown. At 13.4% of its total population, this was higher than both the national figure of 11%, and the figure of 10.3% for Greater Dublin; The total over-55 population of DLR was 46,246, almost 25% of the population of the county; In all adult age groups there were more women than men, with women increasingly predominating in the oldest age groups, because of greater average longevity; The older population has been growing relative to other age groups, in this mostly densely-populated and settled county; Unlike other parts of Ireland, DLR’s old age dependency ratio (currently at 19.6% overall) has increased in recent years, and in some areas was over 35% in 2006; Areas with the largest numbers of older people are across the north and along the east of the county, contrasting with some more recently-developed areas in the south and south-west which have a younger demographic profile. The contributions of older people For this dimension of the older population’s profile, the researchers had to draw on national-level Census data or on county data covering all age groups. This showed: Voting: older people are exceptionally conscientious voters compared to the rest of the population - 86.3% of over-65s voted in the 2002 General Election Volunteering: nationally in 2006, 15% of all over 65s engaged in volunteer activity, but other data suggest that the proportion is likely to be higher in Dun Laoghaire Rathdown. Data on volunteering by all age groups in the county showed men more involved in sporting activities, politics and culture, and women in social, charitable and religious activities, and this is especially likely for older people. 14 Older people in Dun Laoghaire Rathdown: profile and needs ‘Engaging in community activity’ by older people, as recorded in the SLÁN 2007 survey, was a regular part of life for between 30 and 60% of over-65s nationwide (figures varying by social class and gender). Unpaid caring: around 7,500 people of all ages in DLR provided care for others (relatives, friends or neighbours) with more women involved than men. National figures would suggest an estimate of just over 1000 carers over the age of 65 in the county, with varying levels of time devoted to caring. Locations and housing circumstances of older people in DLR The ‘oldest’ areas: the electoral divisions of the county with the highest percentages (over 20%) of older people are in Ballinteer, Churchtown, and Dundrum in the west, Dalkey, Dύn Laoghaire and Foxrock in the east. Types of ownership and tenure: Census 2006 data showed almost 83% or 20,782 older residents in DLR were owner-occupiers; some 958 (3.8%) were renting in local authority housing schemes, while 474 (1.9%) were purchasing from the Council. Also, 448 (1.8%) were in private rented accommodation, and a small number of others rented from a voluntary body or were rent- free. Living alone in DLR: in 2006 there were 6,409 people over 65 years living alone, with the highest concentrations in parts of Churchtown, Windy Arbour, Dύn Laoghaire and Dalkey. Somewhat higher proportions of the older age groups (both 45+ and 65+) lived alone in DLR than in Greater Dublin or Ireland as a whole. Women were more likely to be living alone. Residential care: National figures suggest that approximately 5% of all older people are ‘usually resident’ in nursing homes and hospitals. In DLR terms, this would indicate almost 1,300 older people living in these circumstances, but more specific data was not accessible. Employment and income In 2006, 13.4% (21,338) of those over 15 in DLR were ‘retired’. 13,220 households (including those with a ‘qualified adult’) in DLR received contributory or non-contributory social welfare pensions in 2008, of which 1,780 were means-tested benefits (non-contributory pensions). Nationally, an estimated 13.6% of the older population remain ‘at risk’ of poverty and 3.7% are in ‘consistent’ poverty. For DLR, this would suggest that around 3,500 older people are ‘at risk’ of poverty and around 950 in consistent poverty. Many studies identify an increased risk of poverty for older women, who are less likely than men to have adequate pension income in their own right. Education Compared to the country as a whole and the Greater Dublin Area, Dún Laoghaire Rathdown has strikingly high educational attainment levels overall. 15 Older people in Dun Laoghaire Rathdown: profile and needs However, significant numbers of people in the county have no more than primary or lower secondary education, and this is true of 45-55% of people in some areas. A high proportion of those with low educational levels are over 65. Health and disability Overall, around two thirds of people over 65 in Ireland regard their health as good or very good, but this is correlated with income and social class. Selfdefined good health is more typical of social classes 1 and 2, while the less well-off define their health as less than good. The position in DLR is likely to be similar; Almost 7,000 people over 65 in Dún Laoghaire Rathdown live with a disability or chronic illness (they constitute 27% of all over 65s, and almost 40% of all those in DLR with disability); the proportion of people with a disability in the population increases with age; 32% overall of older people with a disability live alone in DLR, but figures for women (40.3% living alone) and men (19.6%) are strikingly different. Safety and security Nationally, just over half of the older population fear becoming a victim of crime, but figures show they are less likely to be victims of crime than other age groups; In Dún Laoghaire Rathdown in recent years there has been a general drop in the incidence of most types of crime, with the exception of drug-related crimes; HSE reports on elder abuse indicate that between 3 and 5% of older people have been, or are being, subjected to some form of abuse. 245 referrals regarding allegations of elder abuse were made to HSE Dublin-Mid Leinster (which includes DLR but is considerably larger area) in 2008. The majority related to people over 80 living at home, and almost two-thirds were women; Road accident statistics for Ireland as a whole show that people over 65 are more likely to be killed on the roads as pedestrians than as car drivers or passengers, the converse of the situation for younger age groups. 30% of all pedestrians killed on the roads countrywide between 1997 and 2007 were over 65. 16 Older people in Dun Laoghaire Rathdown: profile and needs (iii) Main findings from the Network survey Ranging in age from 55 to over 90, mostly retired and predominantly female, the 291 survey participants seem to be the well and active older people of the county, able to attend meetings, and to spend time and energy on a 44-question survey form. Their mostly positive responses about their own health, and their general (but not universal) satisfaction with health services, seem to confirm this likely participant profile. Contributions of older people: it was not surprising that just over half of participants were volunteers, and 94% voted in the last election – more than the national averages for older people. Also, around one fifth of them had regular caring responsibilities. Education and income levels: it was surprising that, in a county with a high overall educational profile, a quarter of participants had left school by age 14, and a further 25% by age 16. Also surprising was the fact that, while most people felt financially secure, around one in five said their current income was insufficient for their needs. IT use and information issues: only one-third of participants used a computer, and significant minorities said they experienced difficulties with obtaining and understanding information, both on financial entitlements and on health and social services. Social contact: levels of face-to-face contact were low for some participants: while over half met and talked with friends and neighbours on most days of the week, a quarter had contact on just 1 or 2 days a week, while for others it was less frequent. The ‘big issues’ – how problematic are they? Of topics listed, safety on the streets was problematic for the largest number of people (67%), followed by transport, information, and security in the home (all problematic for 50%). Naming one change that would improve their lives, three times as many people mentioned transport issues (providing a long series of comments on inadequate bus services, no transport to hospitals, parking problems and costs and related matters) as mentioned the next most frequently cited topic, pedestrian safety. Transport is crucial to daily life: 75% use some form of transport for local journeys at least 2 or 3 times a week. 4 out of 5 use it for hospital appointments, 70% for shopping and for social/ leisure purposes; 60% to get to their GP. 45% mostly use a car, but 37% mostly use the bus, with one quarter wholly dependent on one or the other. Other changes and improvements wished for included: more activities and meeting places for older people; improved Council services (footpaths, waste collection, seating, libraries and others) and more contact from local representatives. ‘Are older people’s voices being heard by local representatives?’: over 40% of survey participants said ‘no!’, while 35% ‘don’t know’ and only 17% said ‘yes’. Issues of safety and security: footpaths were rated as causing most difficulty (75% of participants found them problematic to some extent) while vandalism was problematic for 65%, anti-social behaviour for 58% and pedestrian crossings for 50%. Satisfaction with local policing: it was striking that 30% were not happy with the level of Garda presence in their neighbourhoods, 35% were undecided, and only 35% said they were satisfied. 17 Older people in Dun Laoghaire Rathdown: profile and needs (iv) Main findings from the consultations Similar themes to those that featured in the Network survey emerged from the different perspectives of the organisations consulted in this strand of the research. Definitions and boundaries: obstacles to obtaining a clear overview of older people in the county were highlighted by the fact that few organisations shared the same geographical boundaries, and there were many definitions of what ‘older’ means in terms of chronological age. Some bodies focus on ‘disadvantage’ while others do not, but this can mean different things in different organisational contexts. Overall aims of services: all the organisations tended to stress the maximum wellbeing of older people as an overall goal, but generally framed in terms of the dimension of life addressed by that service. There is not yet a shared broad and holistic vision of positive ageing, to which each service sees itself contributing it own part. Awareness of diversity: There was a shared awareness of some fundamental facts ‘on the ground’: (1) the particularities of demography in Dún Laoghaire Rathdown and the challenges posed, and (2) the range of experiences of older age lived by local people with different health statuses and from different age groups, genders, social, economic and cultural backgrounds, and locations. Participation: is the voice of older people being heard in policy- and decision-making on matters affecting them? Bringing older people onto some of the county’s structures is a positive beginning, and all the organisations are willing to engage with their views, but mechanisms for thorough and ongoing consultation have yet to be developed. The challenge of reaching those who are not ‘linked in’ is generally acknowledged, and many older people will have to be encouraged to play a more active part. Contributions of older people to communities and society: most responses focused on volunteering (charity shops, Lions Clubs etc.) and the increasing involvement of grandparents in childcare, but little was said about more traditional forms of caring for sick or frail relatives, much of which falls to older people. Those who are involved in running Active Retirement groups or in the Network were seen as contributing to community life, while the ‘wisdom and experience’ of older people was considered a powerful untapped resource for the general good. Positive developments: there was agreement that older people live longer, healthier and more active lives, that more services and supports are available, and that countylevel initiatives have increased coordination of services, and mutual understanding. A number of specific developments received positive mention, including home care packages and the extension of community policing methods. Challenges and gaps for services: there were useful insights, some unexpected: Resources (funding and staffing) are a serious current problem contributing to uneven provision of services, and there can be difficulties of coordination between services. Major issues for older people, such as loneliness and elder abuse, remain to be fully addressed, and there is a lack of suitable accommodation for people as they age (though views vary on what might be ‘suitable’). 18 Older people in Dun Laoghaire Rathdown: profile and needs Age awareness/ anti-ageism training for staff would result in better experiences for older people who access services. Information is clearly a key issue for older people, since the role of information is ‘connecting people with services’. Currently there are many valuable information initiatives, but drawbacks were identified with most commonly-used dissemination methods. Most contributors agreed that lack of computers and internet access hinders access for many older people to information that could improve their lives. Identifying the disadvantaged/ excluded: responses identified a range of older people at risk of exclusion in its various forms: older men, especially from unskilled working backgrounds; older tenants in privately rented accommodation; those with disability (physical and intellectual), or serious and chronic ill-health; the ‘oldest old’ living alone; the ‘unlabelled excluded’ – isolated older individuals experiencing deprivation in more affluent areas with few services and weak neighbourhood networks. Proposals for new programmes and services to promote inclusion and well-being included implementing plans already in place but not yet translated into action. Contributors emphasised the important principles of consultation and personcentredness in designing new services, and suggestions were made for specific services and activities to overcome isolation and offer opportunities for personal growth in older age. Inter-generational activities can break down age barriers, and a number of measures to promote safety and security at home and in the outside environment would enhance the lives of everyone in the county, not just the lives of older people. -0–0–0- 19 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 2: Context: policy at international, national and local level; the role of the Southside Partnership 2.1 Background: global trends and the Irish situation We celebrate rising life expectancy in many regions of the world as one of humanity’s major achievements. We recognise that the world is experiencing an unprecedented demographic transformation…by 2050 the number of persons aged 60 years and over will increase…from 600 million (2000) to almost 2 billion and…the proportion of persons 60 years and over is expected to double from 10 to 21 per cent…This demographic transformation challenges all our societies to promote increased opportunities, in particular opportunities for older persons to realise their potential to participate fully in all aspects of life. (United Nations Madrid Declaration, 2002, Article 2) The UN also estimated that by mid-21st century, the old and the young will represent equal shares of the world’s population, making it urgent for all countries to rethink policy and strategy on older people. This entails changing the perspective from one which sees them solely as an economic burden to one which supports ‘positive ageing’ and can utilise the ‘demographic bounty’ that this population trend represents. Ireland is certainly experiencing its own demographic change, as its older population grows relative to younger age groups, and older people live longer and healthier lives. Already in 2006 11% of the population (465,000 people) were over 651, and this proportion is estimated to rise to around 20% by 2036, with significant growth in the numbers of people living beyond 80 years of age. Alongside this changing profile, there are new factors such as: strengthened advocacy by organisations of older people; improved data-gathering and much more extensive academic research; the different expectations of younger cohorts of people approaching or experiencing retirement, as well as a growing recognition by policymakers and service providers of the immense diversity of ‘older people’. These are contributing to a rethinking of policies and approaches to the older Irish population, at national and at local levels. The voices of older people are beginning to be articulated and represented in national policy arenas, and they are increasingly recognised as a force to be reckoned with, rather than a passive group of ‘service receivers’. So any study of the older population in a local area, such as Dún Laoghaire Rathdown County, must be seen against this backdrop, and plans for initiatives and interventions at county level to address needs and tap into their resources must be developed in the context of up-to-date knowledge and understanding of their situation now – not based on ideas from an earlier era about what it means to be ‘older’ in Ireland. 1 Central Statistics Office: Census 2006 20 Older people in Dun Laoghaire Rathdown: profile and needs Terminology Different definitions of ‘older’ are used in different contexts. While the UN refers to the 60+ population, and European usage has tended to define people as ‘older’ at 55, Irish national demographic statistics (Central Statistics Office) and policy statements define ‘older’ as 65 plus, as do statutory services such as health and social welfare services. However this research project for Southside Partnership aimed to explore as far as possible the experiences of those over 55, in order to include the next generation of ‘older people’ alongside those who are already, at over 65, past the standard retirement age and in receipt of services specifically for that age group. 2.2 International policy on older people 2.2.1 United Nations Principles for Older Persons (1991) Responding to the fact of the growing number and proportion of older people globally as both an achievement and a challenge, the United Nations General Assembly in 1991 published its agreed UN Principles for Older Persons, urging all national governments to incorporate these into national policies and programmes. This document is a touchstone for assessing progress towards realising the fullest possible life for older people in a society. It focuses on the rights of older people, outlining them in relation to five key areas: Independence – including supports and services, work and learning opportunities, safe environments, and the means of remaining at home as long as possible; Participation - including full and active integration in society, involvement in plans and policies that affect older people’s well-being, volunteering opportunities; Care from family and community, health and social services, appropriate institutional care based on human rights, dignity and privacy. Self-fulfilment - developing one’s potential, and having access to society’s educational, cultural, spiritual and recreational resources; Dignity - fair and equal treatment, being valued irrespective of economic status, and freedom from abuse. (Full text in Appendix 1) 2.2.2 Madrid Declaration and International Plan of Action on Ageing (2002) At the second UN-convened World Assembly on Ageing, held in Madrid in 2002, delegates adopted a comprehensive Plan of Action to achieve a ‘society for all ages’ in which the rights of older people to full equality and the best possible quality of life are fully supported and implemented. The Declaration (full text in Appendix 1), published alongside the Plan, emphasises the need for governments, who have the primary responsibility, to foster joint and integrated action for change with ‘local authorities, civil society including NGOs, the 21 Older people in Dun Laoghaire Rathdown: profile and needs private sector, volunteers and voluntary organisations, older persons themselves and associations for and of older persons, as well as families and communities’ (Declaration, Article 13). The Plan of Action covers three priority areas, and the main themes are listed below: Priorities: Older persons and development; Advancing health and well-being into old age; Ensuring enabling and supportive environments. Major themes include: o The full realisation of all human rights and fundamental freedoms of all older persons; o The achievement of secure ageing …eradicating poverty in old age; o Empowerment of older persons to fully and effectively participate in the economic, political and social lives of their societies… including incomegenerating and voluntary work; o Provision of opportunities for individual development, self-fulfilment and wellbeing…in late life, through…access to lifelong learning…; o The elimination of all forms of violence and discrimination against older persons; o Commitment to gender equality among older persons through inter alia the elimination of gender-based discrimination; o Recognition of the crucial support of families, intergenerational interdependence, solidarity and reciprocity for social development; o Provision of health care, support and social protection for older persons, including preventative and rehabilitative health care. 2.2.3 World Health Organisation: Global Age Friendly Cities: A Guide (2007) This important initiative, involving a range of different countries including Ireland and based on extensive consultation with older people, focused on the UN priority area of ‘enabling and supportive environments’, highlighting the need to maximise the health and well-being of the older population in the urban environments which are becoming the norm world-wide.2 Pointing out that already in 2007 75% of older people in the developed world are urban dwellers, the Guide emphasises that age friendly environments and communities benefit the whole population, improving safety for women, small children, and those with disabilities, reducing family stress by the provision of good services for older people, and utilising the energies of older people, through employment and volunteering, for the good of the community. 2 See http://www.who.int/mediacentre/news/releases/2007/pr53/en/index.html 22 Older people in Dun Laoghaire Rathdown: profile and needs An eight–point framework covers the main areas for action and change: o o o o o o o o Outdoor spaces and buildings Transportation Housing Social participation Respect and social inclusion Civic participation and employment Communication and information Community support and health services The document argues that some simple and cost-effective changes can be enormously beneficial: for example, proper maintenance of pavements, provision of seating and public toilets, and good local transport services enable older people to make best use of the places in which they live, which enhances their overall well-being. Alongside the Guide a shorter Checklist of Essential Features of Age Friendly Cities (full text in Appendix 1) was produced, intended for practical use by individuals and groups interested in making their city more age-friendly: ‘ For the checklist to be effective, older people must be involved as full partners. In assessing a city’s strengths and deficiencies, older people will describe how the checklist of features matches their own experience of the city’s positive characteristics and barriers. They should play a role in suggesting changes and in implementing and monitoring improvements. (Checklist p 1) (It is noteworthy that the poor state of some footpaths/ pavements and problems with transport are among the most-mentioned issues in the survey carried out with the Network for Older People in Dún Laoghaire Rathdown, covered in Chapter 5). 2.3 The national context: policy and strategy It is just over twenty years since the strategy document ‘The Years Ahead – a Policy for the Elderly was published. Its valuable recommendations on the care of older people in Ireland have only been partially implemented. In the context of the changing demographic picture since then, and the changed circumstances and experiences of many older people themselves, the government recognised the need for a new and revised strategy, and in the Programme for Government 2007 committed itself to developing a new national strategy for older people. As part of this commitment, a Minister for State with responsibility for Older People was appointed in 2007, and a supporting ministerial office established in January 2008. Located in the Department of Health and Children, its role is to co-ordinate policy on ageing and older people across relevant departments including Social and Family Affairs and Environment, Heritage and Local Government. In particular this office is responsible for developing a new National Positive Ageing Strategy, which it aims to present by the end of 2009, after a consultation process including dialogue with a range of relevant organisations. 23 Older people in Dun Laoghaire Rathdown: profile and needs A recently-established coalition of the main non-governmental organisations working with and for older people3 is mounting an ‘Older and Bolder’ campaign, determined to hold the government to this commitment and ensure the widest possible public involvement in drawing up the strategy. At the same time, ‘think tanks’ such as the Ageing Well Network are bringing stakeholders together to identify priority issues, discuss future options and consider international best practice; and research bodies are extending the existing body of knowledge on older people in Ireland. In particular, TILDA (The Irish Longitudinal Study on Ageing), launched in 2006, is a ten-year study of 8000 Irish people over 50, which charts health, social and economic circumstances. It is hosted by Trinity College Dublin, in collaboration with a range of experts from other academic institutions4. All of these will support the development of the National Positive Ageing Strategy as a framework within which policies and provision can be developed at a more local level. Other developments such as the possibility of appointing an Ombudsman for Older People are currently under consideration. Specific government commitments: in terms of government policy, a number of explicit commitments have recently been made to address the situation of older people in Ireland. Important policy documents such as the Social Partnership Agreement Towards 2016, the National Development Plan 2007-2013, and the New Programme for Government 2007-2012 each outline a vision for the well-being of older people. Towards 2016 commits government and social partners to work to realise a ‘vision’ for older people in Ireland - a society in which: Every older person would be encouraged and supported to participate to the greatest extent possible in social and civic life; Every older person would have access to an income which is sufficient to sustain an acceptable standard of living; Every older person would have adequate support to enable them to remain living independently in their own homes for as long as possible. This will involve access to good quality services in the community, including: health, education, transport, housing and security, and; Every older person would, in conformity with their needs and conscious of the high level of disability and disabling conditions amongst this group, have access to a spectrum of care services stretching from support for self-care through support for family and informal carers to formal care in the home, the community or in residential settings. Such care services should ensure the person has opportunities for civic and social engagement at community level. Towards 2016, Section 32: Older People 3 The Older and Bolder campaign coalition consists of: Active Retirement Ireland, Age and Opportunity, Age Action Ireland, Alzheimer Society of Ireland, Carers Association, Irish Hospice Foundation, Irish Senior Citizens Parliament and the Senior Helpline. 4 http://www.tilda.tcd.ie/ 24 Older people in Dun Laoghaire Rathdown: profile and needs Priority action areas are: pensions/ income supports; long-term care services; housing/ accommodation; mobility for older people; quality health services; education and employment opportunities. (Full text in Appendix 1) Social inclusion: specific targets were set out in the National Action Plan for Social Inclusion 2007-2016, where the ’high levels goals’ for the support of older people relate specifically to (1) increased provision of community care (including the new home care packages) and (2) the improvement of income support, along with a review of the current pension system. Other areas for action include: housing and related services to improve home security, access to further and higher education, provision of IT training, encouraging take-up of paid employment by older people, and development of the Rural Transport Initiative. The National Women’s Strategy 2007-2013 identified strategies for improving the wellbeing of older women, particularly in relation to financial security. All of these national policy documents utilise the person-centred ‘life-cycle’ approach set out by the National Economic and Social Council in the Developmental Welfare State (2005) which provides a framework for addressing the issues people face at different stages of their lives, and includes children, people of working age, older people and people with disabilities. Income and pension policy: as mentioned earlier, the National Action Plan for Social Inclusion 2007-2016 includes, among priorities for government investment which will ensure a good quality of life and tackle poverty among older people, options for continuing employment through training and upskilling, as well as access to life-long learning opportunities. The continued participation of older people in the labour market will be encouraged and facilitated…Training and advisory services…will assist older people who wish to return to or remain in the workplace. (p.51) The current Programme for Government 2007 contains a commitment to introducing phased retirement, giving older people greater choice in this respect. It also states the intention to raise the contributory state pension to at least €300 per week by 2012, and to encourage private savings for pension purposes. The Green Paper on Pensions, launched in 2007, aimed to stimulate debate and bring about consensus among the main stakeholders, including workers themselves, on the best way to achieve sustainable levels of post-retirement income for individuals and households, in the light of changing demography. Housing policy: the ambitious aim of current national housing policy, as set out in Delivering Homes, Sustaining Communities (2007), is To enable every household to have available an affordable dwelling of good quality, suited to its needs, in a good environment and, as far as possible, at a tenure of its choice. (p.7) 25 Older people in Dun Laoghaire Rathdown: profile and needs Provision of social and affordable housing by local authorities should be directed towards creating integrated communities, and to supporting individuals and households appropriately at different points in their life-span. Following the life-cycle approach, accommodation for older people is specifically considered in the policy document. Areas for action include: Providing greater variety of housing options to enable people to change accommodation to suit their needs as they age (such as the ‘financial contribution schemes’ for exchanging a too-large private house for rented social housing designed for older people); Extending the grants schemes for adaptation of private housing for older people, including those with disability, and targeting it to those most in need; Use of the new Rental Accommodation Scheme to enable older people housed in the private rented sector to move to more secure tenure; Ensuring that local authorities (1) include in their Housing Action Plans a specific strategy to meet the housing needs of older people, which will involve the voluntary and cooperative housing sector, and (2) set up a cross-departmental team to make progress on sheltered housing for the area.5 Health policy and strategies: at national level, the Health Service Executive (HSE) has over the years published a range of strategies which address the needs of older people, either specifically, or as part of a wider framework. They include the 1998 Adding Years to Life and Life to Years: a Health Promotion Strategy for Older People, developed jointly by the Department of Health and the National Council on Ageing and Older People. It aimed to improve life expectancy and health status of the over 65s and improve the lives and autonomy of those already affected by illness and impairment. The national Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population, published in 2008, aims to decrease the number of falls and fractures in the over-65 age group. The Falls Strategy recommends: an inter-agency assessment system; increased emphasis on prevention; building bone health through exercise; health promotion among older people; risk reduction and management services. Older people were included as a target group in the National Health Promotion Strategy 2000-2005, as they also were in A Vision for Change, the national mental health strategy (published 2006), and in Reach Out, the national strategy for suicide prevention (2005). Although older people are not specifically named in the National Strategy for Service User Involvement in the Irish Health Service 2008-2013, representatives of some older people’s organisations participated in the development of the strategy, which emphasises the involvement of groups experiencing poverty and social exclusion in the shaping of the new primary health care services, and thus builds on the foundation of the 2001 strategy, Primary Care: A New Direction. Demonstration projects are under 5 http://www.environ.ie/en/PublicationsDocuments/FileDownLoad,2092,en.pdf 26 Older people in Dun Laoghaire Rathdown: profile and needs way, but is not clear to what extent the voices of older people specifically are included in the participation model currently being tested. Elder abuse: in recent years the phenomenon of elder abuse has been increasingly recognised by health service policy makers and practitioners. In 2002 Protecting our Future: the Report of the Working Group on Elder Abuse was published, providing a foundation for the development of policy and procedures to respond to actual or alleged cases of elder abuse. Following this, the Department of Health and Children established the Elder Abuse National Implementation Group, which made recommendations for appropriate structures to safeguard older people at a more local level. The HSE has been working to implement these structures and has appointed a Senior Case Worker in most regional areas to handle allegations of elder abuse. In 2008 the Minister for Health and Children launched an HSE training DVD for staff in residential care settings, and a policy document, Responding to Allegations of Elder Abuse, a set of guidelines for hospitals, community and primary care settings, and day care centres. Pointing out the various forms that elder abuse can take (financial, psychological, physical or sexual abuse or simply neglect), the Minister stated clearly that they are all ‘unacceptable’ and that all services must work together for prevention and tackling of abuse6. The HSE has recently published a further document, Elder Abuse: Open Your Eyes (2009) which outlines incidences and outcomes of referrals of elder abuse in each of the regional areas. The Elder Abuse National Implementation Group recommended establishing a dedicated national centre for research and evaluation on elder abuse. The Centre is now established in the School of Nursing, Midwifery and Health Systems in UCD, and will research elder abuse from a variety of disciplinary perspectives. Carers: many older people are unpaid family carers or recipients of family care, and one commitment in Towards 2016 was the development of a national strategy for the support of carers. However in early March 2009, the Minister for Social and Family Affairs announced its decision not to publish a National Carers’ Strategy at this time. Community policing: The Garda Policing Plan 2009 makes specific reference to engaging with older people, under its Strategic Goal 6: community engagement. It seeks to ‘develop effective and innovative policing approaches to enhance our engagement with older people in our communities…’ in order ‘to achieve a Garda service that is partnership based and community oriented’. (p9) Lifelong learning: the government’s White Paper, Learning for Life (2000), in a section on services for older people, notes the high proportion of older adults who had only primary level education, and the high proportion with literacy difficulties. The document also recognises the potential of older people in adult education as providers and mentors as well as learners. While no new recommendations for older people are 6 http://www.dohc.ie/press/releases/2008/20080613.html 27 Older people in Dun Laoghaire Rathdown: profile and needs made, the overall priority of literacy provision is underlined, and the policy of access for all age groups to Back to Education initiatives re-stated. Adult education is seen as playing a role in ‘contributing to active ageing…promoting social integration…enhancing the quality of life, and providing training in new technology for many whose mobility and access to information and communication might otherwise be restricted’ (p.167) Active Citizenship: it is notable that, where ‘older people’ feature in the report submitted to government in 2007 by the Active Citizenship Taskforce, it is as the vulnerable old: they figure as potential recipients of services, or as a group likely to be excluded, alongside people with disability or new immigrants. An accompanying statistical document reports on an ESRI survey commissioned by the Taskforce, showing that, country-wide, people over 65 were less likely to be volunteers or ‘actively involved in the community’ than any other age-group, but particularly the 40 to 64 group. Equally, those with less than Leaving Cert. level education were less likely to be active citizens in this sense. The recommendations of the Taskforce did not include any proposals for maximising the potential and resources of the older population. Other strategies: there are a number of other national strategies in place which are relevant to older people’s lives. Older people are specifically named as a target group in some, such as the Irish Sport’s Council’s Go For Life programme, but not in others, such as the Arts Council Strategy 2006-2010, or the Road Safety Strategy 2007-2012. In 2008, the HSE Expert Advisory Group on Older People recommended adopting the ‘Teaghlach’ or ‘Household’ model of care for older people living in nursing homes and residential care. This person-centred model is designed to promote the privacy, independence and self-determination of older people’ and aims to make long-term residential centres more like ‘home’ in terms of their design and layout, décor and furnishings. Training for some staff took place in 2008 and a number of units in Cork and Louth have begun to implement the model.7 The Louth: Age Friendly County initiative A new initiative at county level, but with national potential, is the Louth: Age Friendly County Strategy, launched in 2008 by the Minister for Justice, Equality and Law Reform. It aims to improve the lives and health of all older people in the county, increase their participation in all areas of life, and make Louth ‘the best possible place to grow old in’. 8 7 The Irish Times Health supplement 27.01.09 and HSE (2009) Annual Report 2008 Article in Ageing Matters 2009: ‘Louth goes age friendly’. December 2008-January 2009, pp 12-13. Age Action Ireland. 8 News release: ‘Barrack Street project launched’, October 10th 2008, plus other information from the Netwell Centre, Dundalk IT http://netwellcentre.ie 28 Older people in Dun Laoghaire Rathdown: profile and needs The first initiative of its kind in Ireland, it is intended as a flagship project, to be followed by similar projects in other Irish counties in due course. Supported at government level, it is based firmly on the WHO Friendly Cities guidelines, and their eight-point framework for action (see above). It is led by a partnership of agencies, including the County Development Board, County Council, HSE, the Gardai, and the Dundalk Institute of Technology. Its progress will be carefully monitored, and it hopes to show how significant improvements can be made cost-effective through an imaginative and integrated use of existing resources – including the resources of older people themselves. An Older People’s Forum for the county is being established as a partner in the process, and the whole initiative is now at the planning and consultation phase, with specific practical actions expected to begin in summer 2009. Louth is already at the forefront of thinking about housing and care in the community for older people, with a new demonstration project of 16 adaptable housing units under way. This uses sensor technology for energy-saving in the home, and for monitoring and protecting the safety of older occupants, enabling people to continue living independently for longer. 2.4 Local policy and strategy: Dún Laoghaire Rathdown County At local level, each County Development Board is required to develop a shared vision for the long-term social, economic and cultural development of their county or city. Some of these strategies identify older people as a ‘target group’, whilst others do not.9 The Dύn Laoghaire-Rathdown County Development Board Strategy, An Integrated Strategy for Social, Economic and Cultural Development 2002-2012, was developed following consultations with a range of groups and organisations in 2001- 2002. The objectives and actions outlined in the Strategy are divided according to three strands the social development strand the economic development strand the cultural development strand Accompanying the strategy are three Strategic Action Implementation Plans, one for 2003-2005, another for 2006-2008 and the third for 2009-2011, which is to be approved in the near future. These identify actions relating to the broader strategic plan, and their progress is monitored and tracked by a variety of named lead stakeholders. Within the social development strand in the 2003-2005 Strategic Action Implementation Plan,10 three strategic objectives contain actions specifically directed to the situations of older people. First, within the ‘Family Support Theme 1’ the strategic objective is ‘to enhance the longevity, quality of life and care provision for the older citizen and to 9 Delaney S, Cullen K and Duff P (2005) The Social Inclusion of Older People at Local Level. Dublin: WRC 10 http://www.dlrcdb.ie/strategy.pdf 29 Older people in Dun Laoghaire Rathdown: profile and needs recognise the contribution of older citizens in communities and the society of Dύn Laoghaire-Rathdown’ (p.17). Ten specific actions are listed, as follows (table 3.1 in the Strategy document) Community care units for older people: influence all stakeholders including private enterprise to ensure the realisation of the ECAHB’s objective of establishing 3 communitybased units similar to the Dalkey unit to provide care for older people in the county Accident prevention: replicate and expand the pilot accident prevention programme Personal alarms: develop a uniform county-wide system for the use of personal alarms by older people Benches: place more benches at critical and safe locations throughout the county to create an environment where older people especially can be more active Seats in shops: work with businesses to create seats in shops reserved for older people and people with disabilities Pedestrian crossings: publish a plan to improve and increase pedestrian crossings in the county Retirement planning courses: increase the offering of retirement planning courses in the county and specifically engage employers to plan such courses as part of Human Resources allocation of staff development time IT training for older persons: implement a training of trainers programme to develop the capacity of older people to train other older people in IT skills Dissemination of information on services for older people: Put together a network of organisations and businesses that will assist with the dissemination of information to older people, specifically information pertaining to the activities of older people’s organisations Annual exhibition for older people: host an annual exhibition event of projects and services for older people in the county ‘Family Support Theme 2’: the strategic objective here is ‘to ensure all family support services will be provided across the county by agencies in a coherent, integrated manner at a local level’, and 3 actions address the older population (table 3.2): Establish a county wide interagency forum on services for older people as a sub-group of the healthy county forum Establish a network of older persons’ organisations/voluntary groups Update and produce a county-specific older persons information pack, and facilitate presentations and discussions of information contained in the pack These actions have since been undertaken: the services’ forum and the network have been established, and the information pack is awaiting publication at the time of writing. Finally, under the ‘Living Space Theme’ of the economic development strand, the strategic objective is ‘to increase awareness of and ensure providers deliver inclusive 30 Older people in Dun Laoghaire Rathdown: profile and needs and innovative approaches to the living space needs of everyone in the county’ and there are three actions specifically directed towards older people (table 10.2): Best practice in accommodation for older people and people with disabilities: analyse existing best practices in the public and private sectors with a view to improving living space facilities with particular emphasis on older people and people with disabilities Upgrade accommodation facilities for older people and people with disabilities: identify the requirements for the upgrading of existing local authority accommodation facilities for older people and people with disabilities Source funding for upgrading local authority accommodation facilities: source funding to facilities the development of a programme for the upgrading of existing local authority accommodation facilities and services for older people and people with disabilities A number of actions relating to older people also appear in other parts of the Strategy: Strand Theme Strategic objective Actions Social development Education To work with all providers of and stakeholder in the county’s education system to ensure that anyone disadvantaged by social exclusion, marginalisation, location or disability has access to education Education needs of target groups: focus on the target groups which are vulnerable to social exclusion etc. People with disabilities, early school leavers, Travellers, ethnic minorities, older people, lone parents, long-term unemployed etc with regard to their educational needs. Rural communities To reduce the problem of isolation experienced by many residents of rural areas through the provision of a rural transport system Access for older people in rural areas: develop a programme to improve access to services for older people in rural areas Arts To harness the potential of the county for artistic expression and appreciation with the focus on the role of arts as a medium for inclusion of people and the celebration of diversity Accessible Arts programme: bring theatre into local schools and local residential areas, and to those who wouldn’t normally be able to access theatre e.g. young offenders, senior citizens, persons with impaired mobility To encourage access by all and for all to sports, recreation and leisure activities and facilities, particular those funded of supported through public funds Older persons’ participation: work with existing organisations/bodies to increase participation by older people in sport, recreation and leisure, and promote awareness about the benefits of participation in exercise Cultural development Sports recreation and leisure In the Strategic Action Implementation Plan for 2006-2008, the overall objectives remain the same; however, the actions targeted towards older people are different: 3.1.1 Care Provision for Older People: Explore models of care provision that are appropriate to serve the needs of older people in the county. 31 Older people in Dun Laoghaire Rathdown: profile and needs 3.1.2 Retirement Planning : Review and promote the offering of retirement planning courses in the county and specifically promote the uptake of such courses well in advance of retirement date. 3.1.3 Accident Prevention; Raise the awareness of accident prevention programmes among older people themselves and the agencies serving older people. 3.1.4 ICT training for older people: Develop the services in the county that provide training and facilities specific to the ICT needs of older people. 3.1.5 Public transport needs of older people: Assess the transport needs of older people in the county and the extent to which existing public transport provision meet their needs. 3.2.1 Older People’s Information Pack: Update and produce a county-specific Older Persons Information Pack and facilitate presentations and discussions of information contained in the pack. B16.5.1 Accessible Arts Programmes: Make arts and crafts programmes more accessible to the wider community…Bring theatre into schools, residential areas, those that wouldn’t normally have access to theatre, through the programme of access arts e.g. young offenders, senior citizens, persons with impaired mobility, the disabled and other minority groups. 2.4.1 Educational Needs of Target Groups: Identify the educational needs specific to vulnerable groups in the county and develop adequate responses to address such needs. 2.1.1 Support for Life Long Learning Programme Providers: Support life-long learning providers to develop and offer responsive, accredited educational and training programmes to increase participation of individuals at all stages of personal and career development. In this second Implementation Plan, older people are included in many of the general actions such as those concerning the analysis of health needs and healthy living, innovative approaches to living space, and sustainable accommodation. At the point where this report was being finalised, the third Strategic Action Implementation Plan 2009 -2012 was launched. The document itself was not available to the researchers, but they were informed that priorities for older people included: The promotion of retirement planning; Developing accident prevention awareness; Developing older people’s IT skills and extending access; Encouraging intergenerational activities; Continuing to raise awareness of elder abuse, as a preventative strategy. An undated news release covering the launch, placed on the County Council website, lists also ‘support of a local volunteer centre’ and ‘responding to the education and training needs of the newly unemployed and other vulnerable groups’ though it does not specify whether older people are included.11 11 www.dlrcoco.ie/PressReleases/CDB_Action_Plan.htm 32 Older people in Dun Laoghaire Rathdown: profile and needs Accessibility and disability As is recognised in many of the overall policy and strategy documents, the diversity of older people encompasses a wide range of personal circumstances, health status, views and needs, including those relating to disability. Nationally, approximately 30% of all people over 65 have some sort of disability (Census 2006) and this proportion increases with age. There are clearly overlaps between the needs of those with a life-long disability, and those of older people who acquire a disability or impairment as they age. Under the provisions of the Disability Act 2005, each local authority is required to develop its own accessibility plan, and design ‘measures to be taken to facilitate access by person with disabilities to public roads, public places and buildings, the provision of public services and information’. The Accessibility Implementation Plan 2009 of Dún Laoghaire Rathdown County Council has three parts: a general statement of intent and outline of objectives; an outline of the priority issues identified in recent accessibility audits of publicly accessible buildings, footpath networks, parks, cemeteries and open spaces; an outline of objectives in terms of service and information delivery. The overall intention is’ to foster an exemplary social, physical, economic and cultural environment for all of the people living in, working in or visiting our County’. The ‘accessibility ethos’ of the County covers ‘both physical and attitudinal barriers’ and includes information services and staff training as well as maintenance and development of the built environment. The Council sees itself, because of its range of responsibilities, as ‘in a unique position to dramatically impact on the lives of those who may have been traditionally confined to their homes or excluded from participation’.12 Housing and the built environment The vision of the County Development Plan 2004-2010 in relation to residential development (Plan, chapter 5) is one of vibrant and sustainable communities served by a wide choice of dwelling units, where residents will be within walking distance of shops, services, employment, education, leisure, community facilities and amenities, and … enhanced public transport. (p.60) The Plan takes cognisance of the life-cycle approach underpinning national policy, since it is recognised that viable and sustainable communities and neighbourhoods consist of a mix of individuals – families, single persons, young, elderly, student, traveller, and a corresponding mix of accommodation types. (p.61) 12 http://www.dlrcoco.ie/gp/Accessibility_Plan_2009.doc 33 Older people in Dun Laoghaire Rathdown: profile and needs However, it is noteworthy that, whereas the national policy context, acknowledged in the Plan as the starting point for local planning, makes reference to the principles contained in the National Children’s Strategy, it still lacks a comparable National Positive Ageing Strategy which could guide and lead local authority thinking. Where older people’s housing needs are mentioned in the document, it is generally by way of stating broad aims and principles, and encouraging a different approach by developers, rather than specifying strategies: One specific provision of the Plan, is intended to encourage developers to provide ‘elderly accommodation’ (sic), thus offering ‘empty nesters’ the choice to move to more suitable housing. If a developer provides such accommodation is provided, the amount of social/ affordable housing to be included in a new development is reduced accordingly. (p. 64) Further to the encouragement of a varied housing ‘mix’ in any development – which should include ‘special needs housing’ - is the encouragement of ‘greater flexibility of design…so that residential units can evolve with their occupants’ needs, e.g. by combining apartments, or the ability to extend into attic space’ (p.66). However, a rather different type of designing for reconfiguration, to provide for people as they age, is not mentioned here. Under the heading of ‘Social Housing’ this Plan states the local authority’s intention to follow the principles of the government policy document of 2000, Action on Housing, which includes ‘ensure the provision of …sheltered housing for the elderly’. (p.66) In addition, in a section devoted to ‘increasing residential density’, one of the standards to be met in new developments is that ‘consideration [is] given to the needs of children, elderly and disabled’. (p.75) Chapter 8 of the Plan is entitled ‘Communities’ and covers safety and security in residential areas, under the broad aim of ‘facilitat[ing] the achievement of a safe environment for residents of and visitors to the County’. This is seen as an element of quality of life, and the Council’s objective is To develop an environment of natural surveillance on public walkways and open spaces by encouraging supervised people-centred activities…[and] improve the use of targeted lighting and CCTV cameras in liaison with An Garda Siochana (p.109) The Draft County Development Plan 2010 – 2016, currently open for public consultation and submissions, reiterates many of these broad principles and intentions, and refers to more recent government policy guidelines, Building Homes, Sustaining Communities (2007). Continuing to use the terminology ‘elderly’, the Draft Plan is more specific in some respects than its predecessor, for example in relation to desirable aspects of housing for older people: It is Council policy that proposals for accommodation for the elderly should be located in existing residential areas well served by infrastructure and amenities such as footpath networks, local shops, public transport, in order not to isolate residents and allow for better care in the community, independence and access. 34 Older people in Dun Laoghaire Rathdown: profile and needs This principle of connection to the community and its facilities will apply to all types of accommodation for older people, including ‘facilities providing higher levels of care, self-contained units or a mix of these’ (p.42). Arts policy Arts development is now considered to be part of local government planning, and the remit of the Dún Laoghaire Rathdown Arts Office Education and Community Programme is to develop and co-ordinate arts programmes aimed at various population groups in the county. One programme targeting older people is the Arts and Health Programme, in which the Health Promotion Department of HSE Dublin MidLeinster is a strategic partner. The DLR Arts Strategy 2007-2010 (2007) recognises the contribution of the arts to citizens’ quality of life. The Strategy’s Goal 3 - ‘Public Participation in the Arts’ - and its associated actions identify older people as one specific group to be included. With the overall aim of ‘creat[ing] dynamic and exciting opportunities for people to engage with the arts as audiences and participants’, the first action listed is: To develop an arts access policy which supports public participation (including children, young people, community and older people) in all strands of the County Council arts programmes. Strategy, p.27 -0–0–0– 35 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 3 Older people in Ireland and older people in Dún Laoghaire Rathdown: demographic and statistical information 3.1 Older people in the national demographic picture In common with other countries globally, and especially those in the industrialised world, the demographic profile of older Irish people is changing. Because people are generally living longer and healthier lives, older people constitute a growing section of the population. Although Ireland’s population profile is still relatively young compared to many other European countries, current and projected demographic changes have considerable implications for national policy and provision in areas such as pensions and income support, retirement policy, health services generally and provision of community-based services and supports, residential care for older people, and the protection of vulnerable older people. Table 1 shows the age profile of the Irish population at the most recent census (2006). Table 1: Irish population figures 2006 Age group Males Females All persons 0-14 443,044 421,405 864,449 15-24 321,007 311,725 632,732 25-44 681,988 663,885 1,345,873 45-64 468,037 460,831 928,868 65 years and over 207,095 260,831 467,926 TOTAL 2,121,171 2,118,677 4,239,848 Source: CSO 2007 In 2006, there were 467,926 people aged 65 years or over in the Irish population, 54,000 more than in 1996, and making up 11% of the population. While absolute numbers have grown, the proportion of older people in the population has remained fairly stable: the corresponding percentage in 1991 was 11.45%. At 11% of the whole, this was the lowest proportion of people aged 65 or over across all of the EU 27 countries, where the average proportion was 16.8%, with the highest proportions in Germany (19.3%) and Italy (19.7%). Ireland’s unusual profile arises both from the relative youth of its population overall, and recent population increases due to immigration, mainly involving people in younger age groups. However, on current projections, the proportion of people aged 65 years and over in Ireland is expected to rise to 20% by 2036, with absolute numbers increasing to 1,145,300, an increase of almost 250% over the 2006 figure. The greatest increase is expected to be in the over-80 age group, where a trebling of the numbers is anticipated. However, no figures were available at the time of writing to suggest the 36 Older people in Dun Laoghaire Rathdown: profile and needs likely impact of recent changes in immigration due to the economic downturn of 20082009. The ‘oldest old’: in 2006, among the Irish population of people aged 65 years or over, 24.1% were aged 80 years or over. This figure has shown a steady increase since the 1930s and 1940s, when it was around 12%; in 1986 it was 17.8%. There were more women over 80 than men – they formed 29.1% and 19.1% respectively of the over-65 age group. Gender balance: in 2006, in the whole population of people aged 55 years and over in Ireland, there were 79.4 men to every 100 women, with roughly equal numbers in the 55-69 age groups, but declining beyond that age, so that in the 80-84 age group, there were 61.4, and in the over-85 age group 44.7, men for every 100 women. However, there were marked differences between urban and rural settings, with 89.9 men to every 100 women in rural areas compared to 72 men to every 100 women in urban areas. In terms of marital status, while proportions of single and divorced men and women were not dissimilar, approximately 64% of men aged 65 years and over were married, compared with only 39% of women; 44% of women were widowed, compared to only 14% of men. Life expectancy in Ireland in general has continued to improve since the foundation of the State, with life expectancy at birth increasing by about 20 years for men and 24 years for women over the past 80 years, in large part due to improved infant mortality rates. CSO figures for 2009 show women’s average life expectancy at birth to be 81.6 years, and men’s 76.8 years, compared to only 57 and 58 years in the 1920s. In addition, the large gap between men’s and women’s life expectancy at birth, which was a feature of recent decades, is now narrowing, possibly because men are taking better care of their health. (However, there are fears that in future, the positive trends for both sexes may be reversed because of life-style factors, in particular the growing incidence of obesity13) Life expectancy at age 65: Department of Health and Children figures show that men aged 65 in 2001-2003 could expect on average another 15.4 years, as opposed to 13.8 in 1995-97. For women aged 65 in 2001-2003, the corresponding figure was 18.7 years, compared to 17.4 years in 1995-1997. (DOHC (2007) Health in Ireland Key Trends.) European figures : According to the Institute of Public Health, although life expectancy is on the increase ‘Ireland still lags behind most of the rest of Europe. In 2006, Irish male life expectancy ranked in joint 12th place with Luxembourg, while Irish female life expectancy ranked 16th among EU member states’.14 13 14 Irish Times article, 30-01-09 Irish Times article, 30-01-09 37 Older people in Dun Laoghaire Rathdown: profile and needs 3.2 Older people in Dύn Laoghaire Rathdown Introduction: measuring deprivation For an accurate understanding of the circumstances of older people in Dún Laoghaire Rathdown, and in particular the likelihood of their experiencing deprivation and social exclusion, it is important to be aware of the fact that the official measures of exclusion can be misleading. These have traditionally been based on comparisons of the proportions of people in each electoral division (ED) affected by a particular circumstance, such as early school leaving or disability. This method of analysis has resulted in a deceptively positive social profile of the county as one characterised principally by affluence rather than deprivation. However, as the recently published Social Inclusion Profile of Dún Laoghaire Rathdown points out, these ‘existing methodologies for mapping deprivation…do not necessarily measure effectively nor reveal the true extent of or concentration of exclusion’ and the real position is very different’.15 This new social inclusion profile is based on absolute numbers rather than percentages, and paints a very different picture, showing clearly that Areas [in other counties] officially considered more disadvantaged, and in some cases considerably more deprived, than DLR exhibit smaller numbers of persons falling into one or more social inclusion indicators than seen in DLR. In other words, the numbers in DLR may be larger…This finding suggest that there is a greater ‘on the ground’ need in DLR than in such areas. (page v) In addition, the GAMMA report prepared for the DLR County Development Board in 2008 issued a further word of caution regarding the potentially distorting effect of the very different sizes of the electoral divisions used in maps displaying local demographic data – some of which are used in the present report. The disproportionate sizes of the 69 EDs in the county (the largest of which are the most sparsely populated) can be extremely deceptive in terms of showing the overall reality of, for example, population growth or decline at local level. A graphic indication of the Dublin Mountains area of the county was overlaid on some of the GAMMA maps as a reminder of this fact (see figure 3 p.10 of the present report)16 Aocial Inclusion Profile of Dún Laoghaire-Rathdown for Southside Partnership DLR Research and Report by Niall Watters, Unique PerspectivesA Social Inclusion Profile of Dún Laoghaire-Rathdown 15 Watters N, Unique Perspectives, 2009: A Social Inclusion Profile of Dún Laoghaire Rathdown. Southside Partnership. (Quotation from the Foreword, no page number) 16 GAMMA: Dún Laoghaire Rathdown; Demographic & Socio-Economic Profile. Report prepared for CDB, 2008 (p. 3) 38 Older people in Dun Laoghaire Rathdown: profile and needs for Southside Partnership DLR Research and Report by 3.2.1 Background: general population data for DLR Population change: The total population of Dún Laoghaire Rathdown (DLR) was 194,038 in 2006. In common with other counties in Ireland, the overall population of the county has continued to grow, as table 2 shows. Table 2: Population of Dún Laoghaire Rathdown 1996 - 2006 Dún Laoghaire 1996 2002 2006 Males 90,435 91,337 92,899 Females 99,564 100,455 101,139 Totals 189,999 191,792 194,038 Rathdown Source: GAMMA (2008) Report for DLR CDB However, the rate of growth in Dún Laoghaire Rathdown has slowed over the last three inter-censal periods, and has been slower than in the rest of the Greater Dublin Area (GDA), of which it is a part. In 2002, DLR accounted for 4.9% of the population of the State, and 12.5% of the population in the GDA, whereas in 2006 it accounted for 4.6% of the population of the state and 11.7% of the GDA. Areas of growth and decline: the overall growth rate of Dún Laoghaire Rathdown’s population in the ten-year period to 2006 was just over 2%, but population growth has been very uneven across the county, with substantial growth in areas in the south which have areas of newer housing and proximity to the M 50, including: Glencullen (72% increase between 1996 and 2006), Loughlinstown and parts of Dundrum/ Sandyford. In contrast, population declined in older areas like Dún Laoghaire, Killiney and Dundrum. Gender balance: unlike the pattern elsewhere in the country, women outnumbered men both in Dún Laoghaire Rathdown and the Greater Dublin Area in 2006, as they had in earlier censuses. In DLR they formed just over 52% of the whole population, outnumbering men by approximately 8,000. In the GDA women formed just 51 % of the whole population, and outnumbered men by almost 22,000. 3.2.2 Older people in Dún Laoghaire Rathdown: the over- 65s While the Dublin area overall (including DLR) has a younger profile than Ireland as a whole, the situation in Dύn Laoghaire Rathdown County is different. Its percentage of people aged 65 or over in 2006 was, at 13.4%, higher than the national average of 11% and the Greater Dublin Area figure of 10.3%. The county’s number of older people has increased at twice the national rate, and is growing relative to other age groups within the DLR population, as table 3 shows: 39 Older people in Dun Laoghaire Rathdown: profile and needs Table 3: Numbers aged 65 and over 1996 – 2006, as percentage of population DLR GDA Ireland 1996 11.30% (21,486) 9.67% (13,5987 11.41% (413,882) 2002 12.42% (23,830) 9.64% (147,982) 11.13% (436,001) 2006 13.39% (25,987) 9.67% (160,837) 11.04% (467,926) Source:GAMMA (2008) Report for DLR CDB As would be expected, the bulk of the population in Laoghaire Rathdown was in the age groups between 15 and 64, but there were almost almost 26,000 people over 65 in 2006. An analysis of Census 2006 figures carried out for Southside Partnership by Unique Perspectives (2009) shows: Table 4: Dún Laoghaire Rathdown population numbers by age in 2006: Area 0-14 15-64 65+ TOTAL DLR 35,244 132,807 25,987 194,038 Source: Census 2006 The charts below demonstrate the difference in population profile between Dύn Laoghaire Rathdown and the Greater Dublin Area in 2006 by looking at five year interval age ranges. These clearly show greater numbers and concentration in the older age groups, and lesser numbers in the younger age groups and of those of working age in Dún Laoghaire Rathdown compared to Greater Dublin. In 1996, these population ‘pyramids’ had roughly the same shape, so this shows a significant shift in overall population profile over the ten-year period. / see over 40 Older people in Dun Laoghaire Rathdown: profile and needs Figure 1: 2006 Population age structures, Dún Laoghaire Rathdown and Greater Dublin Area GAMMA (2008) Report prepared for DLR CDB 41 Older people in Dun Laoghaire Rathdown: profile and needs 3.2.3 The broader older population: 55 plus While national census information defines ‘older people’ as aged 65 years or over, it is vital for the purposes of forward planning and policy-making to consider those aged 55 years and over. (As far as possible, this has been the scope of this research project also). Figure 2 below shows the age and gender profile for people aged 55 years and over who were resident in Dún Laoghaire Rathdown in 2006. Analysis of Census figures shows that altogether, the total number of people aged 55 years and over living in DLR was 46,246, or almost 24% of the total population (for a complete age breakdown by year, see Appendix 2). Taking this larger group of older people as a starting point, the figures clearly demonstrate how women outnumber men in each of the age categories, and that this pattern is accentuated as the population ages, with the greatest disparity being in the group aged 85 years and over. Figure 2: Population of Dún Laoghaire Rathdown aged 55 years and over Population of DLR aged 55 years and over 6000 numbers 5000 Population of DLR from 55 years and above males 4000 3000 Population of DLR from 55 years and above females 2000 1000 0 5559 6064 6569 7074 7579 80- 85+ 84 ages Source: CSO Census 2006: Small Area Population Statistics 3.2.4 Old age dependency ratio: national and DLR figures The old age, or ‘elderly’, dependency ratio refers to the proportion of people of pension age in any given population relative to ‘those in the work force’, i.e. aged 15-64 years. This ratio has remained relatively stable over recent years in Ireland overall, although it is set to change significantly in the years to come as the population ages. The CSO predicts, based on current population trends that the current rate of 16.4% in 2006 will grow to 25.1% in 2026, and projections in the government’s Green Paper on Pensions suggest that it will grow to 32% by 2036. In Dún Laoghaire Rathdown as a whole, the old age dependency ratio increased by 17% during the period 1996-2006, moving from 167 per thousand to 196 per thousand 42 Older people in Dun Laoghaire Rathdown: profile and needs (GAMMA report for DLR CDB 2008). This is in contrast to the situation both in the Greater Dublin area, and in Ireland in general, where the elderly dependency ratio fell somewhat during the same period. This overall figure masks marked variations across the county, which the above map below reveals (though some of the high concentrations may be due to the presence of residential facilities/ nursing homes in certain areas). Figure 3: Old age/ elderly dependency rates, electoral divisions of Dún Laoghaire Rathdown 2006 Source: GAMMA (2008) Report for DLR CDB p.23 43 Older people in Dun Laoghaire Rathdown: profile and needs 3.3 The contribution of older people Many older people make contributions to their communities, and do this in a variety of ways. Their contributions include engagement in voluntary and community groups, unpaid work in local charities, and providing personal care to a friend, relative or neighbour. And many older people are engaged in multiple activities of this kind. 3.3.1 Older people as volunteers According to CSO figures for 2006, approximately 20% of men and 22% of women between 55 and 64 years (almost 86,000 people) said they were involved in some form of voluntary activity. 15% (almost 70,000) of all those aged 65 years and above were engaged in some form of voluntary work, with the most active being in the 65-69 age group (almost 19% of men and 21% of women). Figures are not available to provide an age breakdown of older people in Dún Laoghaire Rathdown who engage in voluntary activity, but the table below indicates that in the county, as compared to the Greater Dublin area, a somewhat higher percentage of people aged 15 yrs or over were involved in such activities (approximately 19% compared to 15%). Table 5: Voluntary activities of all people aged 15 years and over, Dublin and DLR Area Total persons Persons involved in voluntary activity aged 15 years and above Helping or voluntary work with a social or charitable organisation Helping or voluntary work with a religious group or church Helping or voluntary work with a sporting organisation Helping or voluntary work with a political or cultural organisation Any other voluntary activity Total persons involved in one or more voluntary activity Total persons not involved in voluntary work (incl. not stated Dublin 969,524 51,372 40,396 37,989 12,456 37,680 144,388 825,136 DLR 158,794 10,938 7,955 7,669 2,260 7,705 29,669 129,125 Source: CSO, Census 2006 and Small Area Population Statistics 2006 Note: numbers of those listing various types of voluntary activity total more than 29,669, as some people will have registered involvement in more than one type. The chart below shows in graphic form the numbers of people over 15 engaged in various types of voluntary activity in Dún Laoghaire. 44 Older people in Dun Laoghaire Rathdown: profile and needs Figure 4: Numbers engaged in various voluntary activities in Dún Laoghaire, 2006. number of people over 15 engaged in voluntary work in DLR Voluntary work in social/charity 7,705 10,938 Voluntary work in religion Voluntary work in sport 2,260 Voluntary work in politics/culture 7,669 7,955 Any other voluntary work Source: CSO (2006) and Small Area Population Statistics 2006 It is interesting to note that the greatest number of people are involved in ‘social or charitable organisations’, with similar numbers involved in voluntary work connected to religion and voluntary work in sport, mirroring the pattern in the Greater Dublin Area. Gender analysis indicates that more women are involved in voluntary social, charitable and religious activities whereas more men are involved in voluntary sporting activities, and slightly more to voluntary work in politics and culture. There has been some debate about whether levels of volunteering have been declining over recent years in Ireland. The table below shows results from a sample survey conducted by the ESRI in 2006 for the government’s Taskforce on Active Citizenship, using somewhat different criteria to those in the Census form. These results suggest that this is not the case for older people at least, as they show a recent large increase over low levels of active engagement and volunteering in 2002. However, the Taskforce advises caution in drawing definitive conclusions from these figures. Table 6: Over 65s volunteering or actively engaged in their community Regular volunteer Proportion of people aged 65 years and over Actively engaged in community 2002 2006 2002 2006 6.1% 14.8% 7.3% 19.1% Report of Taskforce on Active Citizenship; Statistical Evidence on Active Citizenship (2007) 45 Older people in Dun Laoghaire Rathdown: profile and needs 3.3.2 Older people as voters With regard to voting behaviour, people aged 65 and over in Ireland have tended to participate politically in greater numbers than their younger counterparts. Data for the 2007 General Election were not available at the time of writing, but in the May 2002 General Election there was an overall turnout of 74% of those aged between 18-64 years and eligible to vote, but 86.3% of eligible people aged 65 and over actually voted. The main reason given by those over 65 years not voting was illness or disability (CSO 2007). It is unlikely that voting habits in Dún Laoghaire Rathdown would be different. 3.3.3 Older people as carers National picture In 2006, 4.8% of all persons in Ireland, and 3.9% of those over 65, classified themselves as carers; the comparable figure for all of those aged between 15 and 64 was 4.9%. Carers formed 4.8% of the 65-69 age group , and the proportion dropped to 3.7% for the 75-79 age group, and to 1.8% for the 85 and over age group. Overall, more women than men described themselves as carers, but whereas up to age 79, more women than men were carers, in the oldest age groups there was a higher proportion of men than women, although numbers were small. In terms of actual numbers, there were 18,152 people over 65 in Ireland describing themselves as carers in 2006; of these 11,009 were women and 7,143 were men. [NB This information relates to people providing unpaid care to family members, friends or neighbours, not paid professional care staff nursing or assisting people in their homes.] Table 7: Percentage of age group describing themselves as carers, 2006 % of age group Age group Males Females Persons 65-69 3.6 5.9 4.8 70-74 3.5 4.9 4.3 75-79 3.5 3.9 3.7 80-84 3.3 2.7 2.9 85 & over 2.5 1.5 1.8 65 & over 3.4 4.2 3.9 15-64 3.6 6.2 4.9 Source: CSO (2007) Ageing in Ireland Time spent caring: in 2006, 37% of all carers aged over 65 provided up to 14 hours of unpaid help each week, while 49% provided 43 or more hours (effectively full time), as is illustrated in the table below: 46 Older people in Dun Laoghaire Rathdown: profile and needs Table 8: Hours of unpaid help provided by carers aged 65 and over in 2006 Hours per week Males % of all carers over 65 by sex Females Persons 1-14 38.9 35.8 37.0 15-28 8.4 8.1 8.2 29-42 6.3 6.1 6.2 43 & over 46.4 50.0 48.6 Total 100.0 100.0 100.0 Source: CSO (2007) Ageing in Ireland Those receiving carer’s payments: there were nearly five times as many women as men aged 65 and over receiving carers’ payments nationally in 2005. Table 9 shows the numbers between 1996 - 2005 Table 9: Persons over 65 in Ireland receiving carers’ payments, 1996 - 2005 no. of persons % of all male/female recipients Year Males Females Males Females 1996 104 610 6.0 9.3 1997 124 862 5.7 10.8 1998 164 1,078 6.3 12.2 1999 219 1,312 7.2 11.5 2000 284 1,555 8.2 11.9 2001 323 1816 8.5 11.8 2002 357 2048 8.5 12.2 2003 412 2248 9.4 12.8 2004 462 2408 10.0 13.1 2005 506 2447 10.4 11.7 Source: CSO (2007) Ageing in Ireland The situation in Dún Laoghaire Rathdown Figures drawn from the Small Area Population Statistics from Census 2006 regarding carers in Dún Laoghaire Rathdown show that 4.8% of the population (7,544 people) across all age groups were carers, and as Watters(2009) points out, this is the same as the national average, and slightly higher than Dublin overall. 47 Older people in Dun Laoghaire Rathdown: profile and needs Table 10: Number and percentages of carers by unpaid care hours per week, 2006 Total no of carers Area Number of carers 1-14 hrs per week Southside Partnership 15 – 28 hrs per week % of carers 29-42 hrs per week 43 plus hrs per week 1-14 hrs per week 15 – 28 hrs per week 29-42 hrs per week 43 plus hrs per week 7,544 5,014 717 338 1,475 66.5% 9.5% 4.5% 19.6% Dublin 42,243 25,278 4,466 2,552 9,947 59.8% 10.6% 6.0% 23.5% BMW 45,114 25,358 4,826 2,808 12,122 56.2% 10.7% 6.2% 26.9% S and E 115,803 68,005 12,267 6,770 28,761 58.7% 10.6% 5.8% 24.8% National 160,917 93,363 17,093 9,578 40,883 58.0% 10.6% 6.0% 25.4% Source:CSO Small Area Population Statistics (from Census 2006) The table above also indicates that in Dún Laoghaire Rathdown, compared to Greater Dublin and to other parts of the country and nationally, a higher percentage of carers provided under 15 hours a week, while a lower percentage provided over 43 hours a week. The following table identifies the 30 electoral divisions in the Dún Laoghaire Rathdown County in which there were over 100 people of all age groups providing care for others in 2006. Most striking is the high numbers of carers in the Glencullen area, where there were 405 people providing care, 88 of those providing more than 43 unpaid hours per week. Areas which had roughly double this number in 2006 were Blackrock-Carysfort, Cabinteely-Pottery, Dundrum-Ballally, Foxrock-Carrickmines, and Killiney South. This information may be helpful in the analysis of the profiles (including age profiles) and needs of carers across the county. Table 11: Geographical areas in DLR with more than 100 carers in 2006 Geographical area Total number of carers Numbers of unpaid care hours per week 1-14 hrs 15-28 hrs 29-42 hrs 43+ hrs Ballinteer-Broadford 122 78 14 8 22 Ballinteer-Woodpark 146 94 15 6 31 Ballybrack 126 82 8 8 28 Blackrock-Booterstown 112 70 14 5 23 Blackrock-Carysfort 207 147 23 13 24 Blackrock-Central 134 97 9 2 26 Blackrock-Monkstown 136 103 11 7 15 48 Older people in Dun Laoghaire Rathdown: profile and needs Blackrock-Templehill 114 75 9 2 28 Cabinteely-Granitefield 120 74 13 4 29 Cabinteely-Kilbogget 112 69 14 3 26 Cabinteely-Pottery 194 130 16 10 38 Churchtown-Nutgrove 132 72 13 6 41 Dundrum-Balally 207 138 21 6 42 Dundrum-Kilmacud 105 74 8 4 19 Dundrum-Sandyford 193 144 20 8 21 Dún Laoghaire-Glasthule 117 76 13 8 20 Dún Laoghaire-Sallynoggin E. 127 82 11 8 26 Dún Laoghaire-Sandycove 173 120 15 8 30 Foxrock-Carrickmines 257 180 15 9 53 Foxrock-Deans Grange 103 71 6 3 23 Glencullen 405 263 39 15 88 Killiney-north 154 109 12 3 30 Killiney-south 227 133 35 12 47 Shankill-Rathmichael 171 110 18 12 31 Shankill-Rathsallagh 128 72 15 7 34 Shankill-Shanganagh 140 82 11 5 42 Stillorgan-Deerpark 128 92 6 3 27 Stillorgan-Kilmacud 171 118 15 5 33 Stillorgan-Leopardstown 106 74 12 2 18 Stillorgan-Merville 100 75 15 5 5 Source: CSO Small Area Population Statistics 2006 Estimated number of older carers: On the assumption that the DLR pattern is not very different from that of the country as a whole, it is possible that the county had just over 1,000 carers over 65 (i.e. 3.9% of the over- 65 age group, who numbered 25,987 at the last Census) Estimated older carers receiving carer’s allowances: Only a small proportion (6% or 443 individuals) of carers of all ages were in receipt of (means-tested) carers’ allowance (information supplied to Watters by the DSFA) with the following areas each having around 10% of this group of 443: Ballybrack, Blackrock, Dundrum, Dún Laoghaire (62 or 14% of the whole), Sallynoggin, Sandyford and Shankill. 49 Older people in Dun Laoghaire Rathdown: profile and needs Since the county figures regarding older carers generally seem close to the national figures, it may be estimated that only around one in five of the over-65 carers were in receipt of carer’s allowance. Further investigation would be needed to ascertain whether these estimates are correct. 50 Older people in Dun Laoghaire Rathdown: profile and needs 3.4 Older people as residents of Dún Laoghaire Rathdown 3.4.1 Housing circumstances of older people The diversity of older people in Dún Laoghaire Rathdown is naturally matched by the wide range of their housing circumstances, including: Owner occupation Social housing – local authority or housing association owned Supported housing (with caretaker: local authority, housing association, or other voluntary body) Residential care (including nursing homes and older people’s homes, both private and state sector) Private rented accommodation Traveller accommodation GAMMA data prepared for the County Development Board in 2008 set out the numbers of older people in the various housing categories in Dún Laoghaire Rathdown, based on figures from Census 2006: Table 12: Housing circumstances of people over 65 in DLR in 2006 Housing circumstances Number of people % Not stated 2,003 7.9 Owner occupied with loan 1,714 6.8 19,068 75.8 Purchasing from local authority 474 1.9 Rented from the local authority 958 3.8 Rented from a voluntary body 138 0.5 Private rented - unfurnished 205 0.8 Private rented - furnished 243 1.0 Occupied free of rent 324 1.3 25,127 100 Owner occupied without loan Total Source: GAMMA (2008) report for DLR CDB Note: there is a discrepancy (of 860) between the above number and the total number of people over 65 years. This may be explained by some who are resident in communal establishments or others in religious orders. The table below shows the relative proportions of older people in DLR in the different categories, with well over three-quarters owning their own homes outright, and only small numbers in each of the other categories, including local authority housing. 51 Older people in Dun Laoghaire Rathdown: profile and needs Figure 5: Housing circumstances of over 65s in Dún Laoghaire Rathdown, 2006 Housing circumstances of people over 65 years in DLR (n =25,127) not stated 2003 owner occupier 20,782 rented from LA 958 rented from voluntary body 138 occupied free of rent 324 purchasing from LA 474 private rented 448 Source: GAMMA (2008) report for DLR CDB 3.4.2 Location of older people in the county Analysis of the places of residence of older people in Dún Laoghaire Rathdown by electoral division indicates that, in 42 of the 69 electoral divisions in 2006, the proportion of residents aged 65 years or more was higher than the county average of 13.4% (Watters, 2009) – see map below. 52 Older people in Dun Laoghaire Rathdown: profile and needs Figure 6: Electoral divisions: proportion of over 65s in total population of each, 2006 Source: Watters(2009) Social Inclusion Profile for Southside Partnership 53 Older people in Dun Laoghaire Rathdown: profile and needs Those electoral divisions with over 20% of their population aged over 65 years were: Table 13: Electoral divisions with more than 20% population aged over 65 in 2006 Electoral Division % Dún Laoghaire-Sallynoggin south 25.8 Dalkey-Hill 25.2 Dalkey-Bullock 23.6 Dalkey-Coliemore 21.6 Dalkey-Avondale 21.6 Dún Laoghaire-West Central 21.4 Dún Laoghaire-Monkstown Farm 21.1 Foxrock-Beechpark 23.8 Ballinteer - Meadowbroads 23.4 Churchtown-Orwell 24.2 Churchtown-Castle 20.9 Churchtown-Landscape 22.0 Dundrum -Sweetmount 22.0 These electoral divisions fall into two groups: those on the west side of DLR: Ballinteer (1 ED) Churchtown (3 EDs) and Dundrum-Sweetmount (1 ED) and those on the east side: Dalkey (4 EDs), Dún Laoghaire (3 EDs) and Foxrock-Beechpark (1 ED). Electoral divisions with proportions of between 13% and 20% of their population aged 65 years or over are listed below in descending order below: Table 14: Electoral divisions with between 13.4% and 20% of those aged over 65 in 2006 Electoral Division % Dún Laoghaire-Glasthule 19.8 Dalkey-Upper 19.6 Stillorgan-Kilmacud 19.6 Dún Laoghaire-Sandycove 19.1 Stillorgan-Deerpark 18.7 Blackrock-Williamstown 18.0 Dún Laoghaire-Sallynoggin West 17.7 Foxrock-Deans Grange 17.7 Ballinteer-Ludford 17.3 Churchtown-Woodlawn 17.0 Blackrock-Stradbrook 16.9 Blackrock-Newpark 16.8 Clonskeagh-Windy Arbour 16.8 Clonskeagh-Farranboley 16.7 Ballinteer-Meadowmount 16.4 54 Older people in Dun Laoghaire Rathdown: profile and needs Cabinteely-Granitefield 16.4 Blackrock-Monkstown 16.2 Dún Laoghaire-Glenageary 16.1 Dundrum-Taney 16.0 Stillorgan-Mount Merrion 15.9 Dún Laoghaire-Sallynoggin East 15.8 Stillorgan-Merville 15.6 Churchtown-Nutgrove 15.5 Clonskeagh-Roebuck 15.1 Stillorgan-Leopardstown 15.0 Cabinteely-Pottery 14.9 Shankill-Shanganagh 14.3 Blackrock-Templehill 13.8 Dún Laoghaire-Salthill 13.7 Source: Census 2006. The areas with the lowest percentages of older people (well below the overall county average) include the Clonskeagh Belfield ED (6.8%) electoral division, along with very sparsely populated areas such as Tibradden, (4.4% older people) and areas of newer housing developments, mostly in the south of the county such as Dundrum-Sandyford (6.8%) and Cabinteely-Loughlinstown (5.2%). These figures reflect clearly some of the complexity of settlement and population patterns in the county, where different generations of one family may often live at some distance from each other . 3.4.3 Older people living alone National position in Ireland Gender dimension: Overall, more women than men live alone in Ireland. According to recent statistics, the proportion of women aged 65 years and over living alone in Ireland was 31.7%, the eighth lowest of EU 27 countries, but the rate for men was the fourth highest at 20.6.%17. In 2006, two thirds of all those over 65 years were living in private households with other people, whereas 27% of the overall age group were living alone. However, there is a changing pattern as people age: 78.3% of people aged 65-69 lived in private households with others; 19.4% lived alone; 71.7% of people aged 70-74 lived in private households with others; 25.1% lived alone; 62.5% of people aged 75-79 lived in private households with others; 31.7% lived alone; 53.1% of people aged 80-84 lived in private households with others; 35.4% lived alone 43.7% of people aged 85+ lived in private households with others; 31.7% lived alone. In the oldest age groups there was an increasing proportion of people living in ‘communal establishments’ :11.4% of those aged 80-84 and 25% of those over 85. 17 CSO (2007) Ageing in Ireland Dublin:Stationery Office 55 Older people in Dun Laoghaire Rathdown: profile and needs Older people living alone in Dún Laoghaire Rathdown According to information supplied to Southside Partnership by Gamma (2008), comparison with figures for the Greater Dublin Area showed that Dún Laoghaire Rathdown had somewhat higher proportions of people over 45 and of people over 65 living alone at the time of Census 2006. The two following tables show first, absolute numbers in DLR and GDA, and second, a comparison of percentages in DLR, GDA and Ireland as a whole. Figure 7a: Numbers of people over 45 and over 65 living alone in DLR and GDA. people over 45 and 65 living alone in GDA and DLR number of people 70,000 59,972 60,000 50,000 40,000 45+ 31690 30,000 20,000 10,000 65+ 10,980 6409 0 DLR GDA Figure 7b: Percentages of people over 45 and over 65 living alone in DLR, compared to GDA and Ireland as a whole % of people living alone over 45 years and over 65 years Ireland 65+ DLR 45+ GDA 0 5 10 15 20 percentage 56 Older people in Dun Laoghaire Rathdown: profile and needs Absolute numbers of older people living alone in Dún Laoghaire Rathdown: Shedding further light on the situation of older people In Dún Laoghaire Rathdown are figures in the recent social inclusion report (Watters, 2009) comparing the absolute number of over 65s living alone in the Southside catchment area with those in other Partnership areas across the country. Compared to the 6,409 in DLR, areas with the next largest numbers were Mayo, Dublin Northside and Wexford, which had 4961, 4686 and 3829 respectively. Areas conventionally thought of as more disadvantaged had much lower numbers: Clondalkin had 1,187 and Ballymun 1,078. Variations among electoral divisions: Watters also found that the percentage of people aged 65 years and over living alone varied considerably across different electoral divisions – from 1.9% in Cabinteely-Loughlinstown to 23.5% in ChurchtownCastle. 22 of the 69 electoral divisions in the county had a higher than average percentage of older people living alone, i.e. more than 12.5% of their population. As the report comments: ‘These EDs are for the most part located in the North of the county from east to west, and there are concentrations of EDs around Churchtown and Windy Arbour, Dún Laoghaire and Dalkey.’ They are listed in the table below, and shown on the map from the GAMMA report reproduced on the following page. Table 15: Electoral divisions with more than 12.5% older people living alone Electoral division % living alone Electoral division % living alone Ballinteer-Meadowbroads 13.9 Dalkey-Coliemore 16.9 Blackrock-Monkstown 14.4 Dalkey-Hill 17.5 Blackrock-Williamstown 14.4 Dalkey-Upper 12.6 Churchtown-Castle 23.5 Dún Laoghaire-Glasthule 17.0 Churchtown-Landscape 19.1 Dún Laoghaire-Monkstown Farm 13.4 Churchtown-Orwell 15.6 Dún Laoghaire-Sallynoggin South 19.7 Churchtown-Woodlawn 14.1 Dún Laoghaire-Sandycove 19.7 Clonskeagh-Farranboley 15.7 Dún Laoghaire-West Central 13.0 Clonskeagh-Windy Arbour 13.0 Foxrock-Beechpark 12.7 Dalkey-Avondale 12.7 Stillorgan-Deerpark 15.9 Dalkey-Bullock 13.4 Stillorgan-Mount Merrion 14.0 57 Older people in Dun Laoghaire Rathdown: profile and needs Figure 8: People over 65 living alone in DLR, as a percentage of all households, shown by electoral division Source: Watters (2009) Social Inclusion Profile for Southside Partnership One-person households Other 2008 data provided by GAMMA to the County Development Board includes figures for one-person households in Dún Laoghaire Rathdown. While no firm conclusions can be drawn, it is noteworthy that some of the areas with the highest number of single households are electoral divisions with higher than average percentages of older people in their overall population. 58 Older people in Dun Laoghaire Rathdown: profile and needs Table 16: Electoral divisions with high proportions of single households and older people Electoral division % of single-occupant households 2006 % of residents over 65 years 2006 Dún Laoghaire East Central 43 13.1 Blackrock-Monkstown 35 16.2 Dalkey Hill 33 25.2 Churchtown Castle 38 20.9 Source: GAMMA (2008) report for DLR CDB (p.29) 3.4.4 Housing type (1): Owner occupiers in Ireland and Dún Laoghaire Rathdown Compared to its European counterparts, Ireland has a high owner-occupancy rate, at 80%. The number of older people (over 65 years) in Ireland who are owner-occupiers is even higher still, and is estimated to be 90% by Fahey et al (2007). 18 In addition, many older people who are owner occupiers have wholly paid off their mortgages, making them ‘asset rich’, but in some cases ‘cash poor’. While owneroccupation offers security of tenure, it can also be a source of anxiety in relation to maintenance, especially the cost and organisation of repairs and adaptations. As table 12 (above) shows, the national picture of high owner occupation among people over 65 is mirrored in Dún Laoghaire Rathdown, where 21,256 people over 65 (almost 85% of the total quoted in the GAMMA report) are either buying or have bought their own homes. 3.4.5 Housing type (2): Social housing in Dún Laoghaire Rathdown According to information supplied for this report by the DLR Department of Community and Enterprise and the DLR Department of Housing, 566 of all local authority accommodation dwellings in Dún Laoghaire Rathdown are designated for older people, referred to as ‘senior citizens’ by DLR Housing Section19. Some of this accommodation is located in developments specifically designed for older people, which have a resident caretaker, while in others older people predominate, but there may also be younger households resident there. At the time of the 2006 Census, there were 958 older people accommodated in Dún Laoghiore Rathdown’s social housing schemes, some in designated senior citizen developments and others in standard units. 18 Fahey T, Maitre B, Nolan B and Whelan CT (2007) A Social Portrait of Older People in Ireland Dublin:ESRI 19 The age threshold for accommodation for senior citizens is currently 60 years, but this may be reduced to 55 years in the near future, subject to governmental approval. 59 Older people in Dun Laoghaire Rathdown: profile and needs A further 474 older people were in process of purchasing their homes from the local authority. Other accommodation for older people is planned: the Draft Housing Strategy 20102016 for Dún Laoghaire Rathdown20 indicates that its current construction programme includes 21 senior citizens units at Broadford Rise, Ballinteer and a net addition of 33 units at Rochestown House, Sallynoggin. Waiting lists: at present there are 259 senior citizen households on the county’s waiting list for local authority housing, as follows: Table 17: Older people on DLR housing waiting lists in 2009 Area Blackrock/ Stillorgan Dún Laoghaire/ Dalkey Number on list 86 101 Ballinteer/ Ballyogan 46 Ballybrack/ Shankill 26 Total 259 There are 225 applicants on the waiting list for one-bedroom senior citizen accommodation, 210 of whom are single applicants. 118 ‘Senior Citizen’ applicants are currently living in private rented accommodation . Supported housing: In Dún Laoghaire Rathdown there are three social housing developments with resident caretakers, each with between 30 and 60 units (one is currently being re-furbished). These are Beaufort in Glasthule, Rochestown House in Sallynoggin, (under re-furbishment) and Kilbegnet House in Dalkey. Voluntary housing associations: In addition to County Council housing, there are a number of voluntary sector developments which cater for some 138 older people. Information supplied by the County Council Housing Department indicates that there are five voluntary housing associations providing such housing for older people: Abbeyfield House in Monkstown, Ailt an Oir in Glenageary (run by Dublin Central Missions), Carrig na Greine in Dalkey (run by the Sue Ryder Foundation), Charles Sheils House in Stillorgan (run by Charles Sheils Trust) and Sophie Barat Residence, also in Stillorgan. 3.4.6 Housing type (3) Private rented accommodation in Dún Laoghaire Rathdown According to information drawn from the 2006 Census by GAMMA for the County Development Board, there are 448 people over 65 years in Dún Laoghaire Rathdown living in private rented accommodation, which may be either furnished or unfurnished. 20 http://www.dlrcoco.ie/planning/DevPlan2010_2016/Draft/Appendices/AppendixB.pdf 60 Older people in Dun Laoghaire Rathdown: profile and needs Some commentators would consider that those in private rented accommodation are a potentially vulnerable group of older people: they have no direct links with the local authority, may not have security of tenure, and have only recently become eligible to apply for aids and adaptations to their accommodation, with their eligibilty dependent on a means test. Further detailed research would be needed to explore the situations of this group of older people, for whom income is clearly a critical factor. 3.4.7 Housing type (4) Residential care – in Ireland and in Dún Laoghaire Rathdown National situation: Data from the 2006 Census show that just over 5% of people over 65 years old were ‘usually resident’ in nursing homes and hospitals; this amounted to 4.1% of men and 6.7% of women. However, the proportions increased substantially according to age, as table 18 shows: Table 18: Proportions of older age groups in residential care in 2006 Age % of all men % of all women % of total cohort 60-69 1.4 1.2 1.3 70-74 2.3 2.2 2.2 75-79 4.1 4.9 4.6 80-84 8.4 10.7 9.8 85 and over 16.4 25.5 22.7 65 and over 4.1 6.7 5.5 Source: CSO (2007) Ageing in Ireland In 2006, women represented two thirds of all nursing home and hospital residents aged 65 years and over, and 77.6% of residents aged 85 years and over. In DLR, there are a number of residential care units catering for older residents who may be funded in a number of different ways (ranging from full subvention, part subvention, to wholly privately funded etc). Public residential care for older people in Dún Laoghaire Rathdown The HSE indicated that in 2008 there were three locations in which a total of 251 public residential care beds in DLR were provided: Dalkey Community Unit, Leopardstown Park Hospital and Clevis Welfare Home (also in Leopardstown). 61 Older people in Dun Laoghaire Rathdown: profile and needs Table 19: Public residential care places in DLR homes and hospitals, 2008 Name Total bed capacity Dalkey Comm.Unit 50 Clevis Welfare Home 30 Leopardstown Pk Hospital 171 Continuing care Dementia specific Respite Convalescent beds Long stay 12 2 36 30 145 11 14 1 Registered private nursing homes in Dún Laoghaire Rathdown The HSE provided information on registered private residential nursing homes, and the number of beds available to older people, in Dún Laoghaire Rathdown. Not all the beds are occupied currently, as cost is a consideration for some older people and their families until such time as ‘A Fair Deal’ scheme is implemented. Some of the residents will be in receipt of (means tested) HSE subventions towards their costs in these private nursing homes. More locally, the HSE estimates that there are 969 private nursing home beds on the east side of the county, but information for the west side was not obtained. Table 20: Places for older people in registered private nursing homes in DLR (2008) Number of beds Nursing Home Aclare House Nursing Home Dún Laoghaire 26 Altadore Nursing Home Glenageary 41 Annabeg House Nursing Home Ballybrack 28 Ashbury Private Nursing Home Deansgrange, Blackrock 78 Ashford House Nursing Home Dún Laoghaire 28 Beechfield Manor Nursing Home Shankill 61 Belmont House Nursing Home Stillorgan 113 Cairn Hill Nursing Home Foxrock 42 Carysfort Nursing Home Glenageary 52 Cedar House Nursing Home Mount Anville, Stillorgan 21 Dalkey Lodge Nursing Home Dalkey 31 Glebe House Nursing Home Kilternan 48 Glengara Park Nursing Home Dún Laoghaire 66 Harvey Nursing and Convalescent Home Glenageary 32 Holy Family Residence Little Sisters of the Poor, Roebuck Rd 66 Killiney Grove Nursing Home Killiney 37 The Marlay Nursing Home Rathfarnham 124 Newtownpark Nursing Home Blackrock 64 Our Lady’s Manor Dalkey 175 Rickard House Blackrock 28 St. Joseph’s Centre Shankill 60 Simpsons Hospital Ballinteer Road, Dundrum Total number of beds 44 1,265 62 Older people in Dun Laoghaire Rathdown: profile and needs 3.4.8 Housing type (5) ‘Communal’ living arrangements (including residential care) in DLR Available information is insufficient, and sometimes confusing, in relation to establishing how many older people altogether were living in communal settings, and how many in which types of communal settings in Dún Laoghaire Rathdown in 2006. The table below lists the numbers of people of all ages living in communal arrangements in the county. Unfortunately, as older residents of nursing homes are included in the same category as younger adults in residential care and children in children’ homes, further investigation would be necessary to establish the numbers of older people themselves. It is likely that a high proportion of those living in religious communities are also part of the older population of the county, but details are not readily available. Table 21: People living in communal settings in Dún Laoghaire Rathdown at the time of Census 2006 People present and usually resident in DLR classified by communal household type Total 2,461 Hospital 462 Nursing home/children’s home 1,176 Educational establishment 144 Religious community 424 Shelter/refuge/homeless accomm 61 Hotel 98 Boarding house/guest house/B&B 19 Tourist, youth hostel, campsite 31 Source: GAMMA (2008) Report for DLR CDB According to the SAPS data, the electoral divisions with the highest number of communal establishments of all types were as follows: Table 22: Electoral divisions with highest numbers of communal establishments Electoral Division Number of communal establishments Dún Laoghaire -Glenageary 9 Dún Laoghaire -Glasthule 8 Blackrock- Carysfort 8 Blackrock-Williamstown 8 Glencullen 7 63 Older people in Dun Laoghaire Rathdown: profile and needs Blackrock-Templehill 7 Dalkey-Coliemore 5 Source CSO:SAPS 2006 It is important to note that these communal establishments may include those which cater for people with disabilities, some of whom may also be older people. Further investigation would be required to investigate the resident population of these establishments. 3.4.9 Housing type (6) Traveller accommodation No information was available at the time of writing regarding older Travellers and their accommodation. 64 Older people in Dun Laoghaire Rathdown: profile and needs 3.5 Older people: income and employment The incomes of people aged 55 years and over may be derived from a number of sources including employment/ self-employment private income job seekers benefit supplementary welfare allowance occupational pensions contributory State pension non-contributory State pension carer’s benefits 3.5.1 Employment/ self-employment The CSO’s 2007 report, Ageing in Ireland, uses Census 2006 data to generate useful information on older people and employment in recent years. Nationally, labour force participation rates for older people aged 65 years and over remained relatively stable between 1998 and 2006, the most recent year for which figures are available. Male participation rates stayed at around the 14%-15% level, whereas female participation was 4.2%. Men of over 65 in Ireland had a higher overall rate of employment than the EU 27 average in 2006: 14.4% compared to an average of 6.6%. The difference for women was less marked with 4.2% of Irish women in employment compared to 2.8% of women in the EU 27 countries. There is a natural decrease in employment participation as people age: whereas 58.3% of men aged 60-64 were in the labour force in 2006, the figure for those aged 65-69 years was 24.7%, and for those over 70 it was 9.3%. The pattern for women was similar: 31.2% of women aged between 60-64 were in the labour force, 10.1% between 65-69 and for those over 70 years it was 1.9%21 3.5.2 Retirement, pension provision and the risk of poverty Those people who are 65 years and over and no longer working are likely to derive their income from a combination of occupational pensions, contributory and non-contributory social welfare pensions, and sources of private income, such as investment income. However, at present the majority (almost 70%) of older people in Ireland are primarily dependent on a state pension. Between 1996 and 2005 there has been a shift from state non-contributory pensions to contributory pensions. In 1996, 57.5% of pensions were contributory, but in 2005 this proportion had risen to 71.9% 22 21 22 All information taken from CSO 2007, Ageing in Ireland CSO 2007, Ageing in Ireland 65 Older people in Dun Laoghaire Rathdown: profile and needs People aged 65 years and over are a population group frequently regarded as being ‘at risk of poverty’ (defined as having an income below 60% of the median income). Recent figures (EU Survey on Income and Living Conditions 2006) show that the position has been ameliorated to a certain extent over recent years, so that the ‘at risk’ proportion of the over-65 population has been reduced from 27% in 2004, to 20.1% in 2005, to 13.6% in 2006. (EU SILC 2006)23 However, if Dún Laoghaire Rathdown was a typical county in this respect, it would mean that over 3,500 older people in the county were at risk of poverty. Even allowing for the higher socio-economic profile of the county overall, there would still be significant numbers of older individuals and couples in this category. (In addition, a similar calculation would indicate a further 950 older people in consistent poverty.) The recent Annual Report of the Department of Social and Family Affairs24 illustrates the increased investment in income maintenance of people aged 65 years and over, showing that expenditure on payments for older people was over €3,878 billion in 2007, an increase of 18.3% on 2006 payments. Table 23: Social welfare payments to over 65s, 2007 Classification of benefit Amount in €000 State Pension contribution State pension transition 2,754,947 79,054 Social Assistance non-contributory 920,167 Pre-retirement 124,490 Source: DSFA Annual Report 2008 Nevertheless, across the country there are groups of older people who continue to live in ‘consistent’ poverty (defined as having an income in the ‘at risk’ category and being unable to afford basic necessities in a list of 11 ‘deprivation indicators’). In 2005, there were 18,000 people over 65 in consistent poverty, or 3.7% of the total age group. The existence of social welfare supports does not necessarily reduce the risk of poverty for older people in Ireland. Figures from 2005 show that, although Ireland is in line with the other EU 25 countries in terms of poverty risk to older people before ‘social transfers and pensions’ were taken into account, after these were taken into account the risk for an older person in Ireland was the second highest in the EU. (CSO 2007 p.27.) National data available in the Green Paper on Pensions indicate that State provision was the main source of income for 68% of pensioner households nationally who had no income from occupational or personal pension schemes. A special analysis of social welfare payments to over-65s in 2008 was undertaken by the Department of Social and Family Affairs (DSFA) for Southside Partnership, and is included in the 2009 Social Inclusion Report produced by Unique Perspectives. 23 http://www.cso.ie/releasespublications/documents/eu_silc/current/eusilc.pdf 24 http://www.welfare.ie/EN/Policy/ResearchSurveysAndStatistics/Documents/2007stats.pdf 66 Older people in Dun Laoghaire Rathdown: profile and needs Note: the areas listed in the table below do not equate to the electoral divisions used in Census data, but are based on ‘townland’ areas according to the address of the recipient, since age-related pensions are administered centrally from Sligo, and are often transferred electronically to recipients’ bank accounts. No figures were supplied for numbers below 10, in order to preserve the confidentiality of recipients. 25 Table 23: Recipients of social welfare payments in DLR, 2008 NonContributory Contributory Pension (NCP) Pension Ballinteer 73 440 Ballybrack 47 327 Blackrock 268 2048 Booterstown 33 143 Cabinteely 21 246 Carrickmines 17 62 Churchtown 139 617 Cornelscourt <10 16 Dalkey 98 638 Deansgrange 13 119 Dundrum 123 1087 Dún Laoghaire 165 999 Foxrock 29 641 Glasthule 44 108 Glenageary 38 380 Glencullen <10 18 Goatstown 33 234 Killiney 70 599 <10 69 Leopardstown 27 33 Loughlinstown 33 95 Monkstown 53 363 Mount Merrion 34 253 Sallynoggin 65 221 Sandycove 37 221 Sandyford 58 263 100 450 Stepaside 10 72 Stillorgan 152 678 1,780 11,440 AREA Kilternan Shankill TOTAL Source: DSFA for Unique Perspectives 2009 25 Watters 2009 p. 62. 67 Older people in Dun Laoghaire Rathdown: profile and needs This analysis showed a total of 13,220 households in Dún Laoghaire Rathdown receiving Contributory or Non-Contributory Pension, of whom 1,780 are in receipt of the means-tested benefit (NCP). The figure of 13,220 takes into consideration only one pension recipient for married couples where the spouse may be a ‘qualified adult’, thus accounting for the discrepancy between the number of older people over 65 years in DLR (25,987) and the apparent number of claimants in the table. Watters (2009) went on to study the overlap between areas of the county with higher than average percentages of non-contributory pensions and those with a high proportion of older people living alone. Significant overlap occurred in: Ballinteer, Churchtown, Dún Laoghaire, Sallynoggin and Stillorgan.26 His report suggests that Shankill and Loughlinstown should be included, based on known disadvantage in those areas. 3.5.3 Pre-retirement occupations of people in Dún Laoghaire Rathdown The GAMMA report for the CDB, drawn from Census 2006 data, indicates that 21,338 people (aged15+) in Dún Laoghaire Rathdown stated that they were retired. This figure represent 13.44% of the county’s population, compared to 10.09% in the Greater Dublin Area, and 11.2% of the population nationally. (p36) Given the relatively low unemployment rates overall in the county in recent years, older people in DLR are somewhat less likely to have experienced unemployment before reaching retirement age than are older people elsewhere in the country. The overall socio-economic and educational profiles of the county suggest a concentration in skilled and professional employment overall, so it is interesting to consider the previous occupations most commonly cited by DLR respondents in the chart below. 26 Watters, 2009 p. 63. 68 Older people in Dun Laoghaire Rathdown: profile and needs Figure 9. Pre-retirement occupations in Dún Laoghaire Rathdown 2006 4,853 Other gainful occupations (incl. not stated) 86 181 Army occupations Garda Siochana 778 Central and local government workers 1,397 Teachers 911 Personal service and childcare workers 441 161 96 Other professional workers Religious occupations Social workers and related occupations 1,057 Health and related workers 684 Scientific and technical occupations 167 Computer software occupations 1,076 1,456 Business and commerce occupations Sales occupations 2,508 Clerical and office workers 725 Communication, warehouse and transport workers 1,960 Managers and executives 711 Building and construction workers 227 113 116 198 340 189 83 Other manufacturing workers Chemical, paper, wood, rubber, plastics and printing workers Food, drink and tobacco production workers Textile, clothing and leather workers Engineering and allied trades workers Electrical trades workers Farming, fishing and forestry workers 0 1,000 2,000 3,000 4,000 5,000 6,000 Source: GAMMA 2008, categorised into groups using 2006 CSO occupational classifications 27 Leaving aside the ‘other gainful occupations/ not stated’ category, it is interesting to note from the above table the relatively high numbers of retired people who were formerly teachers, health and related workers, clerical and office workers, managers and executives and those in sales-related occupations in Dún Laoghaire Rathdown. Grouped together, the number of people formerly involved in trades, manufacturing, printing and food production is also substantial. Closer and more detailed analysis of pre-retirement occupations would be helpful in designing appropriate life-long learning opportunities for those over 65 years. Place of residence of retired people in DLR As the varying age profiles across the county suggest, the percentages of those who are retired in various areas are also strikingly varied. In particular, Census 2006 figures illustrated by the map below show 12 electoral divisions in which between 20% and 25% of the population were retired. These were predominantly, and predictably, Dalkey (4 EDs), central parts of Dún Laoghaire (2), Foxrock (1) Churchtown (3) and Dundrum (1). There are an additional 23 electoral divisions with between 15% - 20% of the population retired, and these are mostly adjacent to the areas with the highest proportions of retired people. 27 CSO Census 2006 Volume 8 Occupations Appendix 4 Intermediate level of occupational groups (used in the 2006 Census classification) 69 Older people in Dun Laoghaire Rathdown: profile and needs Figure 10: Proportions of retired people (all people over 15) by electoral division, 2006 Source: GAMMA (2008) Report prepared for DLR CDB 70 Older people in Dun Laoghaire Rathdown: profile and needs 3.6 Older people and health: national level information The information below is based on national level surveys which have provided data relating to the health and well-being of the over-65 population. Once social class and socio-economic status are taken into account, there is no reason to anticipate marked differences between national results and the health status, behaviours, attitudes and lifestyle choices of older people in Dún Laoghaire Rathdown overall. (See also chapter 5 on the Network survey for comparisons with this particular group) Income and health It is generally accepted that the determinants of health status are multi-dimensional. They include social, economic and environmental factors, and at an individual level, factors such as age, gender, personal lifestyle choices and hereditary factors. As evidenced by numerous reports from organisations such as the Institute of Public Health in Ireland, one of the key social determinants of health is income status: the lower the level of one’s income, the less likely one is to enjoy good health.28 This is also borne out by the latest SLAN reports: SLAN 2007 Survey of Lifestyle, Attitudes and Nutrition in Ireland: Main Report, published in 2008, and SLAN 2007 Mental Health and Social Well-being Report, published in 2009. Both are based on large-scale national surveys undertaken in 2007. Older people and self-perceived health status At a general level, many people in Ireland tend to perceive their health in a positive light, as also reported in the EU Survey on Income and Living Conditions (EU SILC) 2005. However, older people’s self-assessment of their health status was somewhat different, with approximately 40% of both men and women judging their health to be ‘fair’, ‘bad’, or ‘very bad’. Table 24: Perceived health status of over 65s as percentages of age group Very good Good Fair, bad or very bad Male Female Male Female Male Female 17.6% 18.2% 41.8% 40.2% 40.6% 41.6% Source: CSO: EU SILC 2005, cited in DOHC: Health in Ireland: Key Trends 2007. Older people, self-perceived health status and social class: The SLÁN 2007 findings highlight the link between an individual’s self-perceived health status and social class,29 which is true of the over-65s as much as of younger age groups: 28 http://www.dohc.ie/publications/pdf/slan_wellbeing_report.pdf?direct=1 p 4 of report In the SLAN study Social Class 1-2 is referred to ‘upper’ class, 3-4 as ‘middle’ class and 5-6 as ‘lower’ class, based on CSO occupational categories for the ‘reference person’ in each household: 1= professional; 2= managerial and technical; 3=non-manual; 4=skilled manual; 5= semi-skilled manual; 6=unskilled manual; 7= all others gainfully occupied and unknown. 29 71 Older people in Dun Laoghaire Rathdown: profile and needs In social classes 1and 2, 45% of men and 43% of women over 65 reported their health to be excellent or very good; In social classes 3 and 4, 33% of men and 37% of women over 65 reported their health to be excellent or very good; In social classes 4 and 5, 30% of men and 23% of women over 65 reported their health to be excellent or very good. Older people, exercise and nutrition: According to the SLAN 2007 main report people over 65 are less likely to be physically active than their younger counterparts, citing injury/disability/medical condition as the reason for inactivity. However, men are more likely to be physically active than women. Results of the survey also showed that older men were more likely to consume more than the two recommended daily servings of meat, fish, poultry or alternative every day, which may impact negatively on their nutritional health. Older women in both lowest and highest social classes are more likely to consume less than the two recommended daily servings which also may have a negative impact on nutritional health. Mental health and social well-being: The SLAN 07 survey shows that, in general, older people in Ireland are more likely to be positive about their mental health and to experience less depression, anxiety etc. than younger people. This too has links to social class, with the least well-off experiencing higher levels of distress. Loneliness: When asked ‘have you often felt lonely in the last 4 weeks?’ 10% of men but 17% of women across all age groups said they had. In the over-65 age group, there were higher percentages than this overall average for both sexes and all social classes, with the exception of men in social classes 1 and 2. A higher percentage of all older women replied ‘yes’ compared to older men, but the difference was more marked in social classes 5 and 6. Figure 11: Perceptions of loneliness among men and women over 65, by social class Perception of loneliness in people 65+ 30 percentage 25 20 Men 15 Women 10 5 0 SC1-2 SC3-4 SC5-6 social class Source: SLAN 200,7 p. 94 72 Older people in Dun Laoghaire Rathdown: profile and needs Older people and community engagement: Interestingly, SLAN 2009 found that 55% of people of both sexes and in all age groups attended one or more community activity on a regular basis. A wide range of activities was quoted, including ‘sports clubs, political parties, trade unions, environmental groups, parent-children associations, tenant groups, neighbourhood safety, religious or voluntary activities, evening classes and social clubs’. When people over 65 were asked whether they regularly attended one or more such community activity, it was the older men in social classes 5 and 6 who were least likely to have attended such an activity (31%),raising the question of the relevance of current activities and provision to men in this group. There may also be an issue of cost in relation to some of the activities listed, such as adult learning activities. Figure 12: Community engagement of older men and women, by social class percentage Regularly attending one or more community activities:men and women 65+ 70 60 50 40 30 20 10 0 Men Women SC1-2 SC3-4 SC5-6 social class Source: SLAN report on Mental Health and Social Well-being (2009): Older people, mental health and perceived stigma: Finally, when asked to agree or disagree with the statement: ‘if I was experiencing mental health problems, I wouldn’t want people knowing about it’, a significant percentage of both men and women in all social classes agreed. In all social classes, slightly more older men agreed than women, perhaps indicating greater reluctance in this respect. The biggest gap between men and women was in social classes 1 and 2, where men reported the highest levels of reluctance to admit to mental health issues of all three male groups, but women reported the lowest levels. Older women in social classes 5 and 6 were more likely to agree than other women. These findings may have implications for understanding the way older people access mental health services, but more in-depth exploration of the attitudes expressed in this set of responses would be a necessary preliminary. 73 Older people in Dun Laoghaire Rathdown: profile and needs Figure 13: Older people’s willingness to acknowledge mental health problems, by social class percentage Reluctant to acknowledge experience of mental health problems - people 65+ 48 46 44 42 40 38 36 34 Men Women SC1-2 SC3-4 SC5-6 social class Source: SLAN report on Mental Health and Social Well-being (2009):48 The report Healthy Ageing: a Challenge for Europe (2006)30 highlights, among other things, that older women’s experience of health in ageing differs from that of men. Women tend to live longer, are more likely to live alone, tend to experience loneliness more acutely, are less likely to have adequate pension provision, and are more likely to report psychological symptoms. Motivations to become involved in health promotion activities are also different for men and women. These findings are particularly pertinent to the situation in Dún Laoghaire Rathdown, where the population of people over 65 years has a greater preponderance of women especially as the group advances in age, as illustrated in the earlier sections of this report. Health expenditure: the national picture One of the government’s commitments to to older people in Towards 2016 is that: Every older person would have adequate support to enable them to remain living independently in their own homes for as long as possible. This will involve access to good quality services in the community including: health, education, transport, housing and security. Section 32: Older People The majority of older people in Ireland in 2009 are in good health and not in need of extensive or on-going medical treatment. It has been argued that the effects of population ageing on healthcare expenditure can often be exaggerated. However the ‘oldest old’ are significant users of healthcare, and the bulk of expenditure is more likely to be required for the last year or two of life. 30 http://www.healthyageing.nu/upload/Rome/Healthy_web.pdf published by the Swedish National Institute of Public Health in 2006 74 Older people in Dun Laoghaire Rathdown: profile and needs Ireland’s performance in relation to expenditure on health is illustrated in the OECD comparative table for 2005 below - it is important to note, however, that the definition of health spend varies, and in Ireland it includes social services, whereas in the UK, for example, it does not. Figure 14: Total health expenditure in OECD countries as percentage of GDP, 2005 National policy and the provision of care at home In line with the policy commitment of enabling older people to remain in their own homes for as long as possible and avoiding the necessity of residential care, the government has been increasing expenditure on ‘home care packages’ in order to make this aim a reality. Budget 2008 committed an extra €24 million for increased support services for older people. This was intended to allow for increases in the number of home care supports, home help hours and respite care. A further commitment was made to develop standardised assessment procedures to establish the needs of older people living in their own homes which are to be delivered by multi-disciplinary teams. In 2007, the Department of Health and Children reported delivery of 8,035 home care packages to clients and 12,351,088 home help hours. According to the HSE Annual Report and Financial Statements 2008, the number of home care packages delivered in 2008 had increased to 8,990 with approximately 11,987 people benefiting (400 more than in 2007) and home help hours had increased to 12,631,602. 31 In contrast to the situation in other countries, there are as yet no home care packages dedicated to the complex needs of older people with dementia. 31 http://www.hse.ie/eng/Publications/corporate/arafs08.pdf 75 Older people in Dun Laoghaire Rathdown: profile and needs Care at home in Dún Laoghaire Rathdown: figures provided by the HSE indicate that approximately around 300 people are receiving Home Care Packages/supports in Dún Laoghaire Rathdown (covering the east side of the county) and approximately 270 in LHO Areas 2 which includes the west side along with several other areas within Dublin City Council’s boundaries. Day care The provision of day care can play a very important role in enabling people to continue to live in their own homes. The definition of ‘day care’ for older people encompasses a broad spectrum and can range from dedicated ‘day care centres’ for very specific groups with specific needs, such as people with Alzheimers, to older people’s groups offering a chiropody service. Day care services for older people supported by the HSE in the Dún Laoghaire Rathdown county area are grouped into: Day hospitals: Community Unit for Older Persons, Kilbegnet Close, Dalkey Leopardtown Park Hospital, Foxrock Social day care: Beaufort Day Care, Glasthule Monkstown Day Centre, Monkstown Brookfield/ Blackrock Day Centre, Monkstown Mount Merrion Friendship Club, Mount Merrion Shankill Day Centre, Shankill Little Sisters of the Poor, Roebuck Road, Clonskeagh Day care for older people with dementia-related illness: St Joseph’s Centre, Shankill Alzheimer’s Day Care Centre, Blackrock Carmen Centre, Leopardstown Park Hospital, Foxrock It is noteworthy that at present day care provision is located mainly towards the east side of the county, and although there are high numbers of older people living in the western side, there is a lack of such care provision. Disability and chronic illness . Data from the 2006 Census32 shows that nationally 29.5% of people aged 65 years and over indicated that they had a disability, compared to 9.3% of the whole population.33 32 CSO (2007) Ageing in Ireland. Dublin:Stationery Office 76 Older people in Dun Laoghaire Rathdown: profile and needs The proportion of people with a disability increased with age, with the disability rate varying from 18.7% for the 65-69 age group to 58.6% for the 85 and over age group. While some older people may not regard their particular health condition as a disability as such, and may take a somewhat stoical attitude to coping with it, significant levels of chronic illness or long-term conditions have been recorded among this group. Table 25: Those with chronic illness among the over 65s as percentage of age group Yes No Male Female Male Female 50.1% 52.8% 50.0% 47.2% Source: CSO: EU SILC 2005, cited in DOHC: Health in Ireland: Key Trends 2007. Data provided to Southside Partnership by GAMMA in 2008 indicated that there were 6,967 people over 65 years with a disability in Dún Laoghaire Rathdown. In percentage terms, as the table below shows, this is a higher proportion of all those with disability in the county than is the case in Greater Dublin and in the state as whole, although the reverse is true in relation to disability rates for people aged 45 to 64. Table 26: Disability numbers and percentages for DLR, Greater Dublin and Ireland Total persons with a disability Persons with a disability aged 45-64 Persons with a disability aged 65+ Persons with a disability aged 45-64 (%) 18,092 4,901 6,967 27.1% 38.5% GDA 112,936 32,852 37,591 29.1% 33.3% National 393,785 114,899 138,257 29.2% 35.1% Southside Partnership Persons with a disability aged 65+ (%) Residence and household arrangements of people with a disability in Dún Laoghaire Rathdown: Census information on people with a disability aged 65 years and over in Dún Laoghaire Rathdown shows a total of 5,762 living in private households (i.e. not in hospital or residential care), of whom just over 3,508 were women. In terms of their household arrangements, the picture is similar in Dún Laoghaire Rathdown to that in the Greater Dublin Area and the state. In each case, the percentage of those living alone is approximately 32% of all older people with a disability. However, there is a marked gender difference: approximately 40% of older women with a disability live alone in DLR, compared to only around 20% of older men with a disability. The percentage of older women with a disability living alone in DLR is also higher than in GDA or the State. (see Table 27 below) 33 The Census 2006 definition of disability included chronic illness, and psychological or emotional conditions as well as physical disability and impairment. 77 Older people in Dun Laoghaire Rathdown: profile and needs Table 27: People over 65 with a disability who live alone in Dún Laoghaire Rathdown, the Greater Dublin Area and the State Location Persons with a disability aged 65+ Males with a disability aged 65+ Females with a disability aged 65+ In private In private In private households Living alone Total in private As % of households persons households Living alone Total in private As % of households persons households Living alone Total in private As % of households persons with with a with a a disability in disability in disability in private private private households households households DLR 5,762 1,853 32.2 2,254 441 19.6 3,508 1,412 40.3 GDA 30,593 10,078 32.9 11,979 2748 22.9 18,614 7,330 39.4 State 109,997 35,932 32.7 45,779 11,361 24.8 64,218 24,571 38.3 Source: CSO 2007 – Disability, Carers and Voluntary Activities (Table 33) 78 3.7 Older people, security and safety There are several aspects to the issue of security and safety for older people living both in Dún Laoghaire Rathdown and in Ireland more generally. These are Safety within the home (physical safety) Elder abuse (either in own home or residential care) Safety outside the home (crime and safety) Safety outside the home (as pedestrians, road users, car drivers, cyclists etc) 3.7.1 Safety within the home A number of innovative strategies have been implemented across the country in relation to the safety and security of older people in their homes. These have included health promotion initiatives concerning regular sight tests and the use of correct glasses, precautionary advice about rugs and mats, the use of non-slip soles, keeping walkways clear etc. There has been encouragement of older people to take more exercise as a contribution to maintaining physical capacity and the national falls prevention strategy is being implemented nation-wide. This national Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population was published in 2008, and aims to decrease the number of falls and fractures in the over 65 age group. The risk of falls increases with age and 10% of all older people need treatment following an injury – falls cause 75% of these injuries. Fall-related deaths increase with age and are higher for older women. Nursing home residents are at the highest risk of falls, fractures and osteoporosis. Alarm systems: a national system operates for the subsidised installation of house alarms, funded by the Department of Community, Rural and Gaeltacht Affairs, and administered locally through varying arrangements. Smoke alarms have recently been made available in Dún Laoghaire Rathdown through the Older People’s Network. Home adaptations: local authorities, under new arrangements, have responsibility for the funding of aids and adaptations to the homes of older people, and under this new means-tested scheme, people in private rented accommodation can also apply for financial assistance,. Older people in Dun Laoghaire Rathdown: profile and needs 3.7.2 Elder abuse Definitions: elder abuse can take place both within an older person’s own home or in the context of residential care, day care, hospital etc. The definition of elder abuse used by the Department of Health and Children is A single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person or violates their human and civil rights.34 The DoHC categorises the different types of elder abuse as follows: physical abuse sexual abuse psychological abuse financial or material abuse neglect and acts of omission discriminatory abuse However, self-neglect and abuse by strangers are excluded from the definition. Although the focus is on specific acts of abuse by individuals, it is recognised that abuse may also arise from inadequacy of care. Numbers experiencing abuse: HSE reports on the issue of elder abuse (2002 and 2009) estimate that between 3 to 5% of older people have been, or are being, subject to some form of abuse. Application of this estimate to the older population of DLR would therefore suggest that between 780 to1,300 older people could potentially be affected in this way. A formal system of collecting data on elder abuse commenced in 2007, and figures for 2007 and 2008 have now been released35. o In the nine months of 2007 in which data was collected, 927 referrals of elder abuse were made to the HSE nationally. In Dublin Mid-Leinster HSE region, which includes Dún Laoghaire Rathdown but extends further, 125 referrals of alleged elder abuse were received within that time-frame. o In 2008, 1,840 referrals were received nationally by the HSE, and 245 of these were made in the Dublin Mid-Leinster region. The table below details both the numbers of elder abuse referrals for both men and women for the full year of 2008 in Dublin Mid-Leinster and nationally, and shows the significant gender difference. Half of all referrals concerned people aged 80 or more. 34 Protecting Our Future: DoHC Report of the Working Group on Elder Abuse, 2002 35http://www.hse.ie/eng/Publications/Older_People_and_Nursing_Homes/OpenYourEyesServic eDevelopments2008.pdf 80 Older people in Dun Laoghaire Rathdown: profile and needs Table 28: Elder abuse referrals in Dublin- mid-Leinster, 2008 Dublin- mid Leinster Male National% Dublin- mid Leinster % National % 82 670 33.5 36.9 Female 163 1145 66.5 63.1 Total 245 1815 100.0 100.0 Source: HSE (2009) Open Your Eyes: Elder Abuse Service Developments 2008: Other aspects of elder abuse referrals: analysis of the referrals received by the HSE nationally indicates that most by far related to individuals who live at home (82%), with only 6% relating to people living in nursing homes, 5% to those in relatives’ homes, 4% to those in public continuing care, with 2% relating to ’other’ circumstances, and 1% to those who are ‘boarding out’. The greatest source of referrals was Public Health Nurses, with hospital, HSE staff, and family being the other main sources. Nationally, complaints of psychological abuse were the most frequent (25%), while about 20% concerned neglect, 16 % were allegations of financial abuse, and 12% related to cases of physical abuse. (HSE 2009) The profile of alleged perpetrators of elder abuse in 2008 is outlined in the chart below Figure 15: Alleged perpetrators of elder abuse in Ireland 2008 50 40 30 20 10 0 so n/ da ug pa ht rtn er er /s po us e ne ig ot h he bo rp ur ai d ca ne re ice r /n ep he ot he w rr ot he el at rs ive er vi ce us er pr of st af f ot he r percentage of all referrals alleged perpetrators of elder abuse in Ireland 2008 alleged perpetrator Source: HSE (2009) Open Your Eyes Proportions of allegations substantiated: it is important to note that not all allegations/ referrals made to the HSE are substantiated. Nationally in 2008, 23% of referrals were substantiated, 31% were not substantiated and 47% were inconclusive. This pattern was mirrored in Dublin Mid-Leinster, where 23% (or 29 referrals) were substantiated, 19% (or 23 referrals) not substantiated, and 58% (or 72 referrals) were inconclusive. 81 Older people in Dun Laoghaire Rathdown: profile and needs 3.7.3 Safety outside the home National information: although many older people experience a degree of fear regarding crime, national figures from the 2006 Census suggest that they are less likely to be the victims of crime than other age groups, as illustrated in the tables below. Table 29(a) Male victims of crime in 2006, classified by age group. Age group Number of crime victims Population Percentage who are victims 18 - 24 26,500 233,900 11.3% 25 - 44 41,400 690,400 6.0% 45 - 64 19,900 472,100 4.2% 65+ 4,100 211,400 1.9% Total 91,900 1,607,800 5.7% Table 29(b) Female victims of crime in 2006, classified by age group. Age group Number of crime victims Population Percentage who are victims 18 - 24 14,700 229,600 6.4% 25 - 44 27,700 671,800 4.1% 45 - 64 12,300 469,000 2.6% 65+ 4,200 265,500 1.6% Total 58,900 1,635,900 3.6% Source: Central Statistics Office(2007)Crime and Victimisation (from QHNS 2006) However, while the figures show them less likely than younger people to be victims of crime, older people’s perceptions may be different. Table 30 shows that more than half of over 65s worry about becoming a victim of crime in general, while just over a third worry about experiencing both personal injury and property crime. Table 30: Fear of becoming a victim of crime – by age group, 2006 18-24 25-44 45-64 65+ All persons Yes, personal injury only 13.6% 14.6% 16.2% 14.6% 14.9% Yes, property crime only 3.4% 4.0% 4.0% 2.8% 3.7% Yes personal and property 24.5% 34.3% 37.9% 36.5% 34.3% No 58.5% 47.1% 42.0% 46.1% 47.1% Source: Central Statistics Office, 2006 82 Older people in Dun Laoghaire Rathdown: profile and needs CSO statistics also bear out the fact that many older people fear walking home alone in the dark. Compared to younger people, fewer older people feel very safe or safe, and more older people feel unsafe or very unsafe, walking home in the dark. Table 31: Fear of walking home alone after dark – by age group, 2006 18-24 25-44 45-64 65+ All persons Feel very safe 27.8% 28.0% 23.9% 13.1% 24.6% Feel safe 51.4% 50.1% 49.9% 41.7% 49.0% Feel unsafe 17.0% 18.6% 21.8% 32.8% 21.4% 3.8% 3.3% 4.3% 12.4% 5.0% Feel very unsafe Source: Central Statistics Office, 2006 The situation in Dún Laoghaire Rathdown: in relation to crime statistics, the 2008 GAMMA report for the County Development Board notes a general drop in criminal offences in Dún Laoghaire Rathdown since 2005. However, this did not apply equally to all offences: although there was a drop in the number of burglaries, there was an increase in the number of drug-related crimes. Age-related information is unavailable, but outline statistics for crime in the Garda region Dublin Metropolitan Region-East for 2007 are as follows: Table 32: Outline crime statistics for Dublin Metropolitan Area-East in 2007 Type of crime Number Homicides Assaults 3 152 Sexual offences 44 Arson 90 Drugs 175 Thefts 3,068 Burglaries 1,548 Robberies 100 Frauds 246 Other headline offences Total 56 5,482 Source: GAMMA (2008) report for DLR CDB Note: Garda areas do not correspond to local authority areas. Dublin Metropolitan Region-East is the smallest unit at which statistics are released which encompasses Dún Laoghaire Rathdown. 83 Older people in Dun Laoghaire Rathdown: profile and needs Older people and road accidents – the national picture Older people as pedestrians: older people are classified as ‘vulnerable’ pedestrians by the Road Safety Authority in terms of how they fare on the roads, This is clearly illustrated in the graph below, taken from the Road Safety Strategy 20072012, which indicates that fatality figures for older pedestrians are considerably higher than those for any other group of pedestrians, compared to fatalities amongst passengers and drivers. However it must be noted that the category ’65 and over’ in the chart below actually corresponds to a larger age banding than any other. Launching a new scheme for the wearing of high visibility vests by older people, the RSA’s chairperson stated recently that, between 1997 and 2007, more than 30% of walkers who died on the roads were over 65 years. One third of those older people who died were killed on dark roads with poor or no lighting.36 It is a matter of conjecture as to why this might be the case, but factors including unsafe crossings, unsafe roadways and pathways, poor visibility etc. may be among the ingredients which contribute to this picture. Figure 16: Road deaths by type of road user and age, 2000 - 2005 36 Quoted in the Irish Times, May 27, 2009. 84 Older people in Dun Laoghaire Rathdown: profile and needs Road accident statistics in Dún Laoghaire Rathdown Figures for Dún Laoghaire Rathdown on the safety of older road users are not available at present, and considering the nature and demography of its population, this is an aspect of security and safety which may warrant further attention. Information drawn from the National Roads Authority’s Road Accident Facts 2003 to 2007, quoted by GAMMA for the County Development Board, reveals the following: Table 33: Fatalities and injuries amongst some road users in DLR 2003-2007 Fatalities Car user Pedestrian Pedestrian amongst all road fatalities fatalities injuries users 2003 8 4 4 45 2004 2 0 1 33 2005 4 2 1 35 2006 5 4 1 27 2007 6 5 0 43 It would be unwise to draw conclusions with regard to trends from the above figures; however the number of injuries to pedestrians is noteworthy. …/ over 85 Older people in Dun Laoghaire Rathdown: profile and needs 3.8 Older people and education in Dún Laoghaire Rathdown While figures are not available for the educational attainments of older people in Dún Laoghaire Rathdown, the county overall has strikingly high educational levels, compared to both the Greater Dublin Area, and to Ireland as a whole. In 2006, according to figures prepared for the Southside Partnership by GAMMA, 51% of the Dún Laoghaire Rathdown population over the age of 15 whose education had ceased had completed a third level or higher qualification, compared to 36% of those in the Greater Dublin Area and only 30% of the whole Irish population. There were a small number of electoral divisions in the north of the county with more than 63% of the population in this category, while the four with lowest levels were: Monkstown Farm, Sallynoggin West and South, and Cabinteely-Kilbogget. The chart below illustrates the levels of educational attainment in 2006 for all people in DLR aged 15 years and over who had completed their education. Figure 17: Educational attainment of over-15s in DLR who had completed education, 2006 Educational attainment of people aged 15 yrs+ in DLR 1,564 Doctorate (Ph.D) Post-graduate degree 8,375 Post-graduate certificate or diploma 5,432 Both degree and professional qualification 7,849 4,476 level of attainment Professional qualification (degree status) Primary degree 10,963 Non-degree 11,587 Series1 2,188 Technical Vocational and Leaving Cert. Technical or Vocational 3,249 Leaving Cert. 15,275 Lower Secondary 8,202 3,205 Primary Education No Formal Education 102 Not stated 1,717 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 numbers Source: GAMMA data prepared for Southside Partnership (2008) Alongside the high proportion of those with third level education or more, there are significant numbers of people in the county with no more than primary or lower secondary education, and it is likely that a fairly high proportion will be over the age of 65. In Churchtown-Nutgrove, Sallynoggin West and Dún Laoghaire-Mounttown, 45–55% of the population completed education at lower secondary level or less in 2006. Areas where this was true for 35-45% of the area’s population included BallinteerMeadowmount, Clonskeagh-Farranboley, Monkstown Farm, Dún Laoghaire WestCentral, Sallynoggin South, Cabinteely-Kilbogget, Killiney South, and ShankillRathsallagh. 86 Older people in Dun Laoghaire Rathdown: profile and needs Overall, this information indicates where and how appropriate lifelong and continuing education could be pitched for the older population. For example, adult literacy support and second-level courses might be offered to those who have had no formal education or primary education only, whereas flexible ‘mature student’ access to third level courses might be extended for those older people who finished education at leaving certificate level. -0–0–0- 87 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 4. Survey: the contributions and needs of older people in Dún Laoghaire Rathdown 4.1 Background: the Network for Older People This survey was carried out in close collaboration with the Dún Laoghaire Rathdown Network for Older People, which in 2008 decided to carry out a questionnaire-based survey focusing on key issues of concern to its members, following training received from Southside Partnership, supported by a grant from Age and Opportunity. The Network saw this initiative as a way of strengthening and consolidating its work of bringing the concerns of older people in the county to the attention of the local authority. Many groups, clubs and associations of older people have been a significant part of life across the county for many years. The range includes Active Retirement associations, parish-based ‘Old Folks’ and other groups, groups linked to Community Development Projects, and groups with a focus on a specific sport or art/craft activity or serving a particular sector (such as the Probus Clubs for retired professional and business people). In 2001, the County Council implemented a decision in the County Development Plan 2002-2012 when it took the initiative to set up a Network of such groups. The current Directory of member groups lists 32 groups in all, and two others have recently become members. A request for information to the contact person of each group in early 2009 produced an estimated total membership of over 2,500 people – approximately 1 in 20 of all older people in the county. This means that the Network – although not a representative body in a formal sense - is potentially very influential, and the views of Network members must be of interest to policy makers and service providers locally. The groups involved in the Network cover a wide spectrum of older people in the county. They include people of all ages from 50 plus to 90 plus, from a variety of social, educational and occupational backgrounds. The areas served by different groups include county council housing estates as well as areas of relatively expensive private housing; members may come from a relatively small neighbourhood or cover much bigger areas of the county. Included in the Network are also a number of day care centres, which also contributes to the ‘mix’ among members. The Network largely consists of those older people who have opted for active involvement in local activities etc, and in addition, anecdotal evidence suggests that its active membership (those who attend meetings regularly) is predominantly female. These two facts need to be borne in mind when interpreting the findings of the survey. The County Council provides the Network’s Committee with some secretarial back-up (currently through a Community Employment Scheme post) as well as funding for all ongoing Network activities, which include a quarterly newsletter and an annual exhibition and awards event in May, aligned with the national Bealtaine festival celebrating creativity in older age. Funding is received from other sources for specific projects. 88 Older people in Dun Laoghaire Rathdown: profile and needs The Network has drawn up a Constitution, holds an AGM each year, but has not looked for the independent legal status of, say, a company limited by guarantee. According to the Constitution, membership is open to ‘all organisations and individuals committed to improving the quality of life of older people’, thus is not currently limited to non-profits nor to organisations with purely local focus. However, the normal membership process is relatively informal: if a group of older people approaches the Network, it will be invited to join if it is already known; if not, contacts will be made and an invitation issued once the Network is assured of its bone fides. There are no individual members at present. The Network’s objectives, which emphasise its close relationship with the County Council, are stated as: To work in cooperation with the Community Section of Dún Laoghaire Rathdown County Council; To enhance the longevity, quality of life and care provision for the older citizens and recognise the contributions of older citizens in communities and society of Dún Laoghaire Rathdown; To work with but not duplicate other associations and to speak with a unified voice in matters of concern for older people in our area; To bring to the notice of the Cathaoirleach, County Councillors and the Community Section these concerns; To establish a newsletter; To maintain and update a Directory of organisations who work on behalf of the older people in the County; For members to give freely of their knowledge and experience and to set up sub-committees where necessary. (Constitution of Dún Laoghaire Rathdown Network for Older People: undated) The Chair and Treasurer of the Network’s Committee are members of the county’s Service Providers’ Forum (Older People) which meets quarterly and is chaired by an HSE representative. The Network is also represented on the Community and Voluntary Forum for Dún Laoghaire Rathdown by its Chair, who has been appointed to its Executive Committee for a three–year term. The Network’s Vice Chair liaises with the Senior Citizen’s Parliament on its behalf. Working ‘in cooperation with…Dún Laoghaire Rathdown County Council’ has entailed, among other activities, being consulted on new seating in local parks, and taking on the role of distributing smoke alarms provided by the Council. The Network also fulfils an information and referral role for individual older people who approach its Committee members with queries and problems.37 37 All above information on the Network supplied by the current Chairperson and the contact person in Dún Laoghaire County Council’s staff. 89 Older people in Dun Laoghaire Rathdown: profile and needs 4.2 Designing and implementing the survey Members of the Network, working with Southside Partnership, chose three main themes for their survey: transport, security and safety, health and health services. They wanted a focus on older people’s contributions to their communities and the wider society, as well as on needs and issues, and they recognised the usefulness of seeking anonymous demographic data as part of the research. Their preferred method was the use of a confidential written questionnaire, so this was the brief for the researchers at the outset. A series of working meetings with a small survey group and with the whole Committee began in early November 2008, and the final agreed questionnaire – its length, language, layout, type size etc. designed to be accessible to a wide range of older people – was piloted in the New Year and introduced and distributed to contact people from each group in the Network at a preparatory meeting held in early February 2009. Groups were free to design their own method of distribution to members, as well as the setting in which they were completed: in some cases, members took the forms home, in others they were completed in private at a group meeting. In one or two cases the contact person acted as neutral interviewer where the participant had difficulty with the form, for reasons such as visual impairment. It was emphasised that answers to questions in the survey should be based on individual experience, views, and perceptions of their own situation (for example, in relation to health matters or adequacy of income). Some concepts were deliberately left fluid – and where the results were striking (such as the high proportion of people who found ‘safety on the streets’ problematic), further research would clearly be fruitful. The response to the survey was extremely positive: members of 30 groups (almost 90% of groups in the Network) participated by completing and returning the questionnaires, and of around 360 forms distributed, 291 (over 80%) were returned over the following four weeks. At a more personal level, participants clearly valued the opportunity to voice their concerns. Some comments of the many provided in response to an invitation to add any relevant information at the end of the questionnaire, illustrate this: Thank you for your consideration regarding elderly folk. We sometimes feel we are the forgotten generation. In general, there’s a lack of understanding and inclusive attitudes to the 65 plus within the overall population. [Addressed to local councillors] Look more to the needs of older people, and listen to them! Not enough recognition of the active retired. The focus is all on youth in our community. Consideration had been given at an early stage to widening the scope of the questionnaire to include other older people unconnected with the Network, such as older Travellers or residents of nursing homes, but this was not done, partly for reasons 90 Older people in Dun Laoghaire Rathdown: profile and needs of practicality and time constraints, and partly because a survey ‘of the Network, by the Network and for the Network’ was considered to have coherence and a greater validity on its own terms than one which included only a small number of older people outside it, and in different circumstances (which could be seen as tokenism). The findings below emerged from the analysis of the survey data. A copy of the complete survey questionnaire is included as Appendix 3 of the report. 4.3 Survey findings 1. The survey participants The demographic profile of the survey participants – all members of, or associated with, groups in the Network - is in some ways similar to, in others very different from, that of the general population of older people, either in Dún Laoghaire Rathdown or nationally. The details of this profile are the essential background against which the survey results need to be understood and interpreted. [National and local details quoted are the most recent CSO figures, usually Census 2006 and the associated Small Area Population Statistics, unless otherwise specified.] The first set of questions in the survey required participants to select from a list of options to indicate: their age, gender, place of residence (out of the 6 electoral areas of the county), age of completing full-time education, accommodation type, household type, occupation, and whether they used a computer. The results were as follows: Age: survey participants covered the whole over-55 age range, with the 70–84 year olds most strongly represented. 24% of participants were in their 60s, 40% in their 70s, and 27% in their 80s. The proportions in each age group differed somewhat from the 2006 county profile, with the largest differences at the lower and upper ends of the age range. This may suggest that (i) a relatively small number of 55-60 year-olds join older people’s groups and (ii) people over 80 are disproportionately likely to be members. Table 1: Age groups of survey participants % survey participants % in DLR 2006 55-59 5.2 23.4 60-64 9.3 20.4 65-69 14.4 17.4 70-74 18.9 14.3 75-79 21.6 11.4 80-84 20.6 7.4 85-90 6.9 5.7 90 + 2.4 ( inc. in 85+) Not stated 0.7 0.0 100 100 Age group Grand Total 91 Older people in Dun Laoghaire Rathdown: profile and needs Gender: three-quarters of all participants were women, mirroring proportions among active Network members in all groups, and the fact that there were four women-only groups participating. Women made up between 70% and 80% of all age groups of survey participants, except the over-90 group, which was all female. These results suggest that women of all age groups are more likely to be involved in groups for older people than are men, since (according to Census 2006) the proportions of men and women in most age groups in the county’s older population are very different: 56% of all over-55s in Dún Laoghaire Rathdown in 2006 were women, and 59% of all over 65s. However, in the oldest age-groups women predominated: almost 70% of all over-80s were women. Participants’ places of residence covered all the electoral divisions of the county, with the largest numbers of participants (35%) living in Dún Laoghaire itself, followed by Ballybrack (23%) Dundrum (14%), and Glencullen (10%) The smallest numbers were in Blackrock and Stillorgan (9% each approximately). Accommodation: most (82.5%) of survey participants were owner-occupiers, and 14% were council tenants. A small number (only 1.4%) were in private rented accommodation, and only one person stated ‘residential care’ as their accommodation. (Nationally, 5.5% of over 65s were in nursing homes or hospitals in 2006.) Figure 1: Survey participants and housing survey participants: accommodation (n=291) 1% 1% 0% 0% 1% owner-occupied 14% council rented private rented residential care hostel other not stated 83% Although numbers were too small to draw definite conclusions, it was noticeable that more women than men were council tenants (16% compared to 5%), and correspondingly less women were in owner-occupied homes (80% compared to 94%). 92 Older people in Dun Laoghaire Rathdown: profile and needs The overall owner-occupier figure for Network members is very close to the most recent national figure of 80%, although studies of the over-65s in Ireland suggest an even higher proportion may own their own homes. 38 Households: almost 50% of the survey participants lived alone, and almost everyone else lived with a spouse and/ or other family members. This does not reflect the proportions in the general population (where among the whole over-65 age group across the country, 27% lived alone in 2006), but it perhaps indicates that people living alone are more likely to become active members of groups and societies than are people living as a couple or in a family setting. Occupations: around 10% said they were employed/ looking for work; 75% were retired, 14% said ‘home duties’. Given the age range of survey participants, there is a reasonable match with the recent national position in which around 15% of the over 60 age group (mostly those under 70, and predominantly men) were still in some form of employment39. Education: almost a quarter of survey participants left full-time education by the age of 14, another quarter by age 16. Over one-third continued in full-time education to age 19, so presumably completed upper secondary level. 13% were in full-time education for longer, so are likely to be graduates. Figure 2: Survey participants - age of completing full-time education Age completing full-time education (n=291) 3% 4% 10% 23% All finishing at 12-14 All finishing at 15-16 All finishingat 17 -19 All finishingat 20- 24 All finishing at 25+ 35% 25% No age stated This profile confirms the fact that overall Dún Laoghaire Rathdown population has the highest overall educational achievement of all Irish counties. Census 2006 showed that 48% of over 65s nationally had only primary education, 16% lower secondary only, 18% had upper secondary (Leaving Certificate level) and 17% third level or higher. 38 39 Fahey T. et al, 2007: A Social Portrait of Older People in Ireland. Dublin: ESRI. ILO statistics for 2006, quoted in CSO Ageing in Ireland 2007 93 Older people in Dun Laoghaire Rathdown: profile and needs However it also shows that, among socially-engaged older people in the county, there is a substantial proportion (around 50% altogether) who did not obtain upper secondary education. There is a strong case for increasing the provision of ‘second chance’ education for this group, especially those with primary schooling only. Computer users numbered only 35% of all participants. There was a big gender divide, with only 29% of women, but 58% of men, saying they used a computer. There was a further divide among women, who were somewhat less likely to be computer users if they lived alone than if they lived with a spouse and/ or children. It may be of interest to note that nationally, in 2006, almost 25% of households with at least one person over 65 had an internet connection. As with educational attainment, Dún Laoghaire Rathdown levels of computer use (and ownership) across all age groups are likely to be somewhat higher than national averages. Even so, the fact that only around one-third of the survey participants (and less than 30% of the women participants) ‘use computers’ is significant, given the other survey findings in relation to obtaining information, to social interaction, and to activities for older people, as well as the growing requirement for people to access information electronically for a variety of practical ‘daily life’ purposes. It presents an opportunity to increase both the provision of age-appropriate (and perhaps gender-appropriate?) computer training and the availability of more easilyaccessed public computer facilities, as means of increasing social inclusion of older people. Figures 3a and 3b: Male and female survey participants’ computer use m en's com puter use (n=67) w om en's com puter use (n=218) 8% 2% 29% 40% 58% yes yes no no no answ er no answ er 63% 94 Older people in Dun Laoghaire Rathdown: profile and needs 2. The big issues Preparatory work by the Network committee had identified a number of issues of serious concern for older people locally. So in the next set of questions, an issue was named and participants were asked to state whether it was a major problem for them, a minor problem, or no problem at all. Combining the responses of those who rated it as a major problem with those who rated it as a minor problem produced striking results: o Safety on the streets was by far the most problematic issue for most people (67% of all participants rated it as a major or minor problem); o Around 50% of participants said they found (a) transport, (b) information on services and entitlements and (c) security in their homes all problematic to some extent; o 38% of people said that health services and access to them were problematic to some extent; o 35% rated age-related discrimination as problematic. Figure 4: What issues are most problematic for older people? (n=291) big issues for older people no answer no problem minor problem serious problem sa fe ty on th e st re et s tra ns po rt in fo rm se cu at io rit n y at ho he m al e th se rv ice s ag ei sm 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Further information on most of these issues was provided by survey participants in response to the following question in the survey, and as additional information at the end of the survey. Specific information on both transport and health problems was provided in response to questions about satisfaction or otherwise with available services. 95 Older people in Dun Laoghaire Rathdown: profile and needs 3. What one thing would you change to improve your life as an older person in Dún Laoghaire Rathdown? Two-thirds of the participants (197 people) responded to this open question. While a small number said emphatically that there was nothing they wished to change, most responses focused on improving daily life through relatively modest changes in the environment and in services. There was a definite consistency between the responses to the previous ‘big issues’ question and the topics most frequently mentioned. Of the various improvements suggested, transport matters – mostly better bus services, but also better and cheaper parking facilities – received 65 mentions, almost three times as many as the next most frequently cited issues, which were improved pedestrian safety on streets and roads (23 comments) and social life and activities (22). Other changes wished for included: easier and more reliable home maintenance, improved council services (footpaths, seating, libraries, waste collection) and more contact and support from local representatives. Other desirable changes listed included better local policing, improvements in health and social services (including information and access), changes in social attitudes to older people, and more contact with local representatives. The complete listing is being provided to the Network itself, but the following selection of comments give an indication of the range of contributions to this open question. [Note: other comments provided in response to Q.10 have been placed later in the report, to illustrate the findings in relation to specific survey questions.] Some points that were made illustrate issues of concern to many older people: I would like to stay in my own house and have home care and house improvements without long delay. I wish there would be a stronger community spirit and care for neighbours. For people to remember that everyone gets old…young people should be taught that and have respect for older people. Local representatives – when they were mentioned, it was to rebuke them for not paying sufficient attention to older people: To get some support from DLR, which is NIL at present! We would like Rathdown to meet us and hear our problems now and then. Council services were frequently mentioned: More seating needed around Main Street [not specified]. The village enhancement scheme for Cornelscourt to be completed and made more pedestrian friendly. Better services like cleaning roads, cleaning drainage…graffiti removed. Get Tesco trollies off our streets. 96 Older people in Dun Laoghaire Rathdown: profile and needs Information and access to it: Gettiing information on entitlements more easily…should be more userfriendly. More information on …insulating our homes, refuse collection especially…unwanted furniture. More information made available to residents about developments, especially in Dundrum area. Public transport – general comments and issues: Just a regular scheduled local bus service. A better bus service for those of us who do not drive to attend hospital. A shuttle to the Luas. Covered waiting stops. Specific problems with public transport –participants named around 20 different issues to do with specific bus services (or lack of them), including: A regular service from Dublin to Dalkey. We miss the no 8 very much. No bus to Dundrum from Goatstown, since 75 taken off – handy for church. A bus going through Cabinteely to Dún Laoghaire would be a great asset. To get the 7B to run once an hour every day of the week. 3 mentions of bus service needed for Loughlinstown Hospital. Access to transport: Old people need more accessible public transport. Better access to DART station. I would like to live nearer a bus route. Parking facilities in Dundrum and Windy Arbour (for Luas). Car parking – availability and cost: Spaces to park on…seafront. One can no longer walk the pier. Parking for older and less active people [in Dundrum area] is very scarce. Reduce parking fees, far too expensive for OAPs. Bray is 50c per hour! Safety – pedestrians dealing with roads and traffic; pedestrian lights: Enforce traffic and parking rules. It’s ‘any old place will do’ mentality – no regard for other road users or pedestrians. Improve road quality…I have poor eyesight and roads are dangerous Pedestrian lights on N11 where there are footbridges…Most elderly people cannot ‘do’ these bridges. More crossings on Ballinteer Avenue…to go to PO, shop, hardware, there should be another. 97 Older people in Dun Laoghaire Rathdown: profile and needs Safety – footpaths: Better surfaces on footpaths. Repair the footpaths! Policing: More bike and foot Garda patrols. Gardai patrolling streets when there are complaints about drunk youth gangs and drug youth gangs, to try to stop ths Do something about safety in the streets and vandalis Home security I would install a security camera to check before opening the doo.r Would like better security. Two cracked windows from stones thrown. Health and social care services – and access to them: More home visits (presumably from GPs). Access to a doctor in hospital – not students. I would like to feel that because of my age (85) I could press a button to inform social services that I had taken ill. More places to cater for the aged & infirm, local Alzheimer services. Daily life – shops and banks. Several comments on specific local problems: Have a bank in Glasthule. Re-open the shopping centre in Shankill A small supermarket in the old Dundrum shopping centre would be of tremendous benefit. Daily life – house and garden maintenance Reliable and reasonable workmen and women. If applying for help [it’s] all bureaucracy – get this signed here and there… Social life and activities for older people: I would like company! To have more people visiting me. Facilities for older people to meet more often and mix with younger generations Better activities and more social outings More services for active retired A register of interests so people with interests in common could get together…could be organised as a website … Better access to transport for senior citizens’ outings at lower cost 98 Older people in Dun Laoghaire Rathdown: profile and needs 4. Are older people’s voices being heard by local representatives? The expressed intention of the Network for Older People is to bring the concerns of older people to the attention of County Councillors and Council staff/ the Community Section. Yet it appears from the responses to the question, ‘are older people’s voices being heard by local representatives?’ that Network members overall were not convinced that older people are being listened to. Over 40% of the participants answered ‘no’, and only 17% gave a definite ‘yes’ in answer to this question, while the high proportion of ‘don’t know’s (35%) suggests that for many people, there is little evidence that their views and concerns are given enough weight by their elected representatives. Figure 5: Perceptions of local representatives’ responses to older people’s concerns Are local representatives listening? (n= 291) 4% 17% yes 35% no don't know no answ er 44% The views of some of those who answered ‘no’ might be summed up by one succinct comment provided as additional information at the end of the questionnaire form: Heard but not acted on! 5. The contributions of older people to community and society The Network committee considered it important to focus on older people’s active engagement with, and positive contributions to, their communities and the wider society. A series of questions sought to explore this in fairly general terms, and produced interesting findings, especially where these can be compared to recent national figures. Group membership: in addition to their membership of an older people’s group, over half of the participants (52%) were members of other groups and associations which were not specifically for older people; for some, this was central to their general satisfaction with life. 99 Older people in Dun Laoghaire Rathdown: profile and needs The following quotation, provided as additional information at the end of the survey, underlines the importance of local groups and networks in supporting their older members: Coming here after 35 years abroad…we have settled down happily in [part of DLR]…We have found here an impressive sense of community. People are genuinely friendly helpful and outgoing. Our membership of [name of church] parish community has been of particular value… Volunteering: more than half the participants (54%) were involved in volunteering activity (they were not asked to specify, but the question mentioned charities, sports groups church-based groups and community organisations). Interestingly, the men’s volunteering rate was higher at 60% than the women’s (51%). [Note: the questionnaire was concerned with the overall picture and perceptions, and avoided any hard and fast definition of ‘volunteering’, and any quantification in terms of time.] Overall, this was more than triple the rate indicated by Census 2006 data, which showed only around 15% of all over 65s engaged in one or more voluntary activities. Some of those surveyed were keen to do more, as these comments indicate: If I were more mobile, I’d do a lot more. 18 months waiting for an operation in Cappagh! I would like to make more of a contribution to community services (allowing for my age and circumstances). Unpaid care work: just over one fifth (22% or 64 individuals, fairly evenly divided between men and women) had ‘regular caring responsibilities for a family member, friend or neighbour’. For most of them, time demands are relatively light - 40% were caring ‘only occasionally’ and 20% for a few hours each week – but 11% devoted a few hours every day to their care work, while, surprisingly, 23% (15 people, of whom 13 were women) said they were ‘full-time’ carers. Figure 6: Time demands of participants’ caring responsibilities Time spent in care work (n=64) 5% 23% occasional care w ork 41% a few hours a w eek a few hours each day full-time caring no answ er 11% 20% 100 Older people in Dun Laoghaire Rathdown: profile and needs In the 2006 Census, only 3.9% of over-65s described themselves as carers. However almost half of those were effectively caring full-time (over 43 hours a week). Clearly this level of caring responsibility makes it difficult to be an active member of a local group. Voting: 94% of survey participants voted in the last national election. One or two of those who didn’t explained that they were in hospital at the time. The pilot phase had suggested that a small proportion of older people in the county are not Irish or UK nationals and so would not be eligible to vote. This voting record by Network members, as stated in the survey, exceeds the already impressive figure for eligible voters over 65 in the 2002 General Election, 86% of whom cast a vote. It is clearly seen as an important duty: I always do! Summary of findings relating to older people’s contributions to society These results of the survey of Network members show higher levels of volunteering, caring and voting than was the case for older Irish people generally in the most recent Census. It seems likely that active membership of an older people’s group will be closely associated, for a variety of reasons, with greater engagement with the local community and the wider society than is the norm across the whole older Irish population. 6. Needs and issues (i): Transport Car ownership and use: questions about car ownership in the household, and whether the survey participant drove the household car, produced the information that, while over 60% of participants (177) live in households with a car, just less than half (137) said they drove the car themselves. However, there was a gender dimension to this aspect of daily life: more men than women (87% of all men surveyed but only 54% of all women) lived in a household with a car, and twice as many men were drivers (79% of all men, compared to 38% of all women). Health/ disability and travel difficulties: one-quarter of all participants said they had a disability or health condition that made travelling difficult for them. This suggests particular problems for those dependent on public transport. Census 2006 found that almost 30% of people over 65 had a disability, with numbers increasing with age. Just over half had a chronic illness. One explanation for the somewhat different Network figures (in answer to a later question, almost 30% said they had a health problem or condition that interfered with daily life) is that they are based on an over-55 rather than an over-65 population. It is also likely that active members of older people’s groups have on average better health, and less disability, than the whole older population. 101 Older people in Dun Laoghaire Rathdown: profile and needs Types of transport used for local travel: asked to indicate all forms of transport normally used for local travel, three-quarters of those surveyed said they used buses for some or all of their travel, while 64% used cars. Luas and DART were each used by around 40% of all participants, while just over one quarter used taxis. There were very few minibus users (6% or just 17 people, probably for attending day centres) and even less were cyclists (3% or 10 people). A handful of people named walking as their ‘other’ form of transport, but the survey did not specifically seek information on getting around locally on foot. Getting out and about: most people (just over three-quarters) said they used more than one form of transport for local journeys on at least 2 or 3 days in the week (this included 40% who used transport on most days of the week). The other 25% who were dependent on one form of transport only were evenly divided between car-users and bus-users. Main form of transport: for almost 45% of participants, the car was their main form of transport, and for 37% it was the bus. There is a gender dimension here: the group of 107 people who use the bus as their main form of transport included just over 40% of all women participants, but just less than 20% of all the men. Travel purposes and needs: just over 80% of all participants used transport to get to hospital appointments, almost the same proportion used it to visit friends and family, while 68% used transport for shopping, and for other social and leisure needs. 57% used transport to see their GP, while 45% used transport to attend church. Less than 25% used transport for adult education or similar purposes. Figure 7: Purposes for which local transport was used percentages of all participants using transport for particular purposes (n=291) adult education etc. church GP 23 45 57 social and leisure activities 68 shopping 68 visiting friends and family hospital appointments 79 81 102 Older people in Dun Laoghaire Rathdown: profile and needs Satisfaction with available transport? There were contrasting experiences for different participants, linked to their own health, car ownership, and the public transport situation in their neighbourhoods. Around 60% of participants were happy or very happy, 20% were undecided, but almost 20% were unhappy or very unhappy, with the transport available to them. When giving reasons for dissatisfaction, most cited: inadequate and erratic bus services, or no services at all in certain areas, unhelpful drivers, long waits at cold bus stops, no buses to hospitals; The cost of taxis - pensioners who have to use taxis for lack of public transport found them too expensive; The difficulty of finding parking spaces, and the high cost – both were problems for older drivers in this survey. Several participants cited the same reasons for dissatisfaction, underlining the serious difficulties for some older people in relation to normal daily life and activities: ‘From where I live there is no public transport to church, library, hairdresser, Post Office, active retirement activities or the park’ ‘In order to me to access (1) my doctor (2) St Michael’s and St Vincent’s Hospitals (3) collect my pension (4) do my shopping and bring my food home (5) attend my church, I have to use and pay for a taxi and I worry about …expense of this on my pension’ ‘Local bus service very undependable. Buses don’t come on time. This entails long waits standing at bus stops. I find this…physically difficult and often painful’ ‘There are no buses in Ballally at all to go anywhere!’ ‘Bus not available to Loughlinstown Hospital. Only means to get to Luas is by car’ ‘I am waiting for a hip replacement. The bus drivers are very unhelpful’ ‘I get cold waiting for [the bus] and it is not a frequent route. Have to get taxis a lot, especially to go to St Vincent’s Hospital which is not on a bus route’ ‘I would love a seat and a bus shelter at every stop, also time of next bus arrival!’ ‘I could not go to day care centre unless I am collected and brought back two days a week. I use a taxi for all other daily needs’ ‘I can only drive short distances, not in rush hours or after dark. If unable to drive, taxis are too expensive and bad bus service’ ‘If I could not drive for any reason, I would be completely cut off, as I cannot walk any distance’ ‘[It’s] difficult to find parking at DART stations’ ‘I will not drive to Dún Laoghaire – lack of parking spaces’ ‘Parking is a major issue – no parking outside my GP service. Fees are very costly for pensioners. There should be one hour free parking for people shopping, attending weekly mass, visiting the library etc. This could be done with a ‘clock’…on the dashboard showing time of arrival’ 103 Older people in Dun Laoghaire Rathdown: profile and needs 7. Needs and issues (ii) Safety and security As with the ‘big issues’ earlier, participants were asked to state whether a particular aspect of life in their own neighbourhood was a major problem, a minor problem, or no problem at all. Combining the responses of those who rated each issue as a major problem with those who rated it as minor showed: o Footpaths were the biggest problem area; they were problematic to some degree for almost 75% of participants; o Vandalism was problematic for 65%, and anti-social behaviour for 58%; o Pedestrian crossings were a problem for 50%; o Street lighting and illegal drug use caused some problems to 40% of participants. Figure 8: Participants’ views on specific safety and security issues problems of safety and security (n=291) no answ er no problem minor problem serious problem fo ot pa th s va an n da ti s li s oc m ia lb pe eh de av st io ria ur n cr os si ng il le s ga ld ru g us st e re et li g ht in g 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% There were a considerable number of comments on footpaths in response to the earlier open question about changes to improve older people’s lives, including: Have the footpaths in [my area] properly repaired and maintained. In their present state they are a danger to the elderly and disabled. Streets roads and parks should be cleaned better and more often, especially of dog poo! Get rid of cobblestones on main streets. A lot of rubbish is left out on the streets – danger of tripping over it. Ban cyclists from the footpath…I am terrified I will be knocked to the ground. 104 Older people in Dun Laoghaire Rathdown: profile and needs Several of the suggestions for making life better for older people in Dún Laoghaire Rathdown and the additional comments provided at the end, referred to pedestrian safety more generally: Speeding cars in residential areas Improve road quality in [their area] I have poor eyesight and roads are dangerous Safety at road junctions Enforce parking rules…no regard for other road users or pedestrians There were very few mentions of vandalism in comments provided, but a number related to the implications of ‘anti-social behaviour’ for older people: The public park…needs better supervision, especially in summer time. Anti-social behaviour around the entrance in evenings, at weekend and in early hours of the morning. Social contact: More than half the participants (56%) said they met and talked with neighbours and/ or friends most days or every day of the week. However, for just over a quarter of participants (76 people), this contact took place on just one or two days each week, and for another 15%, direct contact with friends and/or neighbours was ‘occasional’. Figure 9: Face to face social contact during the week face to face social contact (n=291) never 2% 1% occasionally 15% 24% once or tw ice a w eek 26% 32% most days of the w eek every day of the w eek no answ er Contrary to expectations perhaps, there was little difference between men and women in relation to these social interactions; presumably because the men surveyed were already well ‘connected’ through their membership of a group or club. Among the comments relating to social life and social contact, provided as additional information at the end of the survey, or in answer to the question about changes to improve life for older people, were several about personal isolation and loneliness: 105 Older people in Dun Laoghaire Rathdown: profile and needs There is no social life for older people When your family live overseas, companionship can be an issue I would like more people visiting me But for my son I would be lost. He lives abroad. Others were more focused on increasing the availability of activities for older people and addressing the lack of places where older people can socialise with each other and with younger people: More access to activities at local level for older people, and easily accessible I’d like to see clubs set up for older people to meet and go walking and exercising together I would like a community centre for older people, a place that would be open every day of the week… to drop in and have a chat A meeting place for getting to know other like-minded people e.g. book club, dancing, exercise classes, film club etc. Better access to transport for senior citizens’ outings at lower cost. However, others expressed satisfaction with activities and contacts available to them: I enjoy being a member of Active Retirement Groups in my area – making friends and keeping fit. Thank you! Garda presence in the neighbourhood: participants were fairly evenly divided in relation to how satisfied they were with local policing. Almost 30% were unhappy or very unhappy with the level of Garda presence, 35% said they were happy, and a 34% were undecided, which suggests low levels of confidence overall in the Gardai as protectors of older people. Figure 10: Participant’s levels of satisfaction with Garda presence in the neighbourhood satisfaction with local policing (n=291) very unhappy 7% 2% 9% unhappy 20% 28% neither happy nor unhappy happy very happy 34% no answ er 106 Older people in Dun Laoghaire Rathdown: profile and needs Two of those who were unhappy commented, in relation to changes which would improve life: Just to feel safe and secure in my home. Safety at home is not good. I don’t feel safe. We need better Garda presence. Information on home security: 30% of participants said it was not easy to get information about home security measures, but just over 40% said it was easily obtained. 26% didn’t know (so possibly hadn’t tried to obtain it). It should be noted that, in answer to an earlier question (‘the big issues’) 50% had said that security at home was not a problem for them. 7. Needs and issues (iii): Financial matters Income adequacy: three-quarters of all those surveyed said their income at present was sufficient for their needs. However, this was not the case for just over 20% overall, slightly more than 1 in 5 of participants. However, there was a gender dimension: income inadequacy was the case for 25% of all participating women but only 12% of all participating men. Figures 11a and 11 b: Participants’ levels of income adequacy: men compared to women incom e adequacy: m en (n=67) 12% 0% yes no no answ er 88% incom e adequacy: w om en (n=218) 1% 25% yes no no answ er 74% 107 Older people in Dun Laoghaire Rathdown: profile and needs Women and low income: Although the numbers were small, some findings in relation to women and low income bear further examination. First, among the women who said their income was insufficient, the highest proportions were in the youngest and oldest age groups. Second, while only a small number of women (35, or just 3%) lived in council rented accommodation, almost half of this group said their income was inadequate, compared to just over one-fifth of women in owner-occupied accommodation. Third, putting inadequate income and age of leaving full-time education side by side showed that the highest proportion of women with inadequate income occurred in the group who had left school by age 14, a group which accounted for almost one quarter of all women in the survey. Just over 40% of them said their income was insufficient, compared to, for example, 17% of those who remained in education to age 18. Finally, there was no obvious connection for these participants between their household situation and income adequacy. Similar percentages of women living alone and women living with a spouse and/ or children (25% in both cases) said their income was insufficient. Information about financial entitlements: some people (around 13%) found it hard to obtain information about their financial entitlements, and around 20% of all participants said the information was hard to understand when they do obtain it. I live in [area of DLR]. I don’t know where to apply for…information or entitlements. I have [close relative with serious disability] living with me…I am sure we are entitled to fuel allowance but don’t know where to apply. Managing on the State pension: a number of additional comments provided at the end of the questionnaire reflect the difficulty of managing on a low income: I can live on Social Welfare pension but not much leeway for luxuries or emergencies 210 euros a week!! They also illuminated the information-related difficulties: Getting information regarding entitlements etc. more easily. Getting pushed from one person to another on the telephone if you have a query. It should be easier and more user-friendly. 108 Older people in Dun Laoghaire Rathdown: profile and needs 8. Needs and issues (iv): Health, and health and social care services Self-assessed health status: the majority of participants (60%) assessed their own health as ‘good’ or ‘excellent’, and only 8% said it was ‘poor’ or ‘bad’, with roughly equal proportions of men and women responding in this way. The others (30%) were non-committal. Health problems or conditions affecting daily life: there is an apparent contrast between these self-assessments of general health and the fact that almost 30% of all participants (with little difference between proportions of men and of women) went on to say that they had ‘a physical or mental health problem or condition that interferes with daily life’. The explanation may be that a significant number of older people live with an ongoing condition which they manage well; they may equally have adopted a stoical attitude to what they see as inevitable problems of older age. One example was the person who said their general health was ‘good’ then in commenting on the services available, explained how she attended at least three specialised clinics, all dealing with serious health conditions. Satisfaction with health and social care services: more than half the participants (54%) were happy or very happy with the health and social care services they use in the county, 12% are unhappy or very unhappy, but around one-third are undecided. Those who were unhappy with various aspects of services cited as problems: o o o o o long hospital waiting lists; the difficulty of obtaining information; poor attitudes of healthcare staff; lack of continuity of care; inadequate out of hours services (GPs); and the difficulty of contacting community nurses. Health information: Just over 20% said it was difficult to obtain information on health services. GPs received a very high rating, with 82% happy or very happy with their local GP service. Those who were unhappy mainly talked about issues of availability – especially at night or weekends – and having to wait too long for appointments. The comment of one person who was very happy with their GP suggests the qualities that most older people would seek from the service: We’ve had the same GP for 33 years – efficient, reliable, caring, available. 109 Older people in Dun Laoghaire Rathdown: profile and needs District/ community nursing service: A high proportion of participants (80%) were not users of the community/ district nursing service, although some would like to avail of it. (It is possible that some had used it in the past, but the question did not allow for this to be indicated.) Of the 50 or so survey participants who used it, three-quarters were happy with it. The general impression from the explanations of those who were not satisfied was that they regretted the unavailability of a universal service, with routine visits to all older people in their homes and a more regular follow-up after treatment: I would like it if they kept in touch as you get older Some people commented on the difficulty of making phone contact with the nurse: She’s not there when I ring, and she never gets back to me . 9. Additional comments More than a quarter of participants added extra comments at the end of the survey form. These covered a wide range of topics, but better public transport, and the need for more activities and meeting places/ spaces for older people, covered in earlier sections of this chapter, featured again very strongly. Among other responses to the invitation to provide additional comments were some expressing positive personal attitudes to older age: Every day is a new educator for me. I don’t consider myself old and never will! Overall, not bad! Some comments underlined the importance to older people of their personal support networks (and by implication, the problems faced by those without them): In general, I consider that older people are well looked after. I am fortunate in having a good family, neighbours and friends, all of whom look out for me, and on whom I can call if I need help. Another group of comments related to the increasing difficulty of maintaining house and garden as people age, and the problem of finding reliable and affordable help with these straightforward tasks: Being over 80 I find it difficult to look after my garden, get rid of grass cuttings etc. [I need] a maid and a gardener! A register of tried and recommended tradespeople…would be a godsend. There were several heart-felt comments on participants’ neighbourhoods, illustrating the importance of environment to a sense of well-being, perhaps especially for older people who may spend more time in their locality post-retirement. 110 Older people in Dun Laoghaire Rathdown: profile and needs Interestingly, one important finding of the SLAN 2009 report on mental health and social well-being is particularly relevant to the specific comments of survey participants from different parts of the county: Respondents in rural areas are more likely to report that poor public transport and lack of food shops area problem in their neighbourhood, whereas respondents in urban areas are more likely to report that rubbish lying around, vandalism, house break-ins, people drunk in public, graffiti and insults are a problem. Associations are also found between perceived neighbourhood problems and higher levels of psychological distress and lower levels of energy and vitality. SLAN report 2009, p.5 (italics mine) The gap between the experience of those for whom the immediate environment is a source of pleasure and satisfaction, and those for whom it is the opposite, can be illustrated by the following two contrasting quotations: As I live in Dalkey, close to the town, church and DART, all within walking distance, I am not a good judge of services generally. I regard it as one of the fortunate accidents of my life that I came to live here… The village of Dundrum is destroyed…all the extra cars and people…great sadness to see the change, and the dirt of the village…(2 individual comments combined) A summary: finally, one person summed up very clearly the comments of many of the participants, and the experiences they refer to, touching on some of the key components of well-being in older age: I think overall older people are relatively well served, providing they have adequate income and transport. Policies should focus on encouragement of more and better community involvement by all. -0–0–0- 111 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 5: Consultations with key informants For a different perspective on, and insights into, the situation of older people in the county, a series of consultations was held with key people in a number of different organisations and agencies providing services for older people in Dύn Laoghaire Rathdown. It should be borne in mind that only in the case of the County Council (and the Network for Older People, described in the previous chapter) does the geographical reach of services and activities coincide with the county boundaries. This was a relatively small and selective series of consultations, which did not expect to produce a comprehensive overview, but had the potential to provide important information and insights and to suggest directions for further investigation. As with the Network survey, this strand of the research did not engage directly with organisations specifically concerned with important – if numerically small – groups of older people in the county, such as older Travellers, those with Alzheimers, those with disabilities (including intellectual disability) and older people in residential care, although those consulted were well aware of these potentially vulnerable groups. This remains an important task for the future. Nevertheless the consultations have provided a great deal of potentially very useful data, informed by the professional knowledge and experience of those who were consulted, which should be valuable to those with responsibility for thinking and planning for the future of older people in Dύn Laoghaire Rathdown – who should clearly include the older people themselves! 5.1 Main themes and topics A ‘topic guide’ (included as Appendix 5) was agreed with the Partnership as a framework for these consultations, but was not rigidly adhered to. Within this framework, the discussions focused first on factual matters: the role of, and services provided by, each organisation in relation to older people, along with information about its ‘catchment area’, the organisation’s definition of ‘older people’ for the purpose of service provision, and any overarching goals or ‘mission statements’ relating to those services. Where possible, those consulted were asked for a broader view from their particular perspective of: the position of older people in the county; the positive achievements in service provision, and what seems to be going well; and any challenges and gaps the organisation or its representative had identified. More specific topics on which views were requested included older people’s information needs, and their contributions to their neighbourhoods and the wider community. All informants were asked to identify, from their perspective, the most disadvantaged or excluded older people. The final question was: what new services or programmes are needed to better support these and all older people in the county? 112 Older people in Dun Laoghaire Rathdown: profile and needs Some of these topics were similar to those highlighted in the survey of Network members (covered in Chapter 4), and where relevant, the views of the older people who participated in that survey are briefly referred to, alongside the information and views of the organisations consulted. 5.2 Organisations and agencies consulted Among statutory providers, the researchers met with staff of: Dún Laoghaire Rathdown County Council RAPID Programme for designated disadvantaged areas of DLR: Loughlinstown, Shanganagh and Rathsallagh Health Service Executive (Older People’s Services and Community Nursing) in Dún Laoghaire Local Health Office area (mostly within DLR County) and LHO Area 2 (large areas outside the county boundary) An Garda Siochana (Community Policing) Cabinteely district. Dún Laoghaire VEC (Community Education) – covers approximately the Eastern half of the county. Two voluntary organisations were consulted: The Irish Association of Older People (national, but with headquarters in Dún Laoghaire) St. Vincent de Paul Society, Monkstown Branch. Nine consultations in all were held with representatives from these bodies, and the results are contained in this chapter. Quotations in the text, unless identified as from written sources, are taken from these consultations. In addition, the Chair of the Network for Older People, and the DLR County Council staff member responsible for liaison with the Network, were interviewed about the Network itself. The information from those interviews has mostly been incorporated into Chapter 4. …/ over 113 Older people in Dun Laoghaire Rathdown: profile and needs 5.3 Findings from the consultations 5.3.1 Organisations’ roles, remits and services for older people DLR County Council: Community and Enterprise Department The role and remit of the Council’s Community and Enterprise Department is to work to the Implementation Plans of the County Development Board, in order to promote social inclusion. A specific task is to ‘help communities to identify their needs... come to terms with those needs, and having done so... to meet those needs.’ Services relevant to older people: Nine local Resource Centres, providing activities which generally include senior citizens’ groups, are supported in areas identified as disadvantaged. The Council operates a Community Grants Scheme, intended to assist community groups to address local issues.40 DLR County Council: Housing Department The role of the Housing Department is to provide social and affordable accommodation, and to administer the grant scheme for repairs. It also provides tenancy sustainment, supports and outreach, and housing welfare services. Services: there is a dedicated housing list for older people, and 850 units (out of a total of 4,000) aimed at older people. There are three social housing schemes with resident caretakers (Beaufort, Rochestown House and Kilbegnet). Some schemes have a mixture of households but most are for older people only. The Disabled Persons’ Grant Scheme is administered by the Housing Department and over 90% goes to older people with a disability related to ageing. The RAPID programme is a country-wide Government initiative, overseen by Pobal and supported by County Development Boards, which channels investment into specific disadvantaged areas in response to needs. There is one RAPID programme in Dún Laoghaire-Rathdown County, which focuses on Loughlinstown and Shanganagh / Rathsallagh (there are more older people in the latter). Services include: putting in place a community transport initiative (for all residents); establishment of ‘Over 50s’ clubs for social interaction and retirement preparation; and developing an ‘Ageing with Confidence’ programme. Men’s groups and activities for older men are being planned. Recent capital projects responding to older people’s needs have included: equipment for an Over-50s club in Loughlinstown; kitchen refurbishment of Shankill Old Folks’ Centre, which provides Meals on Wheels; a day room for older people in Shanganagh Park House (community centre). 40 http://www.dlrcoco.ie/CCDA/community/ComGrantsIntro.htm 114 Older people in Dun Laoghaire Rathdown: profile and needs HSE Services for Older People are provided through local Health Offices, under the auspices of the Primary, Community and Continuing Care pillar of the HSE. These are community-based services, as opposed to acute hospital services. Services for older people include: Provision of public, and supervision of private, residential care (moving to HIQA, the Health Information and Quality Authority); Provision of Home Help and home care attendants; Administration of home care support grants and home care ‘packages’; Day care – services provided in a variety of settings; Community-based chiropody, physiotherapy, occupational therapy, and nursing services; Supporting Meals on Wheels services (mostly working with voluntary organisations). These services are provided following referral from a GP or public health nurse, and appropriate assessment of need. The Manager of Older People’s Services in Dún Laoghaire chairs the Service Providers’ Forum, which in 2007 produced a conference report, Healthy Ageing: a Challenge for the County41 An Garda Siochana’s role is to ensure a safe and secure society for all, and they provide community policing services in the county. Through day-to-day contact, the community Gardai try to get to know older people in their areas, and there is regular contact with older people’s organisations and clubs, especially Active Retirement groups. Community Gardai sit on the Older People’s Service Providers Forum, chaired by the HSE. Services: the Community Gardai work with Neighbourhood Watch on the distribution of pendant security alarms. Talks are given to older people’s organisations on safety and security, covering the issue of elder abuse among other topics (through the ‘Get Wise’ programme). At the request of the HSE, Community Gardai may be directly involved in cases of alleged elder abuse. Support is also provided to older people who are victims of crime, in addition to the investigation of the crime itself. Assistance is provided in individual cases, in collaboration with the HSE, Lions Club, St Vincent de Paul Society and others, including ‘Living Links’ counselling service. The remit of the VEC’s Community Education service is part of the overall Adult Education service, and grew out of the commitments to disadvantaged groups, including ‘the elderly’, in the White Paper Learning for Life (2000) which focused on strengthening communities and specified developing older people’s IT skills. It operates on the basis of ‘meet[ing] the expressed needs of local community groups in relation to education and training’. 41 The researchers have been unable to access a copy of the report. 115 Older people in Dun Laoghaire Rathdown: profile and needs Services: tutors are provided to community-based groups including older people’s groups wishing to run non-accredited courses and training. Priority is given to beginners’ courses in IT skills, alongside another course such as art, a language, etc. and the funding is normally provided for two 10-week courses. A very successful Internet Café for seniors was run as a summer project in 2008 and it is hoped to repeat this in future. The VEC is collaborating with Southside Partnership on pre-retirement courses, in the context of the current County Development Board Plan. Adult Literacy and Adult Guidance services are available to all adult learners, and in Dún Laoghaire this includes many older learners. The Irish Association of Older People is a national voluntary body, with headquarters in Dún Laoghaire, and no paid staff. Its membership is open to all who consider themselves ‘older’ and it ‘advocates and supports active participation of older people in social, economic, cultural and spiritual life at local, national and European level’42 Services: the organisation is not a service provider, but aims to be a forum for older people to engage in debate and take action, and a strong voice influencing decisionmaking about services (‘we make submissions all the time!’). It has been invited to represent older people at a variety of national and EU forums and planning bodies, and is consulted by government for its expertise. The Association provides information to older people on practical matters, policy developments etc. through its quarterly magazine, Getting On, and it undertakes relevant research. A member of the organisation offers training to local older people’s groups in the selfmanagement of chronic conditions. The Society of St. Vincent de Paul (SVP) is a non-profit organisation providing services to those in need – whatever their age and circumstances - through person-toperson contact. While financial and practical assistance may often be provided, there is an emphasis on helping people to help themselves by building up their self-esteem and coping skills. The Society operates in small parish-based groups, called ‘Conferences’, whose work focuses on visiting and assisting local people who approach them for help. In terms of local services, affordable holidays are arranged by the Society for older people, and special grants may be provided at Christmas to help with the cost of gifts and providing a meal for family members, which can be important for self-respect. At present, very few older people are receiving ongoing financial assistance from this Conference, but ‘moral support’ and friendship to older people coping with difficult circumstances have been provided in a small number of instances. 42 www.olderpeople.ie/whatwedo.htm 116 Older people in Dun Laoghaire Rathdown: profile and needs 5.3.2 Definitions of ‘older people’ It is striking that, among the organisations consulted for this research project, there is no commonly-agreed definition of what constitutes the ‘older’ age group. The HSE’s services for older people are provided and administered, and budgets are allocated, on the basis of the 65+ age group. For the Gardai, the ‘older’ age group normally begins at age 65, except in cases of specific vulnerability. In relation to housing, County Council regulations on sheltered and supported housing for older people currently use the lower age limit of age 60, though consideration is being given to reducing this to age 55. For RAPID purposes, people are considered to be in the ‘older’ age bracket on reaching age 50, and the Programme has particularly supported ‘Over 50s’ groups in a number of neighbourhoods, to promote social inclusion and good retirement planning. The VEC Community Education service has no specific definition of its own. Working with older people’s groups and with day care centres, they accept the definitions operating in those contexts. Membership of the Irish Association of Older People (like the majority of nongovernmental and non-profit organisations in the field) is open to all who consider themselves to be older. The society of St. Vincent de Paul does not have any age-related criteria for its services and support. There is a variety of membership criteria among the groups in the Network for Older People in Dún Laoghaire Rathdown: some are for ‘over 50s’ or ‘over 55s’; Active Retirement groups focus on the person’s retired status; ‘Old Folks’ are self-defined; while a group based on a specific activity and meeting during the daytime (such as the Indoor Bowling Group) will find that most of its members are both retired and ‘older’. This wide range of definitions is a useful reminder of the sheer diversity of the large sector of the population labelled as ‘older people’, who cannot be reduced to a set of common characteristics, or made to fit neatly into any one set of administrative categories. 5.3.3 Aims of the organisations and agencies consulted All those consulted were asked to state the main aims of their organisation and its services, and their responses indicated somewhat different views and visions of the older population, related to the organisation’s particular remit. Not all of them have a focus on the older population per se, but deliver their services to older people as well as to younger people. This suggests one major advantage of developing a new National Positive Ageing Strategy, and a vision of Ireland as a good country to grow old in, with specific and achievable aims in relation to the older population and based on up to date research and information about different cohorts of older people. 117 Older people in Dun Laoghaire Rathdown: profile and needs A clearly-articulated national Strategy would be a strong framework to guide thinking and planning at local and organisational level, and could ensure not just enhanced practical cooperation, but a stronger alignment of the work of the different statutory and voluntary bodies concerned with older people. The Irish Association of Older People provided what was probably the strongest statement of aims: its positive conviction that ‘the life journey should be life-enhancing’ and so the organisation’s role in ‘supporting positive ageing’ is to ‘inform, empower and enable!’ all older people. This includes the most vulnerable, for whom others must speak and act when they cannot do so themselves. The County Council’s emphasis is on social inclusion and, in relation to older people, ensuring that people do not become marginalised because of their older age. The overall aim of the RAPID Programme is ‘to improve quality of life for the residents of these communities…through targeting government investment and improving the coordination of existing services, mainly among County Development Board members’43 Older people are not specifically named as a target group but one of the aims of the current five-year RAPID plan is to ‘develop a range of programmes of support which encourage older people’s participation’. The current commitment of the Dún Laoghaire VEC is to ‘a quality lifelong education service that is…responsive to social economic and demographic trends and needs’.44 In community education, the aim is ‘to meet the expressed needs of the local community groups in relation to education and training’. One of the main goals stated in the current Education Plan is to ensure that ‘all programmes and services are accessible and socially inclusive’45, and ‘older people’ are named, along with ‘disadvantaged women’, people with disabilities, Travellers and others, among those groups it has prioritised in its community education work. The Gardai work to ‘ensure security’ of older people, including ‘crime prevention, safety and the protection of life and property’. A new National Model of Community Policing was launched in January 2009, with the aim of contributing to a safe and secure society, based on core values, including Respect for people and their needs Promoting human rights Being a courteous and caring public service Maintaining partnerships with the community Promoting and accepting diversity in all its forms.46 One of the objectives outlined in the new Strategy is ‘to engage in a communityfocused approach to provide solutions that reduce the fear of crime’. 43 http://www.dlrcoco.ie/COMM_ENT/index.html Dún Laoghaire VEC 2006. A vision for Lifelong Learning: Education Plan 2006-2010,p. viii. 45 Ibid, p.37 46http://www.garda.ie/Documents/User/National%20Model%20of%20Community%20Policing% 20-%20Jan%2026th%202009.pdf 44 118 Older people in Dun Laoghaire Rathdown: profile and needs The HSE’s overarching objective is: ‘to provide services that improve, promote and protect the health and welfare of the public’.47 Services for older people aim to ‘ensure independence and quality of life…by maintaining them in their own homes for as long as possible’.48 As stated in consultations, this also means ‘to empower and enable older people to maintain and support the best quality of health’, and there is a new emphasis on health services working in partnership with individuals and their families. 5.3.4 Similarities and differences between the situation for older people in Dún Laoghaire Rathdown and in the country generally The comments here echoed the findings of the demographic research (Chapter 3). It was well recognised by those consulted that Dún Laoghaire Rathdown has an untypical population profile: ‘the sheer size of the older population is a challenge’ said one service provider. There is a larger older population here than elsewhere, and a significant proportion of them are more educated and more affluent than averages elsewhere. Most of them, especially in the 60-70 age group, are healthy and active, and require little by way of health and social care services. (It was mentioned that at any given time 85% of older people are fit and well across the whole country, and this is certainly true of Dún Laoghaire Rathdown.) However, those working ‘on the ground’ are well aware of disadvantaged areas, scattered among the better-off neighbourhoods, and of the hidden disadvantage and exclusion of individual older people, for example in private rented accommodation. They are also aware of numbers of older people who left school with only primary or lower secondary education, and those in poor health including those needing long-term care in their own homes or in residential settings. More than one commentator pointed out how the county’s general affluence, allied to poor spatial and transport planning and low provision of social and affordable housing, has had a negative impact on many older people. Many families became geographically separated as younger people forming their own households had to move away to find accommodation, leaving whole areas populated predominantly by older people, cut off from close contact and support of younger family members. Alongside this, relatively well-off older people from elsewhere have chosen to move in to desirable areas of the county, particularly along the coast. These population shifts may have reduced the levels of traditional ‘neighbourliness’, which provided an informal safety net for older people in the past. Another side effect noted was that the county’s perceived economic well-being may have hindered the development of some public services: a comparison was made between provision of residential care in Dún Laoghaire Rathdown and in Dublin City. It has also made it difficult to recruit and retain young professional staff. 47 48 Headline on website www.hse.ie HSE Annual Report 2008, p. 18 119 Older people in Dun Laoghaire Rathdown: profile and needs It was noted that the county is distinctive in relation to its traditional voting patterns. Overall, its voters tend to support more liberal policies and positions, especially on matters of personal morality etc. Some commentators felt that the county offers a much greater range of opportunities to people as they age than do many other places. Transport links, compared to predominantly rural areas elsewhere, were felt by some of those consulted to be relatively good (at least on routes linking to Dublin city centre). In general, those consulted were well aware of the extremely varied levels of well-being of older people in the county: while some of them experience all the benefits of active and financially secure old age in locations that have a great deal to offer, others remain economically and socially marginalised and live in very poor conditions. The outcomes of the Network survey illustrated this range of experience very clearly. 5.3.5 Older people’s participation in decision-making ‘Nothing about us without us’ is the slogan adopted by the Older and Bolder campaign – a grouping of the major non-governmental organisations for older people pressing for a comprehensive new national strategy on positive ageing, encompassing all aspects of older people’s lives, and following international best practice. It seemed important for this project to ask the various service providers about current practice and future plans in relation to the involvement of older people in planning and in decision-making. The organisation with the greatest level of participation was the Irish Association of Older people, where older people lead the organisation and make up its membership. As a national organisation, however, it lobbies at national and international level, so it is not normally involved in planning or delivering services in a local context. Listening to older people: in general the statutory providers are extremely willing to make existing services responsive to the expressed needs of older people locally, and to engage in outreach (‘to go out and ask’) but have not yet devised ways to involve them systematically at a prior stage in the planning and designing of services themselves, or in prioritising the use of resources for the benefit of the older population, sometimes because of sheer lack of resources to do so. However, they do generally recognise the principle that ‘we must have the voice of older people’. Many of the service providers sit on the County’s Service Providers’ Forum (older people’s services), with Committee members from the Network for Older People, so some contact and listening takes place between statutory agencies and the Network. The Network itself was set up a few years ago by the DLR County Council to provide a link and channel of communication for its officials and Councillors with a variety of groups across the county, and it is also represented on the Community and Voluntary Forum. Thinking about representation: these arrangements may represent the start of a process of developing stronger forms of consultation. However, the majority of groups in the Network are Active Retirement groups, while others are based in day care centres, or focus on a specific shared leisure, cultural or sporting interest. 120 Older people in Dun Laoghaire Rathdown: profile and needs Such groups may or may not have internal mechanisms which can be used for consulting members on broader matters of policy and provision of services for the older population, but it cannot be said that there is a system in place for thorough-going consultation of all those who participate in the Network. Even more clearly, no strategies have yet been proposed for involving the majority of older people in the county, who do not belong to groups included in the Network, or indeed to any organised older people’s group, in such consultations on matters which vitally affect them. The survey of Network members included a question relating to representation, and it was noteworthy that the majority of those participating, despite their involvement in their own groups and in the Network, were unconvinced from their personal experience that older people’s voices were being heard by local representatives. There is a good deal of work to be done here if older people’s voices are to be as representative as possible and to be fully heard and acted on. Some of it has to be at local and ‘grass-roots’ level, where more than one contributor commented that older people often need to be encouraged to get involved in running community centres or residents’ associations; they often exclude themselves through a kind of internalised ageism, which undervalues the contribution they can make. 5.3.6 Older people’s contributions to their communities and to society This topic was not discussed with all those consulted, but when it was, one of the main themes was the enormous value of the voluntary contributions made by older people in a variety of contexts across the county. The following specific points were made: o Volunteers in charity shops are almost all older people (mainly older women); o In their immediate neighbourhoods, many older people are to be found running residents’ associations (often the same people who were involved in setting up playgroups at an earlier stage in their lives!) and Neighbourhood Watch; o Most of the active members of Lion’s Clubs and St Vincent de Paul Society are older people; o Older people have been involved in the Dún Laoghaire Refugee Project (this was probably the only mention of immigrants/ minority ethnic people during the consultations); o Church-based activities are frequently dependent on older people’s contribution of time and energy; o Active Retirement Associations and the Older People’s Network are other examples of positive contributions. o A high level of volunteering among older people in the county was also indicated by the findings of the Network survey. 121 Older people in Dun Laoghaire Rathdown: profile and needs Grandparents’ often substantial role in caring for or ‘minding’ their grandchildren is seen by several contributors as a feature of more families’ lives, now that mothers as well as fathers are likely to be in paid employment – and it can be made more difficult and tiring for older people because of the ‘spatial separation’ of families in the county. One contributor mentioned a special case of grandparents who are now foster carers for their grandchildren, and another the need for grandparents in similar situations to act as role models for children whose parents are in serious difficulties. It was noteworthy, though, that, otherwise, very few service providers consulted spoke of the wider unpaid caring roles that many older people have for a spouse or child, or sometimes for a friend or neighbour (one in five of survey participants) and of the support needs of those undertaking extensive caring work. A number of those consulted stressed that there is an important role for healthy and active older people, as advocates on behalf of other older people who are not in a position to speak up for themselves. This role should be developed and supported. Finally, one contributor felt strongly that older people’s ‘experience and wisdom’ were important untapped resources which have the potential to benefit the whole community. To adequately utilise their experience and wisdom, ageist attitudes in the wider community – and sometimes in older people themselves – have to be addressed. 5.3.7 Provision for older people overall – positive developments Service providers were asked simply: ‘what’s going well?’ in relation to provision of services for older people, and in general each responded with comments on the positive developments in their own services. Progress noted by more than one contributor included the fact that there is a much wider range of services and supports for the older population than previously. More than one also mentioned the increased communication and cooperation between agencies, achieved through the work of the Service Providers’ Forum, as a very beneficial development. The fact that older people are living longer, healthier lives, and that 85% of older people in the county, as indeed nation-wide, are generally fit and well, are positive achievements in themselves. Other positive developments at local level that were mentioned included: o The impact of home care packages, which are working well and succeeding in supporting people at home rather than in hospital; o Older people are taking more responsibility for their own health and care, and the ‘younger old’ are more likely to ask for what they need, and not to leave decision-making which affects their lives to the health professionals; o Some feel that provision of social housing is going well (though others had reservations about policies which can segregate older people from the rest of society); o Community policing methods are helping the Gardai ‘get out there’, and training of Gardai for work with older people is proceeding well; 122 Older people in Dun Laoghaire Rathdown: profile and needs o The Network for Older People is up and running and has good potential. The success of other, more local, social networks was also mentioned; o Older people have begun taking a stand and to articulate their wishes more forcefully and publicly, as the demonstrations about the over-70 medical card scheme in 2008 showed. 5.3.8 Services for older people overall – challenges and gaps Challenges and gaps mentioned were frequently concerned with health and social care services, and corresponded to much of what was said by individual older people participating in the Network survey. Those identified by the organisations and agencies consulted included: o Lack of resources generally, especially in relation to health and social support services, is a serious issue. Home care packages are an example of slow or delayed implementation of plans and infrastructure which are good in themselves and could produce major benefits for older people. o Poor coordination of services across different agencies, or weak coordination of different services within the same agency, was mentioned more than once. o Age awareness training is needed for staff of services who work with older people, for a fully professional service to be delivered. o It is essential for all those concerned with policy and provision of services for the older population to develop and act on a fully-informed awareness of its diversity. Different generations have different characteristics and needs, but the tendency of planners and service providers has often been to project the needs of earlier generations (such as those people who are in their eighties now) onto those 20 years younger who are retiring now, and whose life experience and expectations are very different. o For a number of those consulted, the difficulty of making contact with older people who are not linked into a recognised group is an ongoing challenge. o There is uneven service provision across different areas of the county. For example there is no day care centre across the whole Stepaside – Sandyford – Dundrum area. (Possibly this arises from a mistaken assumption that the older age groups are all concentrated on the east side of the county.) o Again, there is no sheltered/ supported housing for older people in the whole densely-populated Dundrum area. o The need for respite care across the county exceeds its availability. o In relation to elder abuse, three issues were highlighted: One is the lack of legislation to underpin the provision of services by statutory agencies; 123 Older people in Dun Laoghaire Rathdown: profile and needs The second is the uneven availability of specialist staff. In the LHOs which cover the county, the approach to the issue of elder abuse is to appoint specialist social workers to each primary care team. However, specialist care teams have yet to be appointed, and so there is currently a lack of these key professionals; The third is the reluctance of older people in this situation, or their concerned friends and relatives, to report the problem, and if necessary press charges. o A new group of people in need are the ageing members of religious orders. Many of them used to work in service provision, but may now need services and support themselves. o Loneliness is increasingly recognised as an issue that calls for a greater response from services. o There is a marked lack of suitable housing for older people to move into in their own communities, and this is considered to be a legacy of short-sighted planning in the past. Separating older people from the rest of society by allocating them to housing complexes intended only for older people can be a major cause of isolation and distress. o When older people do move to special accommodation such as sheltered housing, there are no services to support them in the transition, or in settling in and making connections in their new locality and community. o Many agencies are faced with a major challenge in the form of the combination of urban and rural areas in the county. o Reduced levels of volunteering, from one contributor’s perspective, have created difficulties in ‘traditional’ areas such as drivers for Meals on Wheels, and assistance in Day Care Centres, which are funded by statutory services but often depend for day-to-day operations on unpaid volunteer staff.49 o Some of those consulted were concerned of the effect of the withdrawal of the medical card from some people over 70, in terms of their ‘health behaviour’ and the possibility that they will neglect minor health problems which may then develop into more serious conditions. Some of these comments chimed with what the older people participating in the Network survey indicated, especially in relation to ageism, the weak coordination among services, and the problems of loneliness. 49 In contrast, recent correspondence with staff of the Dún Laoghaire Rathdown Volunteer Centre indicates a current over-supply of volunteers in relation to work available for them. It may be a matter of the nature of the work itself in some instances? 124 Older people in Dun Laoghaire Rathdown: profile and needs 5.3.9 Older people’s information needs Information, in the words of one contributor, is about ‘connecting people with services’. Those consulted were often very aware that, despite their best efforts, the needs of older people for information which could enable them to make positive improvements in their own lives – on entitlements, health and social care services, education/ training and leisure opportunities, home security etc. – are not always adequately met. (The findings of the Network survey certainly underlined this.) Word of mouth, especially among active members of older people’s groups, seemed to some commentators to be the most effective way of disseminating knowledge of new entitlements and services, for instance in relation to home security grants, though it was acknowledged that not all older people can be reached in this way. Even so, well--advertised information-provision meetings based in older people’s groups may not be well-attended, and service providers may be reluctant to commit resources to them. Person-to-person information-giving is important in another setting: community nurses continue to be a vital source of reliable and person-centred information about health services and entitlements etc. for those they visit, and for their families. However, another commentator pointed out that, because there are no routine visits by public health/ community nurses to all those over a certain age, some individuals who need health and social supports but do not actively seek them (for whatever reason) may go without services that could improve their quality of life. Distributing printed information, such as the forthcoming Directory of Services and Activities for older people in the county, via established groups, health centres, libraries and other points where people use services, is frequently seen as an effective strategy, but is not guaranteed to reach ‘hard to contact’ older people. There were differing views on the effectiveness of the ‘Directory’ model for delivering information. Because ‘the goal posts keep changing’ in relation to health and social care services especially, it is difficult for any information sources to keep up to date, but this is particularly true of printed documents. In relation to Citizens Information Centres as a source of information, one informant felt that, while the information is certainly available in the Centres, volunteers delivering it sometimes lack communication skills and wider understanding of older people’s issues. Their information-giving skills need to be strengthened if older clients are not to experience frustration. Local Health Centres, which might be a focal point for information, may not be easily accessible to older people with impaired mobility. A conspicuous example is the recent move of the Dundrum Health Centre away from its original central point, at ground level in the old ‘village’, into a relatively high rise building above the Ballally Luas station, a location which requires pedestrians to cross a series of extremely busy roads. Accessing information by phone may cause frustration to older people because of the range of different officials they need to speak to in order to obtain information on health and social care services, and because of the difficulties of automated telephone systems. A ‘customer services’ model or ‘one-stop shop’ for telephone enquiries was proposed as a solution by one of those consulted. 125 Older people in Dun Laoghaire Rathdown: profile and needs There seems to be a particular difficulty in communicating information about education and training opportunities for older people to some of those who could benefit from them. (There may be a connection here with the relatively low proportion of those participating in the Network survey who appeared to be involved in adult/ community education.) Accessing the information they need is difficult for the many older people who do not have computer literacy or easy access to the internet. There is a clear case for expanding age-friendly provision of IT training in the county by a variety of means. (Figures from the Network survey showed only just over a third of those otherwise ‘connected’ older people used computers.) Since access to clear and reliable information, and ease of understanding information once obtained, were also identified as problem areas by a significant minority of the Network’s survey participants, it will be important to explore through research just how older people (and different groups of older people) access and acquire information at present, and then use those pathways for effective dissemination – and perhaps also to encourage them to consider greater IT take-up. 5.3.10 Identifying disadvantaged and excluded older people As with the age group question, there was no common, shared, sense of what factors are most relevant to a definition of ‘marginalised/ excluded/ deprived/ disadvantaged/ vulnerable/ at risk’ older people. Different dimensions - whether economic, health/ ability-related, security-related or otherwise – tended to be seen as most significant from different organisational standpoints. (In the consultations, the researchers deliberately used the terms interchangeably, to try to get beyond organisations’ own terminology and conceptual frameworks where possible.) However, while there was clear concern that some categories of older people were not availing of services that are in place and could improve their quality of life, perhaps the main theme emerging was that of the risks and corrosive effects of social isolation where individuals lack supportive family and social networks and are not linked in to existing systems of monitoring and care. The following groups or categories of older people were specifically indicated by one or more of those consulted. In all cases, people in these categories are hard to identify and reach, and the development of appropriate supports and services is likely to be challenging. o Older men as a group were identified as being at particular risk of isolation and exclusion by the RAPID Coordinator and that of the VEC Community Education organiser. There is a particular concern about men in their fifties and early sixties who have or will become redundant in the current economic downturn, and who may face a retirement they have not yet planned for, psychologically or financially. 126 Older people in Dun Laoghaire Rathdown: profile and needs o Older people living in private rented accommodation may be marginalised and are often ‘hard to reach’. They are much less likely to be linked into services or to receive relevant information on entitlements etc. than council tenants are. There are concerns for this group of private tenants as they age: if the house or apartment becomes dilapidated, a landlord may fail to maintain it properly, putting the physical and possibly mental health of the older tenant at risk. There may also be problems with the physical layout of accommodation, such as steep staircases, as people age. o Also identified were those in local authority housing who need sheltered/ supported accommodation but for whom it is not available because of the extremely short supply, especially in the west of the county. o Older people with disabilities and serious chronic conditions have special needs, and were considered a vulnerable group, or set of groups, at risk of exclusion and disadvantage. They included: (1) Older people with long term intellectual disability – a group of older residents in St John of God’s hospital/ care home in Stillorgan was cited; (2) Older people with any form of physical disability, a particular concern for the RAPID programme; (3) Older people with Alzheimers were mentioned more than once as a particularly vulnerable group, likely to be excluded from community life; (4)The Irish Association of Older People takes the view that it is the responsibility of the more able older people to stand up for the rights of the less able, and to speak for those who cannot speak for themselves. The ‘voiceless’, according to the Association, include those with Alzheimers, and ‘the frail elderly’ in care homes. o Those experiencing elder abuse were considered to be particularly vulnerable and at risk of exclusion. o There are strong indications of a category referred to by one informant as ‘the unlabelled excluded’, who are a particular concern in a largely affluent area such as Dún Laoghaire Rathdown. These may be people from middle-class backgrounds who find themselves isolated in older age, often living alone in houses too big for them to manage, and too expensive to maintain and heat on a restricted income. Such older people may be ‘invisible’ to current services because they are scattered around the more affluent areas of the county, have few family members, friends or helpful neighbours close by, are ‘asset-rich but cash-poor’, and often assume that no support is available to them, or are too proud to seek it. 127 Older people in Dun Laoghaire Rathdown: profile and needs As one contributor said, ‘it can be harder to fall through the net in an affluent neighbourhood’, where support services are not active, and where local social networks may be weaker. Another aspect of the experience of this category of older people is their tendency to attend a day care centre strictly for a purpose such as chiropody, but not to socialise with others using the centre. It was noted by more than one contributor that, because of the history of many such centres – ‘for the poor’ there can be a social stigma attached to attending one. o The Gardai identified: ‘those who are not “joiners”’ as more likely to be vulnerable and at risk of exclusion – especially since their information services aimed at increasing older people’s security and safety are delivered through existing groups and networks. o A linked category may be those with ‘poor coping skills’ – such as recently widowed older women whose spouses had been solely responsible for a range of practical and financial matters for the household. o Unmarried ‘older old’ people: it was pointed out that the marriage rate for the generation now over 80 was ‘the lowest ever’ in the history of the state, so members of this older age group have a higher chance of moving into extreme old age alone than will subsequent cohorts. 5.3.11 Suggested new services for the disadvantaged/ excluded, and for older people in the county as a whole A wide range of suggestions were put forward by those consulted, including recommendations on the principles which should underpin the development of new services: o Stronger and more wide-reaching forms of ongoing consultation with older people were recommended, in order to develop services and supports that accurately reflect their needs and wishes. o The voice of older people needs to be strengthened at local as at national level, and any reluctance to speak out in support of their right to positive ageing overcome. o The sheer diversity of the older population, across its whole 30 – 40 year age range, must be acknowledged, and there needs to be an emphasis on the appropriateness of all services provided, and activities offered, to different categories of older people. In other words, person-centredness is key. 128 Older people in Dun Laoghaire Rathdown: profile and needs Housing, transport and health/ social care strategies and actions: o Planning at county level should focus on the need for strong communities and family/ social networks to support older people – these are greatly affected by housing and transport policies. o A rethinking of policy on the provision of social housing for older people is urgently required, to promote continuity and social inclusion. o Since some forms of ‘care’ can have the effect of separating people from their friends and neighbourhoods, new models of residential care must be developed and put in place which do not ‘ghettoise’ older people, and create an environment lacking in stimulus, in which an individual’s independence and levels of activity can seriously decline. The new ‘Household/ Teaghlach’ model in West Cork and in Dundalk is pioneering this approach. o In terms of health and social services, good ‘ageing in place’ strategies need to be developed and implemented. Most older people greatly prefer to stay at home as long as feasible, and there is strong economic logic to this strategy. Overcoming isolation, creating opportunities for learning and personal growth: Since social isolation and the accompanying sense of loneliness are major factors in the deterioration of mental and physical health in older age, a range of measures to overcome isolation are extremely important. Specific suggestions arising in the consultations included: o ‘Retirement planning for all’ which could be a valuable preventative measure and support continued social inclusion as people move into older age. o A phone-call system (‘Good morning Dún Laoghaire Rathdown!’) for personto-person support should be put in place. The new service based in Bray, could be extended or emulated. o Low-cost ways of getting older people together around shared interests or through special value regular lunches in pubs and restaurants, marketed specifically to older people (this is very successful in older communities in the US) were also recommended. This, and lunch clubs for older people, were suggested as better alternatives to Meals on Wheels for many people. o Some contributors stressed the importance of integrating services for those with disability into general services for older people, to avoid artificial separation of those with disability, who need the support of and interaction with their peers. The ‘Active Minds’ programme based in Dún Laoghaire, was commended in this regard. o New ways to involve older men in further learning, as well as in health-related and social activities must be developed. Men tend to be in the minority in any mixed group, and there were no examples mentioned of groups for older men only, though some, such as Probus Clubs, have mostly male membership. 129 Older people in Dun Laoghaire Rathdown: profile and needs o Similarly, people with particular cultural interests (travel, classical music, languages, literature, history/ archaeology etc) do not change their interests because they have become ‘older’ though they may have less disposable income to expend on them. (The activities listed for the various groups in the Older People’s Network are clearly indicative of strong social/ educational stratification in this regard.) Lack of stimulus for such people in residential care has been an unfortunate feature of provision to date. Intergenerational activities: Intergenerational activities with a purpose can enhance social integration and help to overcome ageism, while in some cases providing the stimulus of new learning. Recent examples quoted were: the passing on of traditional skills – gardening, knitting, baking etc – by older people to teenagers; young people in transition year assisting older people with technology (computers, mobile phones etc). o The recording of local oral history is an important vehicle for maximising older people’s contribution to the life of the county, and for increasing younger people’s understanding of the different experiences of older generations. Security and safety measures: o It was recommended that Dún Laoghaire Rathdown should engage more consistently with older people in relation to the built environment – making it safer and more manageable for them will benefit all sections of the population. o The services of the Gardai for older people need to extended through more outreach work and the strengthening of community policing. o Also in relation to security, it would be valuable to extend the personal alarm system beyond council tenants, according to one contributor. Voices for the voiceless: o The development of advocacy services for older people unable to speak for themselves is an urgent requirement, and the predictions for growing numbers of ‘older old’ people in the county highlight the need for this. Legislative developments: o Legislation is needed to underpin work and services relating to elder abuse. o A strong framework for advance care directives needs to be implemented. …/ over 130 Older people in Dun Laoghaire Rathdown: profile and needs An enabling framework: policy and resources to support change Finally, several contributors saw provision of funding and staffing resources as the key to implementing and extending the many excellent policies and plans for older people’s services already in place, as well as to developing new ones. In this context, it was pointed out that achieving full implementation of strategies and measures already in place – such as the establishment of all the proposed primary health care teams, with their associated senior social workers, and the implementation of access requirements under the current disability legislation – would benefit the whole population of the county and not just older people, or those officially ‘with a disability’. Finally, it was noted that if the government fulfils its commitment to draw up a National Positive Ageing Strategy, based on adequate consultation with older people, this would boost fresh thinking by service providers at local level, and help to strengthen ‘joined up thinking’ among agencies, and cooperation between the statutory and voluntary sectors. Note: interestingly, there were one or two topics that never surfaced to any extent in the consultations. One was older people as unpaid carers for sick or disabled family members and others, as mentioned above. The other topics that were absent were, first, ideas on ways in which businesses, their older staff and older customers could also benefit from a new approach, and, second, the role of employment and new models of retirement in enabling older people to live life as they choose. These areas could be taken up in future discussions. -0–0–0- 131 Older people in Dun Laoghaire Rathdown: profile and needs Chapter 6: Conclusions and recommendations General conclusions This research process has yielded a great deal of information from a variety of sources, which it is hoped will be of value to Southside Partnership in developing a stronger future role vis-à-vis the needs of older people in Dún Laoghaire Rathdown. The process also focused on the actual and potential contributions of older people to local communities and the wider society, as powerful resources for creating positive change. All of the outcomes are summarised in the section on ‘Main Findings’ in the Introduction and then set out in detail in the central chapters of this report. Given the Partnership’s mission of addressing disadvantage and promoting social inclusion, it is important to restate that most of the research findings relate to what one contributor referred to as the ‘85%’ of older people, the great majority living healthy and active lives of their own choosing, who feel equal in their own communities, and are integrated to greater or lesser degrees into local life and activity. But the old-established communities in urban and rural parts of the county are changing, with younger family members moving away and neighbourly networks weakening. The result for some older people on restricted incomes can be the risk of poverty or, if not poverty as officially defined, of more subtle forms of exclusion because of transport or mobility difficulties, ill-health, poorly-coordinated services, or lack of access to the information they need, as results of the Network survey showed. And the issues that affect the 85% must affect in larger measure the significant minority of older people whose life experiences include additional challenges. The scale and scope of this research did not permit exploration of the experiences and issues of many within this minority: older residents of the county who are in residential care; people in sheltered housing; those with long-term disability or serious chronic illness; the frail and housebound ‘oldest old’; older full-time carers; older Travellers and members of other ethnic minorities, and possibly other groups who are excluded from mainstream community life. These are areas for future research. In terms of statistical information, while a great deal of useful and illuminating data has been compiled, not all the statistics required to generate a complete demographic profile of older people in Dún Laoghaire Rathdown were readily available. Some specific queries for which Census information is likely to be available (for example, on older carers in the county) would require special data requests to the Central Statistics Office. Information on economic circumstances – such as the location of individuals receiving non-contributory pensions – is unlikely to be obtainable. In other instances, the fact that geographical areas served by statutory agencies do not coincide with county boundaries is a barrier to obtaining valid local statistics. Nevertheless, the demographic information gathered here represents a substantial step in the Partnership’s process of engaging more closely with older citizens in the county, and it highlights and substantiates many perceptions and insights of those working on the ground with and for them. 132 Older people in Dun Laoghaire Rathdown: profile and needs Recommendations Throughout the work on the Network survey and the consultations with service providers and others, a large number of positive and practical recommendations for policy, planning and service provision were made, covering many aspects of older people’s lives. Most will be found in the body of the report, but the full list of Network members’ comments and proposals for change can be provided on request50. The following recommendations arise directly from the experience of conducting this research project. Most were put forward by the experts themselves – older people – and by those working closely with and for them. Others are conclusions about the important areas for strategy and action, which emerged strongly from the analysis of the various strands of data. Creating a climate for change Southside Partnership’s role includes the potential to influence high-level thinking and strategising in the county in order to enhance the well-being and quality of life of its older people. It can also be a catalyst for creating new coalitions and partnerships which can address some of the specific issues highlighted in this research project. In terms of overall thinking and strategy: It would be valuable if Southside Partnership, and all agencies concerned with older people in the county, lent their weight to calls for the government to fulfil its promise to older people by producing the new National Positive Ageing Strategy. The local impact of such a national framework could be substantial. Whether or not the Strategy is in place, Dún Laoghaire Rathdown could, like Louth, draw up its own blue-print for the county as a great place to grow old in, drawing on the Louth experience, as well as on principles and best practice outlined in the major international charters for older people, and on the work of high-level ‘think tanks’ like Ireland’s Ageing Well Network. Given the national trends in population ageing, which will affect Dún Laoghaire Rathdown before many other areas, the county and relevant bodies within it should be planning ahead: first, how best to utilise and celebrate the ‘demographic bounty’ of its older population, and second, how to provide for the needs of the ‘oldest old’ in the future. Creative thinking might suggest productive links between the two. When the new findings and fresh understandings of the Social Inclusion Report (Unique Perspectives 2009) are disseminated locally, the risks of deprivation and exclusion faced by some older people in the county should be foregrounded in the context of tackling disadvantage. 50 Southside Partnership has on file an electronic read-only copy of the full statistical findings of the survey, and the complete lists of proposals and comments that were contributed by participants. 133 Older people in Dun Laoghaire Rathdown: profile and needs However, when highlighting the situation and needs of older people, it will be important to give full recognition to their diversity, and to promote the principle of person-centredness in planning and provision of all services. Increasing the alignment of the geographical boundaries of different agencies and services would benefit service providers and service users, making it easier and more effective to build on existing partnerships and to develop new ones. Promoting participation and the voice of older people Promoting and developing participation, both at very local and at county level, and strengthening the voice of older people to articulate their own needs and determine their own futures, could be a key focus for the Partnership and appropriate to its social inclusion agenda. Their more effective participation could be supported through attention to a number of different but inter-related dimensions: Promoting and supporting the systematic participation of older people on public bodies and decision-making fora in the county, which could aid ‘age-proofing’ of new plans and measures. Finding innovative ways to maximise their potential contributions, and increase their activism on their own and others’ behalf at grass-roots level, whether as participants in local initiatives or members of groups and organisations in the county (Ageing with Confidence programmes can help here); Extending learning opportunities for those whose education finished early; Facilitating channels of communication, and enhancing the capacity of Ccountylevel bodies, elected local representatives and service providers to accurately hear and appropriately respond to older people and their needs and wishes; Encouraging the development at county level of a more thorough and ongoing consultation process with older people, building on the positive existing links with the Network for Older People, but also seeking mechanisms to involve the majority of older people who are outside the Network, including those who are ‘hard to reach’. Systems used elsewhere for senior citizen consultation could be explored for relevant models. Strengthening the Network To realise the Network’s potential as a clear voice for older people in the county, its capacity should be strengthened (this might include part-time professional staffing and/or appropriate mentoring), to enable it to increase links with its constituent groups and other organisations for older people, expand its membership, and develop its own mechanisms for consulting systematically on policy and service provision. The preparatory meeting for the Network survey revealed members’ enthusiasm for interaction, and a strong interest in meaningful new projects. The momentum could be maintained through a follow-up meeting to present the outcomes of the survey for feedback, and to stimulate discussion on how to make productive use of them for the benefit of older people in the county and for the Network itself. 134 Older people in Dun Laoghaire Rathdown: profile and needs Older people’s issues: an agenda for action There is a great deal that the Partnership can do to make sure that issues affecting the well-being of older people are kept prominently on the county’s agendas, and that strategies and action plans are devised to address them. This is likely to mean encouraging the creation of coalitions of relevant agencies and organisations, including local businesses, along with substantial input from older people themselves, especially at the stage of overall planning and prioritising. There could also be great benefits all round if the potential of older people’s ‘wisdom and experience’ was tapped into by involving them directly in actions to address the problems identified. The following, which were all highlighted strongly in the research process, could be elements in an overall strategy to promote inclusion and enhance the well-being of all older people in Dún Laoghaire Rathdown. Local transport Relevant bodies should continue working on cost-effective solutions to problems identified in relation to local transport, particularly transport to hospital appointments, for essential shopping and to maintain social life. ‘Safety on the streets’ Exploring the different dimensions of this with older people Tackling inadequacies in relation to pavements, lighting etc. Working with the Road Safety Authority on pedestrian safety Working with the Gardai to reduce the disproportionate fear of crime among many older people Information Building older people’s IT skills and increasing public computer/ internet facilities Researching with service providers and users what works and what doesn’t in current information strategies Homes for older people Increasing the supply, and matching the design and location with older people’s wishes Making residential care homes more like ‘home’ Promoting the setting-up of affordable and reliable house and garden maintainance services Changing attitudes Provision of age awareness and anti-ageism training for service providers, businesses and others including local representatives Supporting imaginative intergenerational activities 135 Older people in Dun Laoghaire Rathdown: profile and needs Reducing isolation, increasing fulfilment Responding to older people’s wishes for more activities and opportunities for social interaction Exploring possibilities for involving more older men in social and learning activities Reaching the ‘hard to reach’ Finding imaginative ways to make contact and engage in dialogue with potentially excluded groups of older people – who may also be ‘hard to reach’ – as a first step in understanding their situation, needs and wishes. As well as those listed above (p.132) attention could also be paid to some other groups of older people who may be at risk of isolation and deprivation, particularly those in private rented accommodation, and older women with a disability who live alone. Supporting carers Two distinct groups of older carers could benefit from greater contact, understanding and support, and finding ways to do this could usefully be explored: Grandparents caring for their grandchildren while the parents work; Older people caring for sick relatives and those with disability - including relatives with intellectual disability and mental health problems. On the face of it, many of these may seem problems and issues facing older people only, but finding solutions to the problems they have identified will in many cases yield definite benefits for the whole community. In addition, ‘older people’ are not ‘others’ – we all hope to become ‘older people ‘one day! Stating its commitment to a more age-friendly society and putting specific plans in place for bringing it about will enable Dún Laoghaire Rathdown to play its own part in realising at local level what the UN Madrid Declaration called A shared vision of equality for people of all ages. (Declaration, Article 19) -0–0–0- 136 Older people in Dun Laoghaire Rathdown: profile and needs Appendices 1. Bibliography / references 2. Relevant policy documents: international, national and documents from Dún Laoghaire Rathdown 3. The older population of Dún Laoghaire Rathdown by age, 2006 4. Key informants consulted in the course of the research 5. Outline of topics for consultations with key informants 6. Network for Older People in Dún Laoghaire Rathdown: text of survey questionnaire 137 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 1: Bibliography / references International documents United Nations 1991, United Nations Principles for Older Persons. New York: U.N. United Nations 2002. Report of the Second World Assembly on Ageing, Madrid April 2002. New York: U.N. (includes Declaration and International Plan of Action on Ageing) World Health Organisation, 2007. Age-friendly Cities: a Guide and Checklist: Essential Features of Age-friendly Cities. Geneva: WHO. Swedish National Institute of Public Health, 2006. Healthy Ageing: a Challenge for Europe. Stockholm, Swedish National Institute of Public Health for the European Healthy Ageing Project 2004-2007. Irish documentation Central Statistics Office, Census 2006: Principle Statistics. Dublin: Stationery Office. Central Statistics Office, 2007. Ageing in Ireland 2007. Dublin: Stationery Office. Department of Education and Science, 2000. Learning for Life: White Paper on Adult Education. Dublin: Stationery Office. Department of the Environment, Heritage and Local Government, 2007. Delivering Homes, Sustaining Communities. Dublin: Stationery Office. Department of Health, 1988. The Years Ahead: A Policy for the Elderly. Dublin: Stationery Office. Department of Health and Children, 2001. Primary Care: A New Direction. Dublin: Stationery Office. Department of Health and Children and Health Service Executive, 2008. National Strategy for Service User Involvment: Your Service, Your Say. Dublin: Stationery Office. Department of Health and Children, 2008. Health in Ireland: Key Trends 2007. Dublin: Stationery Office. Department of Health and Children, 2008. Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population. Dublin: Stationery Office. Department of Health and Children, 2008. SLAN 2007: Survey of Lifestyles, Attitudes and Nutrition in Ireland – Main Report. Dublin: Stationery Office Department of Health and Children, 2009. SLAN 2007: Survey of Lifestyles, Attitudes and Nutrition in Ireland – Mental Health and Social Wellbeing Report. Dublin: Stationery Office Department of Justice, Equality and Law Reform, 2007. National Women’s Strategy 2007 – 2016. Dublin: Stationery Office Department of Social and Family Affairs, 2007. Green Paper on Pensions. Dublin: Stationery Office. 138 Older people in Dun Laoghaire Rathdown: profile and needs Department of the Taoiseach, 2006. Towards 2016: Ten-Year Framework Social Partnership Agreement 2006-2015. Dublin: Stationery Office. Department of the Taoiseach, 2007. New Programme for Government 2007. Dublin: Stationery Office. Department of the Taoiseach, 2007. National Development Plan 2007-2013:Transforming Ireland – a Better Quality of Life for All. Dublin: Stationery Office. Fahey T, Maitre B, Nolan B and Whelan CT (2007) A Social Portrait of Older People in Ireland (report for Office of Social Inclusion). Dublin:ESRI An Garda Siochana, 2008. A Time for Change - Policing Plan 2009. Dublin: An Garda Siochana. Health Service Executive, 2002. Protecting Our Future: Report of the Working Group on Elder Abuse. Dublin: HSE. Health Service Executive, 2005. Reach Out – a National Strategy for Action on Suicide Prevention 2005-2014. Dublin: HSE. Health Service Executive, 2006. Mental Health -A Vision for Change: Report of the Expert Group on Mental Health Policy. Dublin: HSE. Health Service Executive, 2009. Open Your Eyes: Elder Abuse Service Developments 2008. Dublin: HSE. National Council on Ageing and Older People and Health Promotion Unit, Department of Health, 1998. Adding Years to Life and Life to Years: a Health Promotion Strategy for Older People. Dublin: NCAOP. National Council on Ageing and Older People, 2005. An Age Friendly Society: a Position Statement. Dublin: NCAOP. National Economic and Social Council , 2005. The Developmental Welfare State. Dublin: NESC. Nolan B and Maitre B, 2008. A Social Portrait of Communities in Ireland (report for Office of Social Inclusion). Dublin: ESRI Office for Social Inclusion DSFA, 2007 : National Action Plan for Social Inclusion 20072016 (NAPInclusion). Dublin: Stationery Office. Road Safety Authority, 2007. Road Safety Strategy 2007-2012. Dublin: RSA. Ruddle H., Donoghue F. and Mulvihill, R.,1997. The Years Ahead Report: a Review of the Implementation of its Recommendations (NCAOP report no.48). Dublin: NCAOP. Taskforce on Active Citizenship, 2007. Statistical Evidence on Active Citizenship in Ireland. Dublin: Taskforce on Active Citizenship. 139 Older people in Dun Laoghaire Rathdown: profile and needs Dún Laoghaire Rathdown documentation Watters, N / Unique Perspectives, 2009. A Social Inclusion Profile of Dún Laoghaire Rathdown. Dublin: Southside Partnership. GAMMA, 2008. Dún Laoghaire Rathdown: Demographic and Socio-Economic Profile. Report prepared for DLR County Development Board. Dublin: GAMMA. Dύn Laoghaire-Rathdown County Development Board, An Integrated Strategy for Social, Economic and Cultural Development 2002-2012. http://www.dlrcdb.ie/strategy.htm Dún Laoghaire Rathdown County Council, 2003. County Development Plan 2004 – 2010, http://www.dlrcoco.ie/planning/DevPlan04/index.html Dún Laoghaire Rathdown County Council, 2009. Draft County Development Plan 2010 – 2016. http://www.dlrcoco.ie/planning/DevPlan2010_2016/index.html Dún Laoghaire Rathdown County Council, 2009. Accessibility Implementation Plan 2009. http://www.dlrcoco.ie/gp/Accessibility_Implementation_Plan_2009.pdf Dún Laoghaire Rathdown Co. Co. Arts Office, 2007 . DLR Arts Strategy 2007-2010 http://www.dlrcoco.ie/arts/strategy07/StrategyEng1.pdf * 140 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 2: Extracts from relevant policy documents 1.1 United Nations Principles for Older Persons The General Assembly: Appreciating the contribution that older persons make to their societies, Recognizing that, in the Charter of the United Nations, the peoples of the United Nations declare, inter alia, their determination to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women and of nations large and small and to promote social progress and better standards of life in larger freedom, Noting the elaboration of those rights in the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights and the International Covenant on Civil and Political Rights and other declarations to ensure the application of universal standards to particular groups, In pursuance of the International Plan of Action on Ageing, adopted by the World Assembly on Ageing and endorsed by the General Assembly in its resolution 37/51 of 3 December 1982, Appreciating the tremendous diversity in the situation of older persons, not only between countries but within countries and between individuals, which requires a variety of policy responses, Aware that in all countries, individuals are reaching an advanced age in greater numbers and in better health than ever before, Aware of the scientific research disproving many stereotypes about inevitable and irreversible declines with age, Convinced that in a world characterized by an increasing number and proportion of older persons, opportunities must be provided for willing and capable older persons to participate in and contribute to the ongoing activities of society, Mindful that the strains on family life in both developed and developing countries require support for those providing care to frail older persons, Bearing in mind the standards already set by the International Plan of Action on Ageing and the conventions, recommendations and resolutions of the International Labour Organization, the World Health Organization and other United Nations entities, Encourages Governments to incorporate the following principles into their national programmes whenever possible: Independence 1. Older persons should have access to adequate food, water, shelter, clothing and health care through the provision of income, family and community support and self-help. 2. Older persons should have the opportunity to work or to have access to other income-generating opportunities. 3. Older persons should be able to participate in determining when and at what pace withdrawal from the labour force takes place. 4. Older persons should have access to appropriate educational and training programmes. 5. Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities. 141 Older people in Dun Laoghaire Rathdown: profile and needs 6. Older persons should be able to reside at home for as long as possible. Participation 7. Older persons should remain integrated in society, participate actively in the formulation and implementation of policies that directly affect their well-being and share their knowledge and skills with younger generations. 8. Older persons should be able to seek and develop opportunities for service to the community and to serve as volunteers in positions appropriate to their interests and capabilities. 9. Older persons should be able to form movements or associations of older persons. Care 10. Older persons should benefit from family and community care and protection in accordance with each society's system of cultural values. 11. Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental and emotional well- being and to prevent or delay the onset of illness. 12. Older persons should have access to social and legal services to enhance their autonomy, protection and care. 13. Older persons should be able to utilize appropriate levels of institutional care providing protection, rehabilitation and social and mental stimulation in a humane and secure environment. 14. Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility, including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives. Self-fulfillment 15. Older persons should be able to pursue opportunities for the full development of their potential. 16. Older persons should have access to the educational, cultural, spiritual and recreational resources of society. Dignity 17. Older persons should be able to live in dignity and security and be free of exploitation and physical or mental abuse. 18. Older persons should be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and be valued independently of their economic contribution. http://www.un.org/esa/socdev/ageing/un_principles.html#Principles 142 Older people in Dun Laoghaire Rathdown: profile and needs 1.2 United Nations Madrid Declaration on Ageing Report of the Second World Assembly on Ageing, Madrid, 8-12 April 2002 United Nations New York, 2002: Political Declaration Article 1 We, the representatives of Governments meeting at the Second World Assembly on Ageing in Madrid, have decided to adopt an International Plan of Action on Ageing, 2002 to respond to the opportunities and challenges of population ageing in the twenty-first century and to promote the development of a society for all ages. In the context of the Plan of Action, we are committed to actions at all levels, including national and international levels, on three priority directions: older persons and development; advancing health and well-being into old age; and ensuring enabling and supportive environments. Article 2 We celebrate rising life expectancy in many regions of the world as one of humanity’s major achievements. We recognize that the world is experiencing an unprecedented demographic transformation and that by 2050 the number of persons aged 60 years and over will increase from 600 million to almost 2 billion and that the proportion of persons aged 60 years and over is expected to double from 10 to 21 per cent. The increase will be greatest and most rapid in developing countries where the older population is expected to quadruple during the next 50 years. This demographic transformation challenges all our societies to promote increased opportunities, in particular opportunities for older persons to realize their potential to participate fully in all aspects of life. Article 3 We reiterate the commitments made by our heads of State and Governments at major United Nations conferences and summits, at their follow-up processes and in the Millennium Declaration with respect to the promotion of international and national environments that will foster a society for all ages. We furthermore reaffirm the principles and recommendations for action of the International Plan of Action on Ageing, endorsed by the United Nations General Assembly in 1982, and the United Nations Principles for Older Persons, adopted by the General Assembly in 1991, which provided guidance in areas of independence, participation, care, selffulfilment and dignity. Article 4 We emphasize that, in order to complement national efforts to fully implement the International Plan of Action on Ageing 2002, enhanced international cooperation is essential. We therefore encourage the international community to further promote cooperation among all actors involved. Article 5 We reaffirm the commitment to spare no effort to promote democracy, strengthen the rule of law and promote gender equality, as well as to promote and protect human rights and fundamental freedoms, including the right to development. We commit ourselves to eliminating all forms of discrimination, including age discrimination. We also recognize that persons, as they age, should enjoy a life of fulfilment, health, security and active participation in the economic, social, cultural and political life of their societies. We are determined to enhance the recognition of the dignity of older persons and to eliminate all forms of neglect, abuse and violence. 143 Older people in Dun Laoghaire Rathdown: profile and needs Article 6 The modern world has unprecedented wealth and technological capacity and has presented extraordinary opportunities: to empower men and women to reach old age in better health and with more fully realized well-being; to seek the full inclusion and participation of older persons in societies; to enable older persons to contribute more effectively to their communities and to the development of their societies; and to steadily improve care and support for older persons as they need it. We recognize that concerted action is required to transform the opportunities and the quality of life of men and women as they age and to ensure the sustainability of their support systems, thus building the foundation for a society for all ages. When ageing is embraced as an achievement, the reliance on human skills, experiences and resources of the higher age groups is naturally recognized as an asset in the growth of mature, fully integrated, humane societies. Article 7 At the same time, considerable obstacles to further integration and full participation in the global economy remain for developing countries, in particular the least developed countries, as well as for some countries with economies in transition. Unless the benefits of social and economic development are extended to all countries, a growing number of people, particularly older persons in all countries and even entire regions, will remain marginalized from the global economy. For this reason, we recognize the importance of placing ageing in development agendas, as well as in strategies for the eradication of poverty and in seeking to achieve full participation in the global economy of all developing countries. Article 8 We commit ourselves to the task of effectively incorporating ageing within social and economic strategies, policies and action while recognizing that specific policies will vary according to conditions within each country. We recognize the need to mainstream a gender perspective into all policies and programmes to take account of the needs and experiences of older women and men. Article 9 We commit ourselves to protect and assist older persons in situations of armed conflict and foreign occupation. Article 10 The potential of older persons is a powerful basis for future development. This enables society to rely increasingly on the skills, experience and wisdom of older persons, not only to take the lead in their own betterment but also to participate actively in that of society as a whole. Article 11 We emphasize the importance of international research on ageing and agerelated issues as an important instrument for the formulation of policies on ageing, based on reliable and harmonized indicators developed by, inter alia, national and international statistical organizations. Article 12 The expectations of older persons and the economic needs of society demand that older persons be able to participate in the economic, political, social and cultural life of their societies. Older persons should have the opportunity to work for as long as they wish and are able to, in satisfying and productive work, continuing to have access to education and training programmes. The empowerment of older persons and the promotion of their full participation are essential elements for active ageing. For older persons, appropriate sustainable social support should be provided. 144 Older people in Dun Laoghaire Rathdown: profile and needs Article 13 We stress the primary responsibility of Governments in promoting, providing and ensuring access to basic social services, bearing in mind specific needs of older persons. To this end we need to work together with local authorities, civil society, including non-governmental organizations, the private sector, volunteers and voluntary organizations, older persons themselves and associations for and of older persons, as well as families and communities. Article 14 We recognize the need to achieve progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. We reaffirm that the attainment of the highest possible level of health is a most important worldwide social goal, the realization of which requires action of many other social and economic sectors in addition to the health sector. We commit ourselves to providing older persons with universal and equal access to health care and services, including physical and mental health services, and we recognize that the growing needs of an ageing population require additional policies, in particular care and treatment, the promotion of healthy lifestyles and supportive environments. We shall promote independence, accessibility and the empowerment of older persons to participate fully in all aspects of society. We recognize the contribution of older persons to development in their role as caregivers. Article 15 We recognize the important role played by families, volunteers, communities, older persons organizations and other community-based organizations in providing support and informal care to older persons in addition to services provided by Governments. Article 16 We recognize the need to strengthen solidarity among generations and intergenerational partnerships, keeping in mind the particular needs of both older and younger ones, and to encourage mutually responsive relationships between generations. Article 17 Governments have the primary responsibility for providing leadership on ageing matters and on the implementation of the International Plan of Action on Ageing, 2002, but effective collaboration between national and local Governments, international agencies, older persons themselves and their organizations, other parts of civil society, including non-governmental organizations and the private sector is essential. The implementation of the International Plan of Action on Ageing, 2002 will require the partnership and involvement of many stakeholders: professional organizations; corporations; workers and workers organizations; cooperatives; research, academic and other educational and religious institutions; and the media. Article 18 We underline the important role of the United Nations system, including the regional commissions, in assisting the Governments, at their request, in the implementation, follow-up and national monitoring of the International Plan of Action on Ageing, 2002, taking into account the differences in economic, social and demographic conditions existing among countries and regions. Article 19 145 Older people in Dun Laoghaire Rathdown: profile and needs We invite all people in all countries from every sector of society, individually and collectively, to join in our dedication to a shared vision of equality for persons of all ages. Adopted at the 10th plenary meeting of the Second World Assembly on Ageing, on 12 April 2002; Resolution 1 http://www.un.org/esa/socdev/ageing/madrid_resolutions.html 146 Older people in Dun Laoghaire Rathdown: profile and needs 1.3 WHO Checklist: Essential Features of Age-friendly Cities This checklist of essential age-friendly city features is based on the results of the WHO Global Age-Friendly Cities project consultation in 33 cities in 22 countries. The checklist is a tool for a city’s self-assessment and a map for charting progress. More detailed checklists of age-friendly city features are to be found in the WHO Global Age-Friendly Cities Guide. This checklist is intended to be used by individuals and groups interested in making their city more age-friendly. For the checklist to be effective, older people must be involved as full partners. In assessing a city’s strengths and deficiencies, older people will describe how the checklist of features matches their own experience of the city’s positive characteristics and barriers. They should play a role in suggesting changes and in implementing and monitoring improvements. Outdoor spaces and buildings ☐ Public areas are clean and pleasant. ☐ Green spaces and outdoor seating are sufficient in number, well-maintained and safe. ☐ Pavements are well-maintained, free of obstructions and reserved for pedestrians. ☐ Pavements are non-slip, are wide enough for wheelchairs and have dropped curbs to road level. ☐ Pedestrian crossings are sufficient innumber and safe for people with different levels and types of disability, with nonslip markings, visual and audio cues and adequate crossing times. ☐ Drivers give way to pedestrians at intersections and pedestrian crossings. ☐ Cycle paths are separate from pavements and other pedestrian walkways. ☐ Outdoor safety is promoted by good street lighting, police patrols and community education. ☐ Services are situated together and are accessible. ☐ Special customer service arrangements are provided, such as separate queues orservice counters for older people. ☐ Buildings are well-signed outside and inside, with sufficient seating and toilets, accessible elevators, ramps, railings andstairs, and non-slip floors. ☐ Public toilets outdoors and indoors are sufficient in number, clean, wellmaintained and accessible. Transportation ☐ Public transportation costs are consistent, clearly displayed and affordable. ☐ Public transportation is reliable and frequent, including at night and on weekends and holidays. ☐ All city areas and services are accessible by public transport, with good connections and well-marked routes and vehicles. ☐ Vehicles are clean, well-maintained, accessible, not overcrowded and have priority seating that is respected. ☐ Specialized transportation is available for disabled people. 147 Older people in Dun Laoghaire Rathdown: profile and needs ☐ Drivers stop at designated stops and beside the curb to facilitate boarding and wait for passengers to be seated before driving off . ☐ Transport stops and stations are conveniently located, accessible, safe, clean, welllit and well-marked, with adequate seating and shelter. ☐ Complete and accessible information is provided to users about routes, schedulesand special needs facilities. ☐ A voluntary transport service is available where public transportation is too limited. ☐ Taxis are accessible and affordable, and drivers are courteous and helpful. ☐ Roads are well-maintained, with covered drains and good lighting. ☐ Traffic flow is well-regulated. ☐ Roadways are free of obstructions that block drivers’ vision. ☐ Traffic signs and intersections are visibleand well-placed. ☐ Driver education and refresher courses arepromoted for all drivers. ☐ Parking and drop-off areas are safe, sufficient in number and conveniently located. ☐ Priority parking and drop-off spots for people with special needs are available and respected. Housing ☐ Sufficient, affordable housing is available in areas that are safe and close to services and the rest of the community. ☐ Sufficient and affordable home maintenance and support services are available. ☐ Housing is well-constructed and provides safe and comfortable shelter from the weather. ☐ Interior spaces and level surfaces allow freedom of movement in all rooms and passageways. ☐ Home modification options and supplies are available and affordable, and providers understand the needs of older people. ☐ Public and commercial rental housing is clean, well-maintained and safe. ☐ Sufficient and affordable housing for frail and disabled older people, with appropriate services, is provided locally. Social participation ☐ Venues for events and activities are convenientlylocated, accessible, well-lit andeasily reached by public transport. ☐ Events are held at times convenient for older people. ☐ Activities and events can be attended alone or with a companion. ☐ Activities and attractions are affordable,with no hidden or additional participation costs. ☐ Good information about activities andevents is provided, including details about accessibility of facilities and transportation options for older people. ☐ A wide variety of activities is offered to appeal to a diverse population of older people. 148 Older people in Dun Laoghaire Rathdown: profile and needs ☐ Gatherings including older people are held in various local community spots, such as recreation centres, schools, libraries, community centres and parks. ☐ There is consistent outreach to include people at risk of social isolation. Respect and social inclusion ☐ Older people are regularly consulted by public, voluntary and commercial services on how to serve them better. ☐ Services and products to suit varying needs and preferences are provided by public and commercial services. ☐ Service staff are courteous and helpful. ☐ Older people are visible in the media, and are depicted positively and without stereotyping. ☐ Community-wide settings, activities and events attract all generations by accommodating age-specific needs and preferences. ☐ Older people are specifically included icommunity activities for “families”. ☐ Schools provide opportunities to learn about ageing and older people, and involve older people in school activities. ☐ Older people are recognized by the community for their past as well as their present contributions. ☐ Older people who are less well-off have good access to public, voluntary and privateservices. Participation and employment ☐ A range of flexible options for older volunteers is available, with training, recognition, guidance and compensation for personal costs. ☐ The qualities of older employees are well promoted. ☐ A range of flexible and appropriately paid opportunities for older people to work is promoted. ☐ Discrimination on the basis of age alone is forbidden in the hiring, retention, promotion and training of employees. ☐ Workplaces are adapted to meet the needs of disabled people. ☐ Self-employment options for older people are promoted and supported. ☐ Training in post-retirement options is provided for older workers. ☐ Decision-making bodies in public, privateand voluntary sectors encourage and facilitate membership of older people. Communication and information ☐ A basic, effective communication system reaches community residents of all ages. ☐ Regular and widespread distribution of information is assured and a coordinated, centralized access is provided. ☐ Regular information and broadcasts of interest to older people are offered. ☐ Oral communication accessible to older people is promoted. ☐ People at risk of social isolation get one-to-one information from trusted individuals. 149 Older people in Dun Laoghaire Rathdown: profile and needs ☐ Public and commercial services provide friendly, person-to-person service onrequest. ☐ Printed information – including official forms, television captions and text on visual displays – has large lettering and the main ideas are shown by clear headings and bold-face type. ☐ Print and spoken communication uses simple, familiar words in short, straightforward sentences. ☐ Telephone answering services give instruction sslowly and clearly and tell callers how to repeat the message at any time. ☐ Electronic equipment, such as mobile telephones, radios, televisions, and bank and ticket machines, has large buttons and big lettering. ☐ There is wide public access to computers and the Internet, at no or minimal charge, in public places such as government offices, community centres and libraries. Community and health services ☐ An adequate range of health and community support services is offered for promoting, maintaining and restoring health. ☐ Home care services include health and personal care and housekeeping. ☐ Health and social services are conveniently located and accessible by all means of transport. ☐ Residential care facilities and designated older people’s housing are located close to services and the rest of the community. ☐ Health and community service facilities are safely constructed and fully accessible. ☐ Clear and accessible information is provided about health and social services for older people. ☐ Delivery of services is coordinated and administratively simple. ☐ All staff are respectful, helpful and trained to serve older people. ☐ Economic barriers impeding access to health and community support servicesare minimized. ☐ Voluntary services by people of all ages are encouraged and supported. ☐ There are sufficient and accessible burial sites. ☐ Community emergency planning takesinto account the vulnerabilities and capacities of older people. WHO/FCH/ALC/2007.1© World Health Organization 2007. All rights reserved. http://www.who.int/ageing/publications/Age_friendly_cities_checklist.pdf 150 Older people in Dun Laoghaire Rathdown: profile and needs 1.4 Towards 2016: Ten-Year Framework Social Partnership Agreement 2006-2015 (extract) The Partnership Agreement’s social policy commitments are founded on a new ‘lifecycle approach’, set out by the National Economic and Social Council in its report, The Developmental Welfare State (2005), which ‘places the individual at the centre of policy development and delivery’. This model identifies four life stages: children; people of working age; older people; and people with disabilities. For each stage the document outlines the vision agreed by the Social Partners, the key long-term goals, and the priority actions for the initial phase of the Agreement. It lists innovative measures intended to respond to emerging needs, and also outlines a governance and monitoring framework. Section 32- Older People: 32.1 Vision The parties to this agreement share a vision of an Ireland which provides the supports, where necessary, to enable older people to maintain their health and well-being, as well as to live active and full lives, in an independent way in their own homes and communities for as long as possible. To achieve this vision, the Government and social partners will work together over the next ten years towards the following long-term goals for older people in Ireland in the context of increased longevity and greater possibilities and expectations for quality of life of older people: Every older person would be encouraged and supported to participate to the greatest extent possible in social and civic life; Every older person would have access to an income which is sufficient to sustain an acceptable standard of living; Every older person would have adequate support to enable them to remain living independently in their own homes for as long as possible. This will involve access to good quality services in the community, including: health, education, transport, housing and security, and; Every older person would, in conformity with their needs and conscious of the high level of disability and disabling conditions amongst this group, have access to a spectrum of care services stretching from support for self-care through support for family and informal carers to formal care in the home, the community or in residential settings. Such care services should ensure the person has opportunities for civic and social engagement at community level. 32.2 Priority Actions Six priority action areas are identified as steps to achieving the long-term goals, and indications of specific actions intended in each area are provided: 1. Pensions/ Income Supports 2. Long-Term Care Services for Older People 3. Housing and Accommodation 4. Ensuring Mobility for Older People 5. Ensuring Quality Health Services for Older People 6. Promoting Education and Employment Opportunities for Older People http://www.taoiseach.gov.ie/attached_files/Pdf%20files/Towards2016PartnershipAg reement.pdf 151 Older people in Dun Laoghaire Rathdown: profile and needs 1.5 New Programme for Government 2007: a Blueprint for Ireland’s Future 2007-2012 (extracts) This is the operational plan which outlines how Government commitments in relation to services and supports for older people will be put into practice over the five-year period 2007-2012 Quoted below is the text of the whole section, Better Supports for Older People (pp 51-52), and relevant extracts from the following section on Social Welfare improvements. BETTER SUPPORTS FOR OLDER PEOPLE (p.51) The Government’s commitment: On top of the substantial changes outlined in the health section, we are determined to take further significant initiatives to better recognise the position of older people in Irish society. Pensions The Green Paper on Pensions represents a comprehensive examination of the challenges and options facing Ireland in ensuring that all our people have adequate pension coverage. With half of the working population not part of any personal or occupational pension scheme and few having the security of defined benefit schemes, it is vital that major steps are taken in the coming years to improve pensions. We will: Increase the basic State pension by around 50% to at least €300 per week by 2012. Seek to develop imaginative proposals in the context of the Green Paper (the publication of which is a commitment under Towards 2016) and in consultation with the social partners, to provide an SSIA type scheme in an effort to make supplementary pension provision more attractive to those on low incomes. Aim to secure the target of at least 50% of pre-retirement earnings from all sources including social welfare supports, private and occupational pensions, and savings and investments. Complete the scheme introduced in Budget 2007 to provide a personal pension payment for pensioner spouses in receipt of the Qualified Adult Allowance. The payment will be set at the level of a full rate NonContributory State Pension and the income limits will be improved to enable more people to qualify for it. The role and economic contribution of spouses working on the farm will be better recognised within the social insurance system. Extend the Age Allowance to Qualified Adults over 80 years old. Remove anomalies identified in the pension system. Ensure women are treated fairly in pension provision. Improving Income and Employment Conditions The Government is determined to improve the income and employment conditions of older people. We appreciate that compulsory retirement does not adequately reflect many people's abilities or expectations. Those reaching retirement age should be allowed to retire if they wish, but those who would prefer to stay at work should be facilitated in doing so. 152 Older people in Dun Laoghaire Rathdown: profile and needs We will: Introduce phased retirement which allows workers a greater say in their retirement age. Increase the State Pension for every year that a person over 66 delays taking it. Thus, additional PRSI contributions made after the age of 66 will be added to the pension when it is drawn down. Extend the amount those in receipt of the State Non-Contributory Pension are allowed to earn without it affecting their pension entitlement. Guard against age-related discrimination in the workplace. National Strategy for Older People In light of the growing involvement of many Departments and agencies in this area, and of the successful model for developing policy relating to children and people with disabilities, we will develop in conjunction with the recognised voluntary groups in this area a New National Positive Ageing Strategy to include: The development of operational plans by Government Departments clearly setting out objectives relating to older people; Joined up thinking on initiatives serving older people; Ongoing mechanisms to monitor progress and identify challenges; Liaison with recognised voluntary groups in the area; Give consideration to the appointment of an Ombudsman for Older People. We will also designate a Minister of State for Older People who will be a member of the cabinet committee on social inclusion. In addition, the development of quality transport systems in rural and urban areas and the expansion of the Rural Transport Initiative will improve accessibility for older people. Education and Retraining for Older People We will: Set up a training programme on computer literacy for all those over 50 for the teaching of (sic) Support the extension of initiatives such as IT training in care settings, senior cyber cafés, senior web sites and mature learner groups. Enable more older people to go to College through the enhanced availability of mature student places and the introduction of a new system of meanstested free fees for third level education. Making It Easier for Older People to Stay in Their Own Homes It is in everyone’s best interests that older people are supported and encouraged to remain self reliant and to remain actively involved in their own well-being and that of their families, friends and the wider community. Central to this is the provision of support for older people to stay in their own homes for as long as possible. We will: Continue to provide support services for homecare. Extend the Slán Abhaile programme. This programme provides older people with practical alternatives to long stay residential care by providing enhanced home support services. Provide funding to local authorities for the provision of specialised housing units for older people which is both affordable and appropriate to their housing needs. 153 Older people in Dun Laoghaire Rathdown: profile and needs Facilitate the building of retirement villages and introduce on a pilot basis integrated purpose-built neighbourhoods for older people in existing communities, similar, for example, to the development of Westgate, Ballincollig, Co.Cork. SOCIAL AFFAIRS (p.52) Welfare Reform The Government will: Integrate the tax and social welfare systems fully to allow for more efficient data and money transfer mechanisms and provide for a fully integrated PPS number. Maintain the policy of phasing and using transition payments for those coming off social welfare. Complete the scheme introduced in Budget 2007 to provide a personal pension payment for pensioner spouses in receipt of the Qualified Adult Allowance. The payment will be set at the level of a full rate Non-Contributory State Pension and the income limits will be improved to enable more people to qualify for it. Ensure that women are treated fairly in the Social Welfare code and examine the proposals in the Green Paper on Pensions in this regard. Better recognise within the social insurance system, the role and economic contribution of spouses working on the farm. Continue to maintain the value of the lowest rate of social welfare payments as agreed in the National Action Plan on Social Inclusion. Carers In the next five years, the Government will: Further increase eligibility for the Carers’ Allowance. Double the non-means-tested Respite Care Grant to €3,000 per person cared for. Extend the National Fuel Allowance Scheme to cover eligible carers. Ensure a National Carers’ Strategy focusing on supporting informal and family carers in the community will be developed by the end of 2007. There will be appropriate consultation with the social partners. HEALTH (p.32) Maximising Independence We believe that all older people should have the opportunity to stay in their own home for as long as possible. This is what our older people want and we will support them in their choice. We will also support their family carers to continue their caring role. We will help local and voluntary organisations to establish and run community based facilities that will provide the care services necessary to support older people. We will strengthen and develop stroke rehabilitation services. We will introduce a community led pilot scheme to counter the social isolation of the elderly in rural Ireland. 154 Older people in Dun Laoghaire Rathdown: profile and needs Community and Continuing Care Over the next five years, €2.1 billion will be invested in the Primary, Community and Continuing Care capital programme and we will: Continue to implement measures to ensure the availability of real alternatives to hospital for those who require lengthy convalescence. Starting in 2008, increase funding to the NTPF on an annual basis over the lifetime of the Government to secure long-term care, step down beds and rehabilitation services for patients. This additional funding will be ring-fenced for the above purposes and will be set at €20 million for the first year. Nursing Homes The demand for nursing home places will continue to increase and the public is entitled to expect high quality and appropriate supports for all residents. We will only fund places in nursing homes that meet the highest standards of nursing care set by HIQA. While our main focus will be on providing more and better home care services to allow people to remain at home, we will provide for ten new 50-bed Community Nursing Units in the next five years. We will expand the system of inspection to ensure more comprehensive and regular inspections. All inspection reports will be available to residents and their families and published. We are committed to a standard framework for admission to and payment for nursing home facilities. We will take the financial burden for the residential care of their elderly parents from families. We will implement the Fair Deal for nursing home care costs from the start of 2008. http://www.taoiseach.gov.ie/attached_files/Pdf%20files/Eng%20Prog%20for%20G ov.pdf 155 Older people in Dun Laoghaire Rathdown: profile and needs 1.6 National Development Plan 2007-2013. Transforming Ireland: a Better Quality of Life for All (extract) The National Development Plan, the fourth since 1989, integrates strategic development frameworks for regional development, for rural communities, for allisland cooperation and for the protection of the environment with common economic and social goals. EXTRACT from Older People Programme Strategic Context Older people are recognised as one of the main groups who may be at risk of social exclusion. The Partnership Agreement, Towards 2016, sets out a vision of how older people can maintain their health and well-being, as well as live active and full lives, in an independent way in their own homes and communities for as long as possible. The support for this vision will not be restricted to measures contained in this Programme. The Plan has a range of programmes and measures across a number of Priorities that will support the vision for older people. These include social housing, essential house repairs and improvements in primary health care facilities which are detailed under the Social Infrastructure Chapter. Other measures include the Rural Transport Initiative, education and training, support through community organisations to improve the security of its older members and activation and participation measures as outlined under the Human Capital Chapter. Measures under the Local and Community Development Programme under this Priority also complement the older persons programme. (p. 255) http://www.ndp.ie/documents/ndp2007-2013/NDP-2007-2013-English.pdf 1.7 Extract from An Garda Siochana – Policing Plan 2009 Strategic Goal Six – Community Engagement (p9) Key Actions This will be Performance Process Owner Outcome achieved by Indicators Engage with Developing Satisfaction Assistant A Garda older people effective and levels of older commissioner service that is innovative people with Strategy & partnership policing Garda service Training and based and approaches to established each Regional community oriented enhance our through joint Assistant engagement survey with Commissioner with older relevant partner people in our agencies communities http://www.garda.ie/Documents/User/Policing%20Plan%202009%20English.pdf 156 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 3: Age breakdown of DLR population from 55 years and upwards, 2006 Age 55 56 57 58 59 60 61 62 63 64 Totals Age 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85+ Grand totals Males Females 1180 1165 1097 1102 1144 1109 1012 1026 959 950 10,744 Persons 2230 2151 2120 2170 2150 2054 1922 1931 1815 1716 20,259 774 784 765 690 661 649 599 599 566 514 498 522 410 375 344 320 278 225 231 193 722 10,719 Females 897 881 889 880 818 786 763 727 716 717 660 695 603 585 558 498 471 445 386 371 1922 15,268 Persons 1671 1665 1654 1570 1479 1435 1362 1326 1282 1231 1158 1217 1013 960 902 818 749 670 617 564 2644 25,987 20,234 26,012 46,246 1050 986 1023 1068 1006 945 910 905 856 766 9,515 Males Source: CSO, Census 2006:Small Area Population Statistics 157 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 4: those consulted in the course of the research Statutory providers with responsibilities within the County area: Colm Coffey, Manager, Services for Older People, HSE (LHO 2, Dublin SE) Eilis Hession, Manager, Services for Older People, HSE Dún Laoghaire Margaret O’Donovan, Director of Community Nursing, HSE (LHO 2, Dublin SE) David Lawless, RAPID Coordinator, County Development Board Eugene Vesey, County Development Board/ County Council Dept of Community and Enterprise Sgt Angelene Conefry, Manager of Community Policing, Dún Laoghaire District (based in Cabinteely) Barbara Hammond, Community Education Facilitator, Dún Laoghaire VEC Voluntary organisations: Sheila Symonds, Director, Irish Association of Older People, a national organisation with headquarters in Dún Laoghaire. Susan Ross, of the Monkstown Parish St Vincent de Paul society Network for Older People in Dún Laoghaire Rathdown: Dan Hurst, Chairperson Mags Kenny, DLR County Council staff member responsible for liaison with the Network 158 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 5: outline of topics for consultations A. YOUR ORGANISATION OR AGENCY 1. Its definition of ‘older people’ 2. Its role and remit in relation to older people 3. The services and supports it provides to older people 4. Aims of these services; achievements; challenges and gaps identified 5. Ways of involving older people in decision-making and planning B. THE BROADER PICTURE (from your organisation’s perspective) 1. Similarities and differences between the overall situation for older people here in other parts of Dublin, or other parts of the country? and 2. What’s going well/ what are the successes in relation to provision (of all kinds) older people in Dún Laoghaire Rathdown? for 3. What are the main challenges and gaps? C. INFORMATION NEEDS OF OLDER PEOPLE Are older people’s information needs being adequately met at present? (both generally, and regarding services your organisation provides) D. OLDER PEOPLE’S CONTRIBUTION TO SOCIETY How do you see older people’s contributions (actual and potential) to their neighbourhoods and to the wider community? E. DISADVANTAGED OLDER PEOPLE 1. From your organisation’s viewpoint, which older people or older groups in the County are most at risk of being marginalised or socially excluded? 2. What new services or programmes are needed for them? THANK YOU! 159 Older people in Dun Laoghaire Rathdown: profile and needs APPENDIX 6: Questionnaire for Older People’s Network Survey of contributions and needs of older people in DLR LOGO for Network LOGO for Southside Partnership Network for Older People in Dún Laoghaire Rathdown Survey: The Contributions and Needs of Older People in Dún Laoghaire Rathdown February 2009 160 Older people in Dun Laoghaire Rathdown: profile and needs Information about the survey: questions & answers Why is the Dún Laoghaire Rathdown Network for Older People doing a survey? The Network Committee wants to identify the contributions and needs of older people (everyone over 55) in Dún Laoghaire Rathdown, and to bring important issues and problems to the attention of local elected representatives, and others who can change or improve things. The Southside Partnership is supporting the Network’s initiative, and help has also been received from the County Council and from Age and Opportunity. How is the survey being organised? Each group in the Dún Laoghaire Rathdown Network has been invited to take part, and to appoint a link person to come to a planning meeting in early February. This person will be responsible for distributing a number of questionnaires to group members, making sure they are returned to the Network office. Independent researchers will analyse the information, and write a report for the Network, presenting the main findings. Is the survey confidential? Yes, the information you provide will be completely anonymous and confidential. You are not asked to put your name or address on your questionnaire form, and an envelope will be provided which you can seal with your completed form inside. What will happen to the information? When the report of the findings of the survey is written, it will be presented to Southside Partnership and the County Council, and used for lobbying local and national representatives, as well as agencies and organisations that provide services for older people. All the groups that participate will be informed of the outcomes, so everyone will be able to see how useful their contribution has been. Why should I participate? You are the expert on your own experience as an older person in the county, and your views, based on that experience, are the most important part of the survey. THANK YOU FOR YOUR HELP! 161 Older people in Dun Laoghaire Rathdown: profile and needs How to complete the questionnaire The most important thing! This questionnaire is about your own experience as an older person living in the County. So please base your answers on your personal experience and give the Network your own individual views, rather than what you think other older people might say. How long will it take me? The questionnaire should take about 20 minutes to complete. What is the questionnaire about? It is arranged in six main sections, covering topics the Network considers important for the lives of older people in Dún Laoghaire Rathdown: Some information about yourself (but not your name or address) ‘Big issues’ for you as an older person in the county Your contribution to the local community, through membership of groups and organisations, volunteering work, caring for others etc. Questions about your use of transport (what, where, how often…) Questions about security and safety Questions about health and health services Important instructions and information: 1. Please answer all the questions, except those that don’t apply to you – for example, Q.16 is only for those who answered ‘yes’ to Q.15, and Q.26 asks people who are not happy with their transport options (Q.25) to explain why. Those who are happy should skip this question. 2. Please read the instructions (which are highlighted in red) carefully. You may be asked to tick one or more boxes or circle a number showing how you feel about something. There are also some spaces in which you can provide information and make a point in your own words. 3. Each group in the Network will decide themselves on the best way to organise the filling out of the questionnaires they have been allocated. Some people will be asked to take a questionnaire home to complete on their own, others will fill them out during a group meeting (but in privacy). In some cases, the link person for the survey will act as an impartial interviewer for anyone who finds it difficult to fill out the form. 162 Older people in Dun Laoghaire Rathdown: profile and needs About you 1. Your age group 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 -94 95 + Tick one box only 2. Your gender Male Tick one box only Female 3. In which area do you live? Blackrock Dún Laoghaire Ballybrack Tick one box only [ includes Blackrock, Deansgrange and Booterstown ] [ Dún Laoghaire, Dalkey, Sallynoggin, Monkstown, Glenageary ] [ Ballybrack, Killiney, Loughlinstown, Shankill, Johnstown , , Kilternan, Carrickmines, Cabinteely, and Cornelscourt ] Glencullen Dundrum [ Dundrum, Rathfarnham and Goatstown ] [ Stillorgan, Churchtown, Milltown and Mount Merrion] Stillorgan [ Glencullen, Cruagh, Tibradden, Ticknock, Ballinteer, Sandyford, Foxrock and Stepaside ] Please check the map on page13 if your area is not listed here. 4. How old were you when you finished full-time education? I was ……………………………years old 163 Older people in Dun Laoghaire Rathdown: profile and needs 5. What kind of accommodation do you live in? Tick one box only Owner-occupied house or apartment Council rented house or apartment Privately rented house or apartment Residential care home Hostel Other accommodation If you ticked ‘other’, please describe it ………………………………………………. 6. Which of these best describes your household? Tick one box only I live alone I live with my spouse (husband or wife) or partner only I live with my spouse or partner & with one or more of our children I live with one or more of my children only I live in a group setting, such as residential care Other type of household If you ticked ‘other’, please describe it ………………………………………………… 7. Which best describes your current occupation? Tick one box only In paid full-time employment Self-employed In paid part-time employment, or ‘semi-retired’ Retired Unemployed Home duties Other occupation If you ticked ‘other’, please describe it …………………………………………………. 164 Older people in Dun Laoghaire Rathdown: profile and needs 8. Do you use a computer (at home, at library etc) for internet access? Yes No Tick one box only The big issues 9. Please complete each statement by choosing one box to tick For me as an older person living in Dún Laoghaire Rathdown: a. Health services (including access to services) are A serious problem A minor problem Not a problem at all b. Security at home is A serious problem A minor problem Not a problem at all c. Age-related discrimination against older people is A serious problem A minor problem Not a problem at all d. Safety on the streets is A serious problem A minor problem Not a problem at all e. Getting information on entitlements and services is A serious problem A minor problem Not a problem at all f. Transport is A serious problem 10. 11. A minor problem Not a problem at all If you could change one thing to improve your life as an older person in Dún Laoghaire Rathdown, what would it be? Please write a short answer in the box below Do you think that older people’s voices are being heard by your local representatives (TDs and County Councillors)? Yes No I don’t know 165 Older people in Dun Laoghaire Rathdown: profile and needs Your contributions to the community 12. Are you a member of a group for older people e.g. Active Retirement, Senior Citizens’ group, ‘Old Folks’ group etc? (Tick one) Yes 13. Are you an active member of a club, society or group open to all age groups, such as a sports, gardening, bridge or art club? Yes 14. No Do you have regular caring responsibilities for a family member, friend or neighbour? Yes 16. No Do you volunteer your time to help in a charity, church group, community organisation, sports organisation or similar? Yes 15. No No If you said ‘yes’ to Q.15, tick one box to indicate the time involved It’s occasional a few hours a week a few hours each day full-time 17. Did you vote in the last national election? Yes No Transport Yes No 18. Is there a car in your household? 19. Do you drive it yourself? 20. Does any disability or health condition make travel difficult for you? Yes No Yes No 166 Older people in Dun Laoghaire Rathdown: profile and needs 21. What forms of transport do you normally use for local travel (in the County and the Greater Dublin area)? Tick ‘yes’ or ‘no’ for each item to show all the forms of transport you use No a. Car (yours or someone else’s) Yes b. Bus Yes No c. Taxi Yes No d. Minibus Yes No e. DART Yes No f. Luas Yes No g. Bicycle Yes No h. Other Yes No If you answered ‘yes’ to ‘other’, say what it is …………………………… 22. Which one of these forms of transport do you use most often? Choose one only from the list and circle it Car / bus / taxi / minibus / DART / Luas / bicycle / other 23. In your normal life, how often do you use transport (not cycling or walking) for local travel? Tick one box only Most days of the week Two or three days each week Only about once a week Occasionally Not at all 167 Older people in Dun Laoghaire Rathdown: profile and needs 24. For this question, please tick ‘yes’ or ‘no’ beside each item to show all the purposes for which you need transport. I normally use transport (not cycling or walking) to go to: Shops GP surgery Hospital and specialist appointments Yes Visiting and meeting friends and family Other social and leisure activities Adult education centres, other classes Yes Church services No Yes No No Yes No Yes No No Yes No Yes 25. In general, how happy are you with the transport available to you in your normal daily life? To answer, circle a number from 1 to 5 1 (very unhappy) 2 3 4 (unhappy) (neither happy (happy) nor unhappy) 5 (very happy) 26. If you answered ‘1’ or ‘2’ to question 25, use this box to say briefly why you are not happy. (If you answered 3, 4 or 5, skip this question) 168 Older people in Dun Laoghaire Rathdown: profile and needs Security and safety 27. Please complete each statement by choosing one box to tick. From my own experience, in my neighbourhood or local area: a. Street lighting is A serious problem A minor problem Not a problem at all A serious problem A minor problem Not a problem at all b. Footpaths are c. Pedestrian crossings are A serious problem A minor problem Not a problem at all d. Vandalism is A serious problem A minor problem Not a problem at all e. Anti-social behaviour is A serious problem A minor problem Not a problem at all f. Illegal drugs are 28. A serious problem A minor problem Not a problem at all In an average or normal week, how often do you meet and talk with friends and/ or neighbours? Tick one box only Never occasionally once or twice most days 29. How happy are you with the level of Garda presence in your neighbourhood? Choose a number from 1 to 5 and circle it 1 (Very unhappy) 30. every day 2 3 4 (unhappy) (neither happy (happy) nor unhappy) 5 (very happy) Do you think it is easy to obtain information about services and equipment to make your home safe and secure? Yes No I don’t know Financial security and financial information 31. At present, does your income meet your needs and enable you to maintain an adequate standard of living? Yes No 169 Older people in Dun Laoghaire Rathdown: profile and needs 32. Is information about your financial entitlements easy to obtain? (e.g. pension payments, bus pass, fuel allowance etc.) Yes 33. No I don’t know Is this information easy to understand? Yes No Not applicable Health and health services 34. How do you assess your general state of health? Please circle one Bad / poor / fair / good / excellent 35. Do you have a physical or mental health problem or condition such as poor eyesight or hearing that interferes with your daily life? Yes 36. How happy are you overall with the health and related social care services you use in Dún Laoghaire Rathdown? Circle one 1 (very unhappy) 37. 38. No 2 3 4 (unhappy) (neither happy (happy) nor unhappy) 5 (very happy) If you answered ‘1’ or ‘2’ to Q. 36, use this box to explain briefly why you are not happy. (If you chose 3, 4 or 5, skip this question) Is it easy to obtain information about health and related social care services which are available to you? Yes No Not applicable 170 Older people in Dun Laoghaire Rathdown: profile and needs 39. How happy are you with the overall quality of your local GP service? Choose a number from 1 to 5 and circle it 1 (very unhappy) 2 3 4 (unhappy) (neither happy (happy) nor unhappy) 5 (very happy) 40. If you answered ‘1’ or ‘2’ to Q. 39, use the box to briefly say why. 41. Do you use the district nurse or community nursing services? Yes 42. No If you answered ‘yes’ to question 41, how happy are you with the overall quality of the district/ community nursing service? Circle one 1 (very unhappy) 2 3 4 (unhappy) (neither happy (happy) nor unhappy) 5 (very happy) 43. If you answered ‘1’ or ‘2’ to Q 42, use this box to briefly say why. Finally, if you want to say more about your experience and views as an older person in Dún Laoghaire Rathdown, please write it over the page! THANK YOU FOR YOUR HELP! 171 Older people in Dun Laoghaire Rathdown: profile and needs Additional information Map: electoral districts in Dún Laoghaire Rathdown County 172