Your family

Many older people receive a lot of support from their families. We have already looked at family support in the previous chapter and here are some additional tips you may find useful:

• Accept help gracefully.
• Be willing to consider changes that will make life easier for you and your family – for example, using a motorised wheelchair, having a chair lift fitted, or even moving house to be nearer to a relative.
• Be positive and do not be grumpy. Try to put up with pain and inconvenience stoically.
• Use your money to make life easier for your family. For example use taxis rather than expecting your family always to take you to places. Arrange for someone to look after you so that your children are relaxed about leaving you to go on holiday.
• Do not become unnecessarily dependent. Make your own decisions whenever possible. Contribute to joint decisions. Do not be afraid to surprise your family, for example by arranging to go off on your own.
• Do not be demanding.
• Do not be disappointed when you would like more help than is offered. Ask for extra support in ways that it is easy for your family to say no.
• Try to give support to your family as well as receiving support. For example, listen to their problems as well as telling them yours. If you no longer have a car can you offer the use of your garage to one of your children? If one of the family is throwing a party is there anything you can do to help?
• Be thoughtful. Do not act as if the world revolves around you and your needs.

Do not apply these tips just to your family: most of them apply to your friends, acquaintances and even those people you pay to help you.

Your social network

Your friends and acquaintances frequently will be an important part of your support network. These can be friends, neighbours and acquaintances you have acquired over the years, or they may be part of some grouping, say a local church, walking group, swimmers, bridge players, and the like. I am often impressed by how kind and helpful people will be when someone needs support.

My wife and I swim every morning. There is a strong social grouping among the swimmers, many of whom are quite elderly (two are over 90!). Recently, when two of the swimmers were hospitalised with falls, the swimmers organised an informal rota for hospital visits.

Perhaps the most important support that your social network can give is less tangible. Their friendship and sound advice can help you maintain a positive outlook. You can find yourself encouraged to do something positive to address a problem – be it a visit to your doctor, or arranging a visit from a plumber or electrician. You will also find your social network a great source of advice and personal recommendations. It is always better to select a tradesman from a personal recommendation, than from an advertisement in the local paper.

At the risk of repeating myself – remember to be a giver of support and not just a recipient.

Support you pay for

Many retired people maintain their independence whilst remaining in their own homes, by employing one or more ‘home help on steroids’. In most areas it is relatively straightforward to find sensible, hard-working individuals who will clean, shop and generally help you maintain your independence. In addition there are agencies who provide carers and nurses on an ‘as and when’ basis – these will be significantly more expensive than employing someone yourself, but can be a very valuable resource to provide cover when your usual carer is on holiday or ill, or when you need short-term or nursing care.

If you employ someone who helps you maintain your independence you need to be aware of the fact that probably you will become friends with your carer. This means that you will have to balance your two roles as employer and friend. Just because you are friends does not mean you cannot criticise the service you receive. For example, if your carer persistently turns up late, especially without calling to let you know, then you should make it clear that this is unacceptable. The correct approach in such situations is to be ‘polite but firm’.

Give your carer annual pay rises. It is unfair to make them ask for a raise. Money alone does not buy loyalty, but this sort of professional consideration will make it clear that you know how to behave professionally as an employer and, consequently, will reinforce your position when you require your employee to behave professionally.

It is worth raising one issue that potentially can cause serious problems. Under no circumstances whatsoever should you mention the possibility that you will make provision for your carer in your will. If your carer mentions the possibility then this is a gross breach of professional behaviour that would, in most cases, be grounds for dismissal. If you choose to keep them on then make it clear that the issue must never be mentioned again. There is a very great danger that the carer may be manipulative and cannot be trusted. In extreme cases they might even be a physical danger to you. For similar reasons I would advise strongly against lending your carer money, or making excessively generous gifts to them.

If you feel you need full-time support, then it can be cost effective to have your carer live with you, saving them the costs of accommodation. If you go down this route make sure you make good arrangements for the carer to have plenty of time off – they are not your slave! Remember that many care homes have rooms that offer respite care, which you can use to give your carers a rest. Respite care can also be an excellent way of experiencing residential care.

If you are employing a carer regularly then you ignore employment legislation at your peril. Your social services (see the next section) will be able to provide advice on your responsibilities as an employer. It is not a good idea to collude in your carer being a member of the ‘black economy’. Most house insurance policies provide proper insurance cover for such carers.

Apart from carers you will want to build up a network of service providers, such as:

• local doctor
• dentist
• osteopath/chiropractor/physiotherapist
• chiropodist
• plumber
• electrician
• builder
• roofer
• car mechanic
• handyman
• gardener
• tree surgeon
• heating engineer
• taxi firm
• hairdresser.

Many of the services that usually are provided centrally (e.g. hairdressers and chiropodists) can be provided at home if you have difficulty visiting them.

Many local service suppliers give priority to ‘good customers’. Once you have found someone good then try to stick with them. Remember to pay your bills promptly – nothing annoys professional service suppliers more than having to chase customers for payment.

There are also excellent services that cover home emergencies, such as plumbing, electrics, drains, gas and water supply problems. These provide 24/7 cover that gives peace of mind and will save you the stress of finding someone in a hurry, or over the weekend, or at Christmas!

The social services

Most countries will have a state-funded mechanism for helping you to maintain your independence. Usually services will be subsidised only if you cannot afford to pay for them yourself. At the time of writing, in the UK, £22,250 is set as the limit on your savings above which you must fund support yourself. In calculating your savings, any equity you have in your house is excluded until you need residential care, when your house may have to be used to fund your care. Be aware that if you release equity from your home this will then count as savings. If you have a spouse they will not lose their home – but you should check the rules carefully as rules and regulations change constantly.

Even if you have more than £22,250 of savings, a considerable amount of expert advice is available free of charge. The entry point in the UK is a ‘needs assessment’ where an occupational therapist or skilled social worker will assess what help you need to maintain your independence. This assessment is provided at no charge and future advice is not charged for. However, if your savings are above £22,250 you will have to pay for most services yourself.

I have received mixed reports about the effectiveness of the UK system. Everyone seems to agree that the system is well designed and well intentioned. You will, however, be highly dependent on the skill and personality of the social services staff who implement it – but how could this be otherwise? It is also inevitable that the services that can be offered will be constrained by affordability – there will never be enough money. The UK system does allow others to top up the support you receive and, if you have to go into residential care, the fees can also be topped up by relations or friends. In addition, you can receive either care service or a direct payment that allows you to make your own arrangements.

If you go into residential care paid for out of your house’s equity then you may want to think upfront about what will happen if you live long enough that the equity falls below £22,250. Some care homes will allow you to stay on even if the state pays the statutory minimum fees. You may have relations who will then pay top-up fees. Your social worker will be able to advise you on the options available.

Is it best to think of such things in advance? I am not sure anyone is wise enough to be able to answer this question. I hope if I find myself in this situation I will want to ‘eat, drink and be merry, because tomorrow we …’

If you are not well off but have savings above the £22,250 limit then you have to consider whether it is worth spending, or giving away, sufficient money to qualify for subsidised services.

I hope this section has not depressed you. Knowing what the facts are helps people conquer their fear. As is so often the case, those who treat life’s glass as half full can continue to live very full and happy lives even when they find themselves in constrained financial situations.

Computers

If you do not already have a home PC you will find the benefits enormous. There will be plenty of local courses to help you get started. You will also find your younger relatives are often very keen to help you, especially when the bloody computer misbehaves. You will also be able to buy computer support over the telephone, and there will most likely be local shops who will repair broken systems.

Why am I so keen on the retired getting a home PC? The support it can offer to your independence can hardly be overstated.

The range of products and services that be accessed over the internet truly is vast. You can do everything from buying groceries to buying the most specialist items, or buying second-hand goods. The supermarket we use even allows you to book a two-hour slot for delivery. The information, both visual and textual, about what you are buying is usually comprehensive, and online feedback often will help you assess what is the best product for you. The internet is such an interconnected world that news of bad service spreads like wildfire and, as a result, the quality of service frequently is excellent – even at bargain- basement prices.

The world wide web is an amazing source of information – on just about everything! It is now often the default mechanism for publishing information. For example, the government increasingly will use the web as the primary channel for disseminating information about what services it offers to you.

I can still remember the surprise when an elderly relative’s train was delayed and he apologised for keeping me waiting to pick him up at the station, and I said I had checked the arrival and departures board on my computer, so I had known he would be late.

The web increasingly is being used to create communities.

• Communicating by email (electronic letters that usually are delivered in seconds or minutes) is now second nature to most families and friends, with emails also being used to send pictures, videos, documents, jokes, and the like.
• Many of the younger generation will be using social networking sites or blogs (web diaries); these increasingly will be used by them to send people they know news about what they are doing.
• Voice over the internet increasingly is being used to provide cheap or free international telephone calls to friends and relatives.
• Many hobbies have very active online communities. For example, if you want to research your family tree then the internet will be an invaluable tool.
• Increasingly you can take a portable computer and have wireless access to the internet in many public places, hotels and the like.

Get a relative or friend to show you what you can do with a computer; you will be amazed. There are so many things I cannot imagine coping without: street and road maps that can find any postcode or place name and will soon show pictures of the street scenes; routefinders that give detailed directions and time estimates for journeys; rainfall radar maps to show where it is raining or snowing; instant news and analysis from around the world; replay TV and radio programmes you missed; Google Earth, which provides high-definition satellite pictures of anywhere in the world; Wikipedia, the online encyclopedia, covers everything from Proust to Harry Potter; online banking and access to stockbrokers and analyst information; managing your personal finances; online auctions; writing and storing letters; making and printing your own party invitations and greeting cards; digital photography with instant download, viewing and printing of pictures plus the ability to enlarge and crop photos, organise photo albums and the like (and the same for videos); photocopying; scanning old photos and documents … the list is almost endless.

However, there are some dangers that you need to be aware of. Protecting your computer from viruses and criminals is essential. If you do not protect your computer properly you will be attacked – this is not protection against some unlikely event, you probably will be attacked in hours or days. You need to do the following:

• Obtain a virus checker that receives immediate online updating against new viruses.
• Install a piece of software called a firewall, or ensure that if one comes with your computer it is configured properly (you can ask a friend, relative, or computer support person to do this for you).
• Ensure that you enable online security updates to the computer software (the latest versions of Microsoft Windows allow this to be done very easily).

You also need to find out about, and be alert for, the signs of computer scams and virus attacks. Your bank or building society will never ever, ever, ask you to disclose your passwords except when you log on directly to their sites – if they seem to be asking you then it is a criminal committing a crime called phishing. Emails that tell you that you can get free money by helping someone get money out of their country (the so-called Nigerian scam), or who tell you that you have won a competition, are all from con artists. If something seems too good to be true, it is indeed too good to be true. Emails you do not fully recognise, such as an email telling you a package cannot be delivered, or that invite you to click on a web link that will tell you more, usually are from con artists or activate viruses. Any email in broken English should be very suspect. Stilted offers from abroad to buy goods that you are selling are from con artists – personally I refuse to sell any items abroad even if the buyer appears to be genuine.

If in any doubt whatsoever do not reply and do not click on a web link. Once you have used a computer for a while you will recognise immediately dangerous approaches.

The second major risk you need to be aware of is the need to protect your data in the event that your computer hard disk (which stores your data) breaks down and the data from the disk cannot be recovered. There are numerous ways of dealing with this risk easily and cheaply.

• Most modern computers have an automated facility that regularly will make a copy of your files onto a separate disk that is plugged into your computer. Such disks are not expensive, and you need to make sure you specify this when you buy a new computer.
• You can copy important data regularly onto CDs or DVDs – well worth doing if you have an elderly computer. Alternatively you can email valuable data to a website that offers data storage facilities.
• Increasingly you can avoid storing any data on your computer but instead use software that is run on websites, which also will store your data securely on their computers. Remarkably, most of this software will be free – it is paid for by advertisers placing adverts on the websites. Documents, pictures and virtually all sorts of data can be managed in this way. This approach is referred to by the phrase ‘cloud computing’ and, in my opinion, this is going to become an increasingly popular and easy-to-use way of accessing applications and storing data via the internet.

Trust me, if you do not protect your data it is only a matter of time before you lose it all.

Games consoles

The latest generation of games machines, pioneered by the Nintendo Wii, allows physical interaction with games in a safe virtual environment. Games such as tennis, golf, baseball, skiing, yoga, aerobics, etc. provide a fun way to improve your flexibility, balance, reactions, timing, dexterity and fitness. These machines also allow group activity, which friends and the whole family can enjoy.

Mobile phones

Mobile phones mean that now you can contact your friends and relatives (almost) anywhere and anytime. They provide an excellent way to call for assistance if something goes wrong while you are away from your home. They provide a good back up in case your home phone line breaks down. They provide a cheap way to stay in contact when in hotels or when in residential care. If you find modern phones too small and fiddly, then there are phones available with large buttons and clear displays.

Satellite navigation

A number of elderly drivers told me that sat nav had enabled them to keep driving long distances for a longer period of time than would have been possible without it. The technology also alerts you to the locations of speed cameras, which is a great help now that the UK roads have such a vast number of different speed limits that it can be confusing as to what the speed limit is at any given location. In addition, many sat navs can be used to guide you when you are a pedestrian, or to provide position location when walking in the country.

Telemedicine

At the time this book is being written (2009) there is a lot of interest in the possibilities of telemedicine. Telemedicine uses sensors and modern communications to alert someone who can help you if your physical condition deteriorates significantly. For example, it should be possible for someone with a heart condition to wear a sensor that will alert the emergency services if they have a heart attack. Only time will tell if this becomes a significant technology for helping people maintain their independence. Fall alarms are a simple, but very valuable, first step in telemedicine.