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A GUIDE FOR
OLDER PEOPLE
THE
Health
OFTHE NATION
CONTENTS
Page
Introduction..........................................................4
Healthy Living —
Self-Care for a Healthy Lifestyle ................. 6
You and Your Body........................................ 16
Medicines .............................................................22
Common Health Concerns.......................... 25
Mental Health .................................................... 36
Caring for Someone Else.............................. 45
Bereavement...................................................... 46
Ethnic Minorities.............................................. 46
Housing................................................................ 47
Safety and Security in Your Home.......... 49
Social Services.................................................... 52
Money Matters.................................................. 54
How to Complain.............................................56
Further Reading................................................60
Useful Organisations....................................... 61
Personal Record
Fill in your personal details and keep handy for
immediate reference.
Doctor
Name ...
Address.
Dentist
Name ...
Address.
Tel:
Tel:
Optician
Name
Address...
Chiropodist
Name
Address
Tel:
Tel:
Pharmacist
Name
Address
Tel:
2
Details of medicines
prescribed by your
doctor
Local Authority —
Social Services
Department
Tel:
Housing Department
Tel:
Local Social Security Office
Tel:
District Health Authority
Tel:
Emergency Services —
Police Station
Tel:
Gas
Tel:
Electricity
Tel:
Water
Tel:
Citizens Advice Bureau
Tel:
Person to be contacted in an emergency
INTRODUCTION
Today, people live longer chan ever before and
look forward to enjoying many years of active life.
Changes happen to us all as we grow older —
hair can lose colour, names can slip the mind,
staircases seem to get steeper. But there is much
we can do to improve the quality of our lives
and maintain good health in later life.
Growing old is not a disease. But don’t dismiss
physical or mental problems as “just old age”.
Many conditions can be treated very easily and
successfully; there are many professional people
who may be able to help you and there is a lot
you can do to help yourself.
There have been many improvements in recent
years in the quality and range of available care,
many of which are of particular importance to
older people.
All doctors are required to offer an annual
health check to their patients aged 75 and over.
Local pharmacists (chemists) can advise you on
minor health problems, including when you
should see the doctor. Men over 65 years and
women over 60 get prescriptions free of charge.
Depending on income, you may also be able to
get help with the cost of dental care, sight tests
and glasses.
4
Your local authority Social Services Department
can help you and can advise you what services
are available in your area. If it appears to them
that you are in need of services, they will assess
with you what your needs are and then,
according to their eligibility criteria, arrange for
appropriate services to be provided to meet your
needs. To find their address and telephone
number and other useful services mentioned in
this booklet check in the telephone directory or
ask at your local library, Community Health
Council or Citizens Advice Bureau. When you
have looked them up, you may find it useful to
enter them in the personal record at the front of
this booklet.
Good health is not just about good quality
services. In many ways it is a partnership
between you and the health care professionals
who can help you. The Government
published The Health of the Nation in July
1992 to help forge this partnership and
promote better health for everyone. This sets
out, for the first time, a strategy to reduce
illness and premature death.
Health of the Nation identifies five Key Areas
for action:
° Coronary Heart Disease and Stroke
° Cancers
• HIV/AIDS and Sexual Health
• Mental Illness
Accidents
This booklet gives you practical advice and
information on how you can stay healthy and
avoid illness or injury including advice and
information relating to these five Key Areas. The
first part of the booklet, HEALTHY LIVING,
gives you information to help keep you in good
health. Other sections contain advice on what
to do about particular problems, and where to
find help.
HEALTHY LIVING - SELF-CARE
FOR A HEALTHY LIFESTYLE
It is never too late to change your lifestyle and
habits in order to lead a healthier and happier
life. Although, ideally, healthy living should start
in infancy and continue throughout life.
Smoking
It is a myth that smoking doesn’t matter if
you’ve smoked all your life without apparent ill
effects. It is never too late to feel the benefits of
stopping. In fact, giving up smoking is the
single most effective action you can take
to improve your health.
All forms of smoking are bad for you: cigarettes,
cigars and pipes. Smoking increases your risk of
heart disease, lung disease (especially bronchitis
and lung cancer), and osteoporosis (thinning of
the bones). It also reduces your chances of
survival after a heart attack.
Many people successfully give up smoking every
year and there is plenty of help available.
Doctors are only too happy to help and useful
leaflets can be obtained from ASH, QUIT, and
the Health Education Authority. (See USEFUL
ORGANISATIONS pages 61, 67 and 68.)
Or you could phone QUITLINE on
0171-487 3000 for a free QUITPACK which
explains how to stop smoking.
Het
It is the food we eat that gives us the energy and
nourishment to live and enjoy life. If you don’t
vary your diet or eat enough, you are more
liable to illness. On the other hand, eating too
much can also cause health problems.
A well-balanced diet should be varied and
include plenty of fruit, vegetables, and foods
rich in starches (potatoes, bread, rice and
pasta) and fibre or roughag
(wholemeal bread, potatoe
with their skins left on
and bran). Fish,
especially oily fish like
mackerel, sardines, tuna or
pink salmon are nutritious.
cuts of red meat and poultry, if possible and
avoid eating too many salty and sugary foods.
Saturated fat, which is found in butter, some
cooking fats and full cream milk should be taken
in moderation. Make sure you drink plenty of
non-alcoholic fluids, including tea, fruit juice,
water and milky drinks. Taste may diminish with
age, so the addition of herbs and spices (rather
than salt) is a good way to stimulate the appetite.
Vitamin D is very important to keep bones
healthy, and it can be found in oily fish, margarine
and breakfast cereals. Your skin also makes vitamin
ID when it is exposed to sunlight, so try to sit out
in the summer — even if you only uncover your
hands, face and neck. Even short but regular
exposure can help. However, in sunlight it is
advisable to use a sunscreen cream, to keep your
skin from becoming burned. If you dislike direct
sunlight, sitting in light shade will help your skin
to make vitamin ID without you getting burnt.
Alcohol
In moderation, alcohol is unlikely to cause you
harm, but too much can seriously damage your
health. It slows down the brain and affects
concentration, memory, and reactions and in the
long term, it can also lead to stomach disorders,
high blood pressure, and brain damage.
Sensible levels are 14 units a week for women,
and 21 units a week for men, spread throughout
the week, with two drink-free days. One unit of
alcohol is found in half a pint of ordinary beer,
a single measure of spirits, a small glass of sherry
or a glass of wine. Since alcohol is more likely
to stay in the body for longer as you get older,
8
you may find that you are affected by a very
small amount of alcohol, and it may be wise to
drink below these amounts.
'Weight
It isn’t healthy to be either over or under weight:
° if you are overweight, you will be less
mobile and at greater risk of high blood
pressure, heart disease and diabetes. If you
suffer from arthritis, it is likely to get
worse. The best way to lose weight is
through diet and exercise;
° if you are underweight, you will have
greater risk offractures and osteoporosis.
See your doctor if your weight changes
suddenly and you have not altered either your
diet or how much you exercise.
Exercise
This is good for you at any age and whether you
are physically disabled or able-bodied. It is
never too late to start. Consult your doctor
first if you have been ill, or are unused to
any physical activity.
Exercise will improve your strength,
suppleness and stamina and memory,
and help protect against heart disease,
osteoporosis and many chronic conditions.
9
It helps maintain mobility and prolong
independence. It also fosters a positive mental
attitude and contributes to a sense of well
being.
gardening,
O Activities like O
O’ bowls,’ dancing,
O’
cycling
and
walking
are
all
excellent
forms
of
J
o
o
exercise. Swimming is particularly good if you
are overweight or have any backache, stiffness or
disability, because your body is supported in the
water. Aim to become gradually more active
more often. If you can manage 30 minutes of
activity (in one or more sessions) on most days of
the week. This will be good for your heart as well
as your joints and bones. Many local authorities
offer older people reduced rates of entry to
sports centres and special exercise facilities.
Sexuality
10
Older people can enjoy sexual relations just as
much as younger people; indeed, changes in
your body can enhance your own or your
partner’s pleasure. Of course, there still remains
the risk of getting sexually transmitted diseases
in unprotected sex with a new partner, as with
other age groups. Other bodily changes can
cause difficulties. After the menopause women
may experience physical changes, for example,
vaginal dryness; there are creams and lubricants
to help to ease this. Some older men suffer from
impotence, through an illness (such as diabetes)
or certain medicine they are taking. Don’t be
embarrassed to get help with this or any other
sexual difficulty from your doctor.
Keeping Mentally Active
Keeping mentally alert is just as important as
keeping physically active. Spend time on your
hobbies, join a club or start a course. The
University of the Third Age (U3A) (see
USEFUL ORGANISATIONS page 71) can
help you here. It organises classes and activities
and has over 200 groups around the country.
The governing bodies of sport are always glad to
accept volunteers to assist in running local sports
clubs or act as coaches or referees. The Sports
Council (see USEFUL ORGANISATIONS
page 70) can provide names and addresses of the
governing bodies.
Your local College of Further Education,
Institute of Adult Education or Community
College will have a list of the various courses on
offer, both in the evening and the daytime.
Many local authorities also run recreation classes
during the day and some voluntary bodies
welcome older people who would like to use
their skills to help others. (See USEFUL
ORGANISATIONS pages 61-71.)
Reminiscence is a valuable activity as people age
and can improve the quality of your life by
helping you relive your past and focus on the
personal way you remember life experiences. It
is enjoyable and stimulating and highlights your
assets rather than your disabilities, and is a good
way of meeting people.
Age Exchange, for example, (see USEFUL
ORGANISATIONS page 61) runs a
professional theatre company which presents
plays and song and dance productions based on
older people’s memories in residential care
settings all over Britain. Its base is the
Reminiscence Centre in Blackheath, South East
London, a unique community centre for older
people where there are a variety of reminiscence
activities. For more information, contact Aire
Exchange. Your local Social Services
Department can also provide information about
reminiscence activities in your local area.
Keeping Warm in Winter
This is a vital part of keeping well. At home,
you should aim to keep living and sleeping areas
comfortably warm. You should have at least one
proper meal a day (see the section on diet on
page 7) and if possible, this should be hot food.
Plenty of hot drinks will help you to feel
warmer inside.
Try to avoid moving from a warm room into
a very cold one if you can. In cold weather, it’s
best to warm your bedroom before going to
bed, and keep the window closed at night.
When you go out, the best way to keep warm is
by wearing several layers of clothing. It is
important to make sure your head, hands and
feet are well covered, especially if you know you
may have to wait around in the cold.
Flu is more common in the winter months, and
can pose a threat to your health if you suffer
from conditions like chronic heart and
respiratory disease or diabetes. If you do, you
should ask your GP about immunisation (see
the section on flu on page 35).
For more information about coping with cold
weather, phone the Winter Warmth line free on
0800 289 404.
Getting Out and About —
Driving
Driving licences are valid until the age of 70.
Renewals are applied for using a Form DI00
available at Post Offices and details of how to
apply are given on the form. Depending on the
applicant’s medical condition a new driving
licence can be issued for a further one, two or
three years after which another renewal
application can take place.
You may find driving more of a strain as you get
older. Arthritic fingers, stiffness in the hips, knees,
neck and shoulders and a loss of strength in the
arms are all familiar problems to many thousands
of older drivers. Many people either put up
with the pain and discomfort, or if it becomes
too much, give up driving altogether and
consequently face the loss of their independence.
However, you may be able to get help with
these problems by simple, low cost adaptations
to your car. The Department of Transport’s
Mobility Advice and Vehicle Information
Service (MAVIS) offers free advice by letter
or phone to any older driver worried about
continuing to drive. MAVIS can be contacted
at TRL, Old Wokingham Road, Crowthorne,
Berkshire, RG1 1 6 AU, tel: 01344 770456.
Public transport concessions
All local authorities have legal powers to operate
concessionary fares on local public transport and
most have schemes for people over state pension
age. However, there is no standard scheme and
as the benefits vary from place to place, it is
advisable to check. In addition, as a commercial
venture, the railway and long-distance coach
operators offer reduced fares for older people.
Several holiday companies offer special
concessions to older people who can take
a break at off-peak times. Some companies
specialise in holidays for older people, making
sure their hotels have lifts and that there is
someone to help with luggage.
Wheelchairs
14
Your local health authority will provide a
wheelchair service. If you need one, for indoor
or outdoor use, ask your GP where the service
is based. Alternatively, voluntary organisations,
such as the Red Cross, may have wheelchairs to
loan for occasional use.
Dial-a-Ride Services
In most large urban areas and many small towns
door to door transport services are now available
for people who are unable to use public transport.
The services which are known by a variety of
names, including Dial-a-Ride and Dial-aJourney, provide wheelchair accessible transport
to enable people to visit friends, go shopping,
and attend social events, etc. Fares
are usually based on local bus fares,
but concessionary passes are
sometimes accepted. Generally
the services can only be used by
local residents, who have to register, but some
schemes will assist visitors if possible. The
services cannot be used for trips to hospital for
medical treatment or for any other journeys
where health authority transport is available. To
find out whether there is a Dial-a-Ride service
in your area you should contact your County
Council’s Public Transport Information Officer
or your local Social Services Department.
The Orange Badge Scheme
If you are unable to walk or cannot walk more
than a short distance, and you either drive a car
or are driven by someone else, ask your local
15
Social Services Department about the Orange
Badge Scheme. (See USEFUL
ORGANISATIONS page 70). Many places
have parking spaces specially reserved for cars
displaying an Orange Badge on the windscreen,
and you may also stop for a limited time in
places where parking is not normally allowed.
YOU AND YOUR BODY
Many changes occur in the body with age,
but you may never suffer from the conditions
outlined either in this section or the next.
By taking the advice in the HEALTHY LIVING
section of this booklet, you will give yourself
the best chance to maintain good health.
This section sets out common changes which
can occur with age, many of which can be
helped or prevented.
It is not unusual for a person’s eyesight to
change with age. You may find as you get older
that you have to hold a book at arm’s
length to read or that things are
7
beginning to look blurred. It is a
good idea to have a sight test regularly. Eye tests
can show whether you need to have glasses or
to change them, and how healthy your eyes are.
Sometimes underlying medical conditions can
be detected by examining the eyes.
When you go to the optician, always ask
whether you are entitled to a free NHS sight
test. Free NHS sight tests are available to certain
groups of people. If you have to pay for your eye
test, you will find it best to shop around as the
cost may vary from one optician to another. You
can ask to take away your lens prescription and
use it to buy your glasses elsewhere. If you are
on a low income or need complex lenses, you
may be entitled to an NHS Spectacles Voucher.
A good overall level of lighting at home is
important. Place lights near to where you need
them, especially when doing close work. You
need adequate lighting on staircases especially at
the top and bottom of flights of stairs and at
back and front doors where steps may be more
dangerous in the dark. If your eyesight is such
that you need further advice and guidance, you
will find that there are local and national
voluntary organisations that can give you more
information and help.
Heaving
Many people lose the ability to hear highpitched sounds as they grow older.
Consult your doctor if you find it hard to follow
a conversation, hear the telephone or doorbell,
or if you need to turn the radio or TV up very
loud. There may be a simple cause such as wax
in your ears, which can be easily removed (don't
17
try to do it yourself and NEVER poke anything
in your ears).
The doctor may send you to a hospital for a
hearing test. Hearing aids are free through the
NHS to everyone who needs them, as are the
batteries and any repairs. It is possible to get a
hearing aid from a private dispenser, but this is
often very expensive and you will not get free
repairs or batteries. Be very wary of
advertisements for hearing aids and salesmen
who offer to call at your home.
It takes time to get used to a hearing aid and to
learn how to get the best from it. The person
who fits it will explain this. Be patient, but do
go back if you have any problems. (If the
hearing aid stops working, make sure you try
changing the battery before you take it back!)
Above all, don’t be shy to tell people you are
hard of hearing and to ask them to speak more
clearly. You will find it much easier to hear if
you stand or sit where you can see people’s faces
clearly. If you can, make sure the room is well
lit. You may also like to join a class where you
can learn to lip-read. Lip-reading is not just for
people who are completely deaf — it can be very
useful for anyone who is hard of hearing.
18
If you have difficulty hearing the telephone,
doorbell or television you can also get special
equipment. Ask your local Social Services
Department or contact one of the voluntary
organisations listed at the end of this booklet.
Teeth
You can keep your teeth all your life with
proper care. Looking after your teeth is not
difficult. Brush your teeth and gums every day
with a fluoride toothpaste and avoid eating
sugary foods. Some toothbrushes have been
specially designed for older peop’
It is as important to take as much
care of false teeth as of natural
^^8.
teeth. If you have false teeth you
fea**"**^
should wear them, except when you go to sleep.
Take them out at night and leave them in water.
Clean them carefully with soap and water or a
proprietary denture cleaner and go to a dentist
regularly. Whether you have your own teeth or
not, your dentist should examine your mouth
from time to time. Your dentist may be able to
visit you at home if you are housebound.
NHS dental treatment is free for those who
receive Income Support (and for those with
partners receiving Income Support). People on
a low income may get help with the cost of
dental treatment. Leaflet D l l explains how to
get help, and is obtainable from your dentist or
local Benefits Agency office.
Feet
Looking after your feet is very important,
whatever your age, particularly since minor
19
problems can easily lead to major ones.
Whatever you wear on your feet, make sure it
fits well and is comfortable from the start. Don’t
wear slippers all day.
Feet should be washed regularly and toenails
trimmed. (GPs can provide advice on where this
service can be obtained.) It is important to dry
feet properly, especially in-between toes.
Hosiery should be washed frequently. Any cuts
or sores on the feet should be looked at by a
health professional. This is particularly
important if you have diabetes or peripheral
vascular diseases. If you suffer from diabetes you
should be especially vigilant.
If you have a problem with your feet, your
doctor will be able to put you in touch with an
NHS chiropodist. Practice nurses and
chiropodists attached to the surgery can also
provide very useful assistance and advice to help
you look after your feet and can treat painful
conditions such as bunions.
Skin
Changes in skin colour as you age are quite
normal and these can include brown “liver” spots.
Dry skin can be helped with use of a moisturiser.
In strong sunlight, it is advisable to use a sunscreen
cream to keep your skin from becoming burned.
20
Although skin cancers are becoming more
common, they can be treated successfully if they
are detected early enough. Warning signs are
if a patch on your skin itches, feels abnormal,
becomes inflamed, bleeding or crusty. If you
are at all worried, see your doctor.
Giddiness
Giddiness can become more common when
you get older and can be caused by sleeping
tablets or tranquillizers like valium. Other drugs
or medicines that may make you giddy are
blood pressure tablets and anti-depressants. You
should consult your doctor before stopping
them. Giddiness is often made worse by sudden
movements and you can help yourself by trying
to avoid these. Don’t get up or turn suddenly,
particularly if you have been in one position for
a long time. Try to avoid being immobile for
long periods. If you do become giddy, sit down
or lie down or at least hold on to something
secure until you feel steady. If your symptoms
persist despite these simple measures, consult
your doctor. One of the after-effects of a stroke
is a feelins; of unsteadiness. Abnormalities of
heart rhythm or a drop in blood pressure can
make you feel giddy when you stand up.
Indigestion
Indigestion can have a variety of causes and
symptoms, including a peptic ulcer. It can be
made worse by eating unwisely, by lying down,
21
bending, or sitting in a slouched position, or by
anxiety and also by taking aspirin in large doses
and by certain treatments for arthritis.
It can sometimes help to sleep with your head
higher than your stomach and your pharmacist
may be able to suggest a medicine to ease the
symptoms. But if the indigestion persists for
longer than a few days, or the pain gets worse,
or you are sick, you should consult your doctor.
Constipation
Constipation can be a problem, especially if you
have been ill. You can prevent or relieve it by
eating a high-fibre diet with plenty of fluids and
taking daily exercise. But remember that people
differ. For some, a daily bowel movement is
normal; for others, a movement every two or
three days is normal.
Your pharmacist will be able to advise you if
you need a laxative. You should consult your
doctor if your constipation is sudden, or if you
have stomach pains, are sick, pass blood or if
your bowel habits alter.
MEDICINES
As you get older, you may need a prescribed
medicine to maintain your health (to regulate
high blood pressure, for example) or to treat a
current ailment. Men over 65 years, and women
22
over 60 years get prescriptions free of charge.
You must fill in the back of the prescription
form before giving it to the pharmacist.
To use medicines safely:
o
take them exactly as prescribed; yon should
ask your GP about the effect of drinking
alcohol;
» follow the instructions on the label; if you
do not understand them or if you want more
information, ask the pharmacist;
• do not mix medicines prescribed by the
doctor with those bought from the
pharmacy, without checking with either the
doctor or pharmacist first;
° do not remove medicines from the
original containers as storage in
unsuitable containers may alter
their effect;
• if you do buy medicines, read the
packaging carefully and follow
the printed instructions; if you need further
information ask the pharmacist;
• do not share prescription medicines with
other people — they may look or sound the
same but they may not be suitable and they
could be harmful;
• if you wish to ask a question about your
medicines, but you cannot get to the
pharmacy, or someone collects your
medicines on your behalf, telephone the
pharmacist for advice — yon will find their
number on the medicine label;
• get rid of medicines you no longer need.
Take them to your pharmacist. Most
pharmacists are now involved with local
schemes to collect and dispose of u:< wanted
medicines safely.
Most medicines come in child-resistant
containers, which can sometimes prove resistant
to adults too. If you find it difficult to open
these containers, ask the pharmacist to supply
them in a container with an ordinary cap.
Keep Medicines Out of the Reach of
Children
Complementary Therapies
Complementary therapies such as osteopathy,
chiropractic, acupuncture and aromatherapy are
not commonly available on the NHS and are
primarily provided through the private sector.
If you are seeking such treatment from a private
practitioner you should:
• check with your GP before embarking on a
course of complementary therapy treatment;
• satisfy yourself that the treatment is likely
to be effective or at least not to cause harm;
24
• check that the practitioner is a reputable
member of an established profession and
carries proper insurance.
COMMON HEALTH CONCERNS
I his section lists some illnesses which may affect
some older people. These conditions do need
medical help. But many people stay healthy for
most of their lives. Many practices now provide
a wide range of services from the whole health
care team, such as health promotion
programmes for the prevention of coronary
heart disease and stroke. Almost all will help in
the treatment and management of asthma and
diabetes. They can refer you to an occupational
therapist to help you carry out daily living tasks,
or a physiotherapist to help with mobility,
a speech and language therapist, a range of
community nursing staff, for example, a district
nurse, or a specialist consultant at the hospital.
All surgeries must now provide a leaflet
explaining the range of services on offer.
Alzheimer’s Disease
(see Dementia page 38)
Pernicious Anaemia
This is a condition which is commoner in older
people, particularly in their 60s. It often presents
as anaemia, a decreased number of red blood
cells leading to tiredness and shortness of breath
and may worsen the symptoms in those
suffering from angina (see Heart Disease).
If you or an elderly relative or friend seem to
suffer regularly from these symptoms, you
should consult your GP.
Pernicious anaemia is caused by a lack of
vitamin B12, which requires the production
of a particular factor by the stomach. In patients
with pernicious anaemia, this factor is not
produced, due to the body destroying this by
an immune mechanism. Some people with this
condition may also have other disorders such as
thyroid disease and vitiligo.
When the diagnosis has been confirmed,
treatment is given with Bl2 injections since B12
cannot be absorbed orally. It is often possible to
have this done by a district nurse or at a GP
surgery, rather than needing to attend hospital.
26
Arthritis and Rheumatism
Arthritis is an inflammation of the joints. It can
come in the form of osteoarthritis and
rheumatoid arthritis. Osteoarthritis is much
more common in older people than rheumatoid
arthritis and can be aggravated by obesity. Aches
and pains in the bones and muscles are generally
called rheumatism. To relieve both, your doctor
may prescribe pain-killers or other medicines or
may ask a surgeon or other specialist to help
you. If you develop new persistent pains in your
bones or muscles, you should see your doctor as
some conditions may require special treatment.
But you can also help yourself. Your joints will
be less vulnerable to further damage if you keep
your weight down and stay mobile. Exercise as
much as you can without straining a painful
joint. Swimming is particularly good for this. If
VL
a joint is painful, rest it for a few hours and then
LIT start gently moving it again, perhaps in the bath
as warm water can help. Acute loss of physical
j function and mobility could be due to a number
p V of diseases or conditions. If you or someone you
I. are caring for develops this, see the GP as soon
e.
as possible.
Asthma
Asthma can cause wheezing and difficulty in
breathing. It can occur even in older people
who have never suffered from it before. Your
doctor will be able to help you with a variety
of treatments. Ninety per cent of GPs run
organised programmes for the management
of patients with asthma.
Bronchitis and Emphysema
Coughing and phlegm may occur with both
bronchitis and emphysema (over-expansion and
thinning of lung tissue). These conditions cause
breathlessness and interfere with the amount of
oxygen which gets into the blood; sometimes
the lungs do not get rid of carbon dioxide. This
can cause excessive sleepiness or mental
confusion and extra treatment is required. Some
people are supplied with oxygen which may be
ordered for 15 hours daily. People sleep with
a tube in the nostrils delivering oxygen from
a machine. In addition to the medicines
prescribed by your doctor you can help yourself.
If you smoke, stop immediately; it is never too
late to benefit. Regular exercise keeps the
muscles strong and improves the distance you
can walk.
Cancer
Although people talk about cancer as if it were
one disease, there are in fact many different types,
each with its own symptoms and treatment.
28
Symptoms
Although there will often be a simple
explanation, there are some symptoms that you
should report to your doctor as soon as possible,
because they could indicate a cancer:
° Coughing up blood;
° Bleeding from the vagina;
° Bleeding from your boivel or bladder,
usually noticed when going to the toilet;
o
Unexplained loss of weight;
» Persistent hoarseness;
° Persistent lumps that you have not
previously noticed, especially in the breast
in women;
• Any sores or ulcers on your skin, including
your lips and tongue, that do not heal or are
getting bigger.
Most cancers develop slowly over a period of
months or years. The success of treatment is
dependent upon the stage at which it is
detected. The earlier the better. Older people <
tend to be slower than younger people in
reporting symptoms to their doctor, but it is fJ
equally important for them to be seen and
treated as soon as possible.
Screening
There are national screening programmes for
breast and cervical cancer because there are
29
reliable tests available for diagnosing these types
of cancer before symptoms develop. This is not
the case for other cancers.
Breast Cancer
The National Breast Cancer Screening
programme is free and offers mammography
(breast x-rays) every three years to all women
between the ages of 50 and 64 at screening
centres throughout England. If you are in that
age group and registered with a doctor, you
should automatically get an invitation. Older
women can be screened three yearly on request.
Cervical Cancer
To detect cervical cancer (cancer of the neck
of the womb) all women under 65 should be
invited to have a free smear test every 5 years.
If you are over 65 you will still be invited for
screening if you have not had 2 clear smears
within the previous 10 years. If you have not
been invited to have a smear test and you think
you should have been, consult your doctor. The
test can be done in your own doctor’s surgery or
at a well woman clinic or family planning clinic.
30
It is of course worrying to be told that you or
one of your relatives or friends has cancer, but
many cancers, particularly if diagnosed early,
can be cured. Even if they cannot be cured,
progression of the disease may be very slow and
there are many treatments available to relieve the
pain and other symptoms of more advanced
disease.
Diabetes mellitus
Diabetes mellitus can affect people in all age
groups, but it is far more common in the elderly
population, especially in people who are
overweight. It is also more prevalent in the
elderly Asian and Afro-Caribbean populations.
It is thought to affect 6 out of 100 people in this
age group. The symptoms include tiredness,
thirst, passing water more frequently and weight
changes. These symptoms can occur in other
illnesses but if in doubt you should consult your
doctor who can do an on-the-spot test. Ninety
per cent of GPs run organised programmes for
the management of patients with diabetes.
Diabetes in older people can be treated by diet
alone, diet plus tablets and sometimes with
insulin injections. It is very important to seek
advice if in doubt as diabetes can cause serious
side effects including blindness, angina and
stroke. It has to be taken seriously. The British
Diabetic Association has published a pamphlet
Diabetes and Yon — a Guide for the Older Person
price £\ (see USEFUL ORGANISATIONS
page 63.)
Incontinence
This should not be accepted as “just a part of
getting old”. It is a very common problem
affecting all age groups and both sexes, and can
often be dealt with by very simple measures,
like treating an infection or learning some
simple exercises. If treated properly,
incontinence can in many cases be cured and in
others improved.
Since incontinence can happen to anyone, don’t
be embarrassed to ask for help. Your doctor will
be able to advise you and perhaps refer you to
a continence adviser or physiotherapist for
treatment. (See USEFUL ORGANISATIONS
page 65.)
Heart Disease
Heart Disease, together with stroke, is a key area
for action. There is great scope for preventing
illness and death from these conditions. This is
because both are associated with risk factors that
are themselves preventable, for example, an
unbalanced diet, smoking, raised blood pressure,
alcohol misuse and lack of physical activity.
Heart disease of one sort or another gets more
common with increasing age. The main
problems are coronary heart disease, an irregular
heart beat and heart failure.
Coronary heart disease is caused by gradual
furring up of the hearts own blood vessels by
fatty deposits. As the blood flowing to the heart
decreases people may suffer from ANGINA or,
if there is a sudden blockage, a HEART
ATTACK.
32
Angina is a tight chest pain that comes on
during exercise or excitement and fades quickly
with rest. This can cause faintness, giddiness,
and a feeling of sickness, as well as extreme pain,
or persistent pain lasting more than half an hour.
If you get chest pain accompanied by
breathlessness, sweating, and a feeling of
faintness, you should get medical help
immediately. See your doctor if your ankles
swell, you have palpitations, if you get breathless
at night or suffer from angina.
A heart attack also starts with a severe tight
pain in the chest which may go down one arm
and is accompanied by sweating, faintness and
possibly feeling sick.
An irregular heartbeat is felt as palpitations in
your chest and may be accompanied by faintness
or breathlessness. Heart failure also causes
breathlessness, sometimes in bed at night and
your ankles may swell during the day.
All these heart conditions can be treated and
you may be able to prevent coronary heart
disease by living a healthy lifestyle. Smoking Y
increases your risk of a heart attack. You
should also keep your weight under control, , a:eat a healthy diet, avoiding saturated fats
ty
and take regular exercise. It is also
important to drink alcohol sensibly.
4^
33
If you have sudden severe chest pain and think
you may be having a heart attack you or
someone with you should call for medical help
immediately by ringing 999 if necessary. Do not
wait, rapid treatment can be lifesaving.
If you suffer from breathlessness, palpitations or
angina you should see your own doctor as soon
as possible. He or she may be able to treat you
or may want to send you to hospital to see a
specialist for tests. Most heart conditions can be
treated by drugs but for palpitations you may
need a small operation to fit a heart pacemaker
which can transform your life.
If you suffer from angina or have a heart
attack you may need an operation to unblock
your heart blood vessels. These operations are
now routine and are very successful, enabling
you to return to a normal life. A healthy lifestyle
will then be important to prevent the heart
vessels from furring up again.
Information, advice, leaflets and videos on heart
and health matters are available from the British
Heart Foundation (see USEFUL
ORGANISATIONS page 63.)
A lot can now be done to treat heart disease —
through medicine or through routine, safe
operations. Cardiac pacemakers, which help
people with irregular slow heart beats are
painless and can transform peoples lives.
The best way to prevent coronary heart disease,
or stop it getting worse, is by following a healthy
lifestyle. If you smoke cigarettes, you are more
likely to have a heart attack than a non-smoker.
Keep your weight under control, eat a healthy
diet avoiding saturated fats, and take regular
exercise like walking or swimming. It is also
important to drink alcohol only in moderation.
Flu (Influenza)
Although flu is a common ailment which
attacks people of any age, some are more at risk
than others and may be more prone to
complications following a bout of flu. If you
think you have flu, go to bed and drink plenty
of fluids (not alcohol).
If you live alone, make sure that friends and
neighbours know you’re ill, so they can check
on your progress. If your symptoms don’t
improve after 24 hours, call your doctor.
Immunisation
The chances of catching flu can be reduced by
immunisation which is available from your
doctor from October onwards each year. The
flu vaccine is recommended if you have
diabetes, or a lung, heart or kidney disorder, or
if you are in a residential home, where flu can
spread rapidly. Discuss with your doctor or
nurse whether you are in one of the groups
recommended for vaccine. If you have not had
a tetanus injection, you may also want to discuss
immunisation against this as well.
High Blood Pressure
Blood pressure is the pressure the heart applies
to pump the blood round the body. At times of
stress, anger, fear or activity, the flow of blood is
increased. This is normal. If, however, the level
is constantly high, even at times of relaxation,
this is known as hypertension (high blood
pressure) which puts a strain on the heart and
increases the risk of a stroke. Your doctor can
advise on ways of controlling high blood pressure.
You can help yourself to keep your blood
pressure at a normal level. Watch your weight,
stop smoking, don’t drink too much alcohol, be
more physically active, eat less salt, relax, and
have your blood pressure checked.
MENTAL HEALTH
Mental health problems can occur at all ages.
The problems described here are ones which
can particularly affect older people, although
they may never be a problem for you.
36
Forgetfulness
It is quite normal to forget things from time to
time. Someone who is occasionally forgetful or
who sometimes cannot remember the names of
acquaintances or items on a shopping list does
not necessarily suffer from a medical problem.
However, if you are looking after someone who
is seriously and persistently forgetful, consult
a doctor.
Confusion
There are two common types. One comes on
quickly — within a few days or weeks — and is
likely to be connected with an illness, such as
a chest infection or poorly controlled diabetes,
or as a side effect from a medicine. If this is the
case, the problem can often be easily cured with
medical help. Eyesight and hearing need to be
checked, as problems with either can contribute
to confusion.
If you have to deal with someone who is
confused, it is important to appear calm and
friendly. Remember that the symptoms are the
result of an illness and that the person is not
seeking attention or “being difficult”. Keep
reminding them who you are and what you are
doing. And repeatedly give the reassurance that
things will get better.
The other type of confusion develops slowly
over years, and is likely to result from dementia.
J
7
J
Dementia (including
Alzheimer’s Disease)
Dementia is the name for a group of diseases
that affect the normal working functions of the
brain. It is the fourth most common cause of
death after heart disease, cancer and stroke.
There are more than half a million people in the
UK who suffer from some form of dementia,
with 20 per cent over the age of 80 affected and
6 per cent over 65 affected.
But there are far more older people with all
their faculties intact than there are sufferers from
dementia.
One of the most common types is Alzheimer’s
Disease. Changes take place in the structure of
the brain leading to cell death at a much higher
rate than in normal ageing. The disease is
progressive leading to a steady decline. Vascular
(or multi-infarct) dementia is the next most
common type. A series of small strokes creates
obstructions in the arteries to the brain resulting
in the loss of small areas of cells each time this
happens. Each stroke may be so small the sufferer
is unaware of it. There is a gradual deterioration
although the condition may remain static for
some time. There is currently no known cure
for Alzheimer’s Disease. For vascular dementia,
the best means of prevention and treatment is
the control of high blood pressure.
Because dementia usually interferes with
memory and the ability to think and reason,
people who suffer from the illness become
increasingly unable to look after themselves and
can be rather unreasonable in their relationships.
The first sign is usually an inability to remember
people s names and recent events. The dementia
sufferer can become disoriented about time and
place and forget the names of friends and family.
The sufferer with severe dementia can lose their
way around and become prone to wandering
away from home. An inability to remember
everyday things, such as whether they have
eaten, and constant repetition of one or more £
phrases are also signs of severe dementia.
If you are looking after someone with
dementia you should seek medical help.
But you can also encourage them to take
an interest in day-to-day events and to use
memory aids such as making lists.
<
f;
! '
L. <
Once the diagnosis has been made, it is
impossible to predict exactly how people will
respond to treatment. With adequate support,
individuals and their carers can still have a good
quality of life. Older people with varying
degrees of dementia can all benefit from a
consultation with a general practitioner, and
when necessary, a specialist.
39
People looking after a relative or friend with
dementia need a great deal of support and
guidance about the services available and how
to get a break. If you are having problems in
coping, see your doctor, community psychiatric
nurse, district nurse, health visitor, or Social
Services Department or contact the Alzheimer’s
Disease Society, who can provide personal and
practical advice and support for carers. (See the
section on CAKING FOR SOMEONE ELSE
page 45 and USEFUL ORGANISATIONS
pages 61-71.)
Depression
Depression is a common experience for people
of all ages. At times we all feel low-spirited or
fed up. However, in the medical sense,
depression means much more than just being
“down in the dumps”; it describes a real illness
which affects every7 part of a person’s thinking,
behaviour and health. Older people may be
especially liable to depression after bereavement
or when physically ill.
Depression is treatable, so it is extremely
important to get help when you or a relative or
friend are depressed. Early signs may include loss
of interest and enjoyment, loss of appetite and
weight, insomnia, and withdrawal from social
activity.
40
See your doctor. Sometimes it is just enough to
talk to someone trained to listen. Antidepressant
tablets may lift the depression and they are not
habit-forming. Since their full benefit may not
be felt for three or four weeks, it is very
important to continue the treatment.
Anxiety
Too many old people are housebound by the fear
of falling or being attacked. If you know of
someone like this, try to encourage and help
them to get out and about a bit. The doctor may
also be able to arrange help. Some people suffer
from what are called “panic attacks”. They can
make you feel shaky, breathless, etc and are very
frightening. Often relaxation helps to relieve
these attacks. Your doctor will advise you perhaps
by introducing you to a local relaxation class, or
you can borrow a tape from the local library.
A booklet entitled Mental Illness: mental health
and older people has been produced by the
Department of Health to inform older people
and their friends and relatives about some
mental health problems that can occur in old
age. It is available from libraries, Citizens Advice
Bureaux and GPs’ surgeries. The Alzheimer’s
Disease Society have produced a booklet, Safe as
Houses, which provides vital information for
carers who are responsible for supporting
someone with dementia who lives alone in the
community. The booklet gives advice on
personal care, finance, safety, medication,
wandering and security. It is available from the
Alzheimer’s Disease Society7. Their address is on
page 62.
Osteoporosis (brittle hones)
Osteoporosis is a condition which mainly affects
women after the menopause, but can also affect
men. Bones may become fragile and break more
easily, leading to fractures of wrists, hips and
bones in the spine. It can also lead to backache
and loss of height. Osteoporosis of the knee can
contribute to instability.
A healthy lifestyle, including taking exercise and
avoiding smoking and heavy drinking, will
reduce the possibility7 of developing
osteoporosis. Your doctor will advise you
whether any other action is necessary. If you
have already developed osteoporosis, or a serious
fracture as a consequence, such as a fractured
femur (thigh bone), your doctor may be able to
treat it or refer you to a specialist. (See USEFUL
ORGANISATIONS page 67.)
Parkinson’s Disease
Parkinson’s Disease afreets movement and
balance. Common symptoms are shaking,
particularly in the hands when they are relaxed,
and a stiffness and slowness of movement.
Depression is also common. Your doctor will be
able to help with medicines, and possibly refer
you to a physiotherapist or a specialist. (See
USEFUL ORGANISATIONS page 68.)
Pressure Sores (“bed sores”)
Pressure sores (sometimes called “bed sores”) are
areas of damaged skin and flesh which are
usually caused by sitting or lying in one position
for too long without moving. They can develop
within a few hours. People most likely to get
pressure sores include those in a wheelchair or
who have to stay in bed or spend long periods
in an armchair, people who have difficulty
moving about, are elderly or weak or have a
serious illness, people who are incontinent or
whose body is not very sensitive, for example
because they are diabetic or have had a stroke,
people who have a bad heart or poor circulation
and people who are not eating a balanced diet
or getting enough to drink. The Department of
Flealth has produced a leaflet to help people
avoid getting pressure sores. It is called Relieving
the Pressure — Your Guide to Pressure Sores. You
can obtain a free copy of the leaflet by phoning
the Health Literature Line on 0800 555 777. If
you do get a pressure sore, try not to worry —
they can be treated — get advice quickly — talk
to your doctor or nurse. Don’t be afraid to be
a nuisance - always ask for help if you think
you need it.
43
Shingles (post-herpetic
neuralgia)
Shingles occurs in someone who has had
chicken pox in the past and is caused by the
reawakening of the chicken pox virus in nerves
supplying a well-circumscribed patch of skin.
The blisters contain the chicken pox virus, so
someone who has not had chicken pox could
catch chicken pox from a person with shingles.
It can be brought on by stress. You feel severe
pain over a small area of the face, limbs or body
and after a day or two you notice a blistering
rash. You may notice that the area is numb.
Some people unfortunately get prolonged pain
after an attack and it is wise to see your doctor
immediately at the beginning of an attack as
early treatment may help to prevent prolonged
pain. If your pain is particularly persistent your
doctor may be able to refer you to a specialist
pain clinic.
Stroke (see also “High Blood
Pressure” page 36)
A stroke occurs when the blood supply to the
brain is interrupted. Its impact depends on
which part of the brain has been affected. There
are a number of professional people who can
help stroke patients regain their mobility, speech
and independence.
Some strokes can be prevented by detecting and
treating high blood pressure early. If you are
being treated for high blood pressure, you
should continue with the treatment as
prescribed by your doctor.
Ask your doctor about medicines that may help
prevent a further stroke. (See USEFUL
ORGANISATIONS page 71.)
CARING FOR SOMEONE ELSE
Many older people are carers, looking after
a spouse or other relative, or looking after a
disabled or sick son or daughter.
Looking after people can be very tiring, no
matter how much you love them. Stress and
strain can affect the health of those who
constantly have to care for someone else,
especially if they struggle too long on their own.
Talk to your doctor, district nurse or health
visitor and contact the Social Services
Department who may be able to organise other
services to help. These could include a Home
Care Assistant or sitting service to enable you
to get out or to have some time to yourself.
Perhaps there may be an adaptation for your
home that would make caring easier. (See
HOUSING page 47.)
The Social Services Department may arrange
day care for the person you are looking after,
or for a short break in a residential or nursing
45
home. (See USEFUL ORGANISATIONS
page 64: Carers’ National Association.)
BEREAVEMENT
Loss and grief are very stressful experiences.
Someone who has been bereaved may be
physically unwell for many months. There are
several phases of grief, and people go through
them at their own pace. The loss of a loved one
often brings out feelings of guilt or anger, but
these are natural feelings and are part of grieving.
It can help to talk to someone outside the
immediate family circle. Organisations like
Cruse may be able to help with this. (See
USEFUL ORGANISATIONS page 65.)
MINORITY ETHNIC GROUPS
Many areas with large minority ethnic
conununities have special link workers in clinics
and surgeries to help overcome any problems of
language, religion and culture between the
doctor or nurse and the patient. Ask at your
doctors if you think a link worker might be able
to help you.
Your neighbourhood may also have a
Community Centre where you can meet others
from your local community. Some people get a
lot of support from being able to talk to others
with the same language, religion and culture,
46
and who face the same difficulties. Religious
meeting places such as churches, mosques,
temples and gurudwaras often provide the
opportunity for groups to meet and discuss
various problems including health. Community
Centres sometimes also provide advice on health
matters, or can arrange for an interpreter if one
is not available at the clinic or surgery.
There is a wide range of booklets, videos and
audio tapes available in different languages
covering particular health issues. Ask your
doctor, health visitor or your local District
Health Authority’s health promotion unit to tell
you what is available and how to get it. (The
address of the District Health Authority is in
your local telephone book.) (See USEFUL
ORGANISATIONS page 65.)
HOUSING
As you get older, it sometimes becomes more
difficult to get around the house. For example,
you may find the stairs too steep to climb.
There are a number of schemes to help with this
sort of problem, including Minor Works
Assistance, Renovation Grants and Disabled
Facilities Grants. Your local authority can give
you further information on all these.
HOME IMPROVEMENT AGENCIES
provide independent advice and practical help
to assist people living in properties in a poor
47
stare of repair to undertake repairs,
improvements and adaptions. I lie service
includes advice on getting help with the costs,
and ensuring that the work is completed
satisfactorily. For further information contact
your local authority. (See USEFUL
ORGANISATIONS pages 64 and 70.)
Insulating Your Home
A well insulated and draught-proofed home will
stop the waste of money on fuel. If you receive
Income Support, Housing Benefit, Council Tax
Benefit, Family Credit, Disability Working
Allowance, Disability Living Allowance or you
are aged 60 or over, you may be able to get
a grant for insulating your loft and draught
proofing your windows and doors. If you think
you might be eligible, contact your local
authority or the Energy Action Grants Agency
before you arrange for the work to be
.
started. (See USEFUL
?.ty. ORGANISATIONS pages 66 and 70.)
If you want to do the job
yourself, remember that gas,
oil or solid fuel appliances all need
ventilation to work properly and safely.
It is also essential that there is ventilation in the
rooms where you have gas, oil or solid
fuel appliances.
48
SAFETY IN YOUR HOME
Peace of mind is an important factor in staying
in good health. It is therefore wise to make your
home safe from accidents and secure from
unwanted callers.
Most accidents take place in the home. Many
can easily be prevented.
• Be alert to what might make yon trip or
skid. Don’t leave electrical wires trailing or
slippery objects like magazines on the Jloor;
make sure that mats are not placed on highly
polished Jioors, and that no loose mats are
left where anyone can trip on them.
° Get a smoke alarm. For about £5, it can
give yon those few minutes’ warning of a
fire. If you are deaf or hard of hearing, you
could get a flashing alarm or a vibrating one
that goes under your pillow. Ask your local
Social Services Department about these.
° Try to store things which you need everyday
at a convenient height to avoid reaching and
bending. Reaching aids, and handle
extensions (on a milk bottle holder, for
instance) are useful. If you must reach up,
perhaps to change a light bulb, make sure
you use a strong step stool with a hand rail,
or a step ladder.
49
• Make sure your stairways and steps at
doorways are well lit. Have a torch ready in
case the powerfails. Don’t use candles.
• Put a rubber mat in the bath or shower as it
is very easy to slip on a wet surface. Rubber
mats do perish and will require replacing
regularly. Have grab rails fitted to the side
of the bath to assist with getting in and out.
Never run the water while in the bath and
check the temperature before yc i get in it.
People have got stuck and suffered very
nasty burns. Keep a hand bell close by to
call for help if you have a problem, as well
as some towels to keep you warm after
letting the water out.
• If you find going downstairs difficult, it can
help to go down backwards with one hand
on the banister and one resting on the stairs.
e Use a one-handle tray, especially when
wearing a long dressing gown or nightdress
which may need to be held up to move
safely. Trays are available that are specially
designed and balanced for older people.
SECURITY IN YOUR HOME
While most people are helpful and wellintentioned, there are unfortunately always
spine .who try to take advantage of their fellow
.
citizens. Make it hard for them by improving
|, ,zyour security at home.
° Never let anyone in, unless yon are
absolutely sure who they are. Fit a spyhole
or viewer and a security chain to your door,
and use them — don’t open the door fully
until yon knotv the identity of a caller.
If he or she claims to be from the police,
electricity board, etc, always ask to see their
identity card. Check it by ringing the local
o ffice of the organisation they claim to be
from. Look up the number in your directory.
Don’t rely on a number given on the card or
mentioned by the caller. A genuine caller
won’t mind waiting outside with the door
closed while you ring.
• You may want to arrange with companies
for meter readers to call by appointment,
giving their name, or a previously agreed
passivord.
• Be wary of confidence tricksters. If an
investment seems too good to be true, then
it probably is! Always seek advice, and
never sign anything on the spot.
• Be wary of tradesmen who arrive
unannounced. Before having any work
done, ask two or three companies for
written quotations: they are binding but
estimates are not.
Fit good door and window locks, and
always use them.
ux y,
SOPHtA-SOChARA^
y °r 8 °1 n q
* (c LI
• Yoh may be able to get help to improve the
security of your home if you are on a lorn
income — ask the crime prevention officer at
your local police station or the housing
department of your local authority.
» Protect your possessions by marking them,
and don’t keep a lot of money at home.
° If you go away, don’t forget to cancel the tnilk
and newspapers. Ask a neighbour to keep an
eye on your home while you are away.
• If you see anything that worries you, don’t
hesitate to call the police.
• foin the local Neighbourhood Ikatch
Scheme, or talk to your local crime
prevention officer about setting one up.
SOCIAL SERVICES
Access to services purchased or provided by the
local authority Social Services Department is
subject to an assessment of individual need.
Local authority Social Services Departments are
able to purchase or provide a wide range of
services for people living at home including
meals-on-wheels, home care help, day centres,
lunch clubs, help for people looking after a
spouse, other relatives or friends, and the loan of
aids and equipment which may be useful to
older people or their carers, such as toileting or
lifting equipment. Services provided vary from
area to area. For more information you should
contact your local Social Services Department
or Citizens Advice Bureau, or a voluntary
agency such as Age Concern. (See USEFUL
ORGANISATIONS pages 61, 64 and 70.)
If you think you may need one of these services
you should ask your local Social Services
Department for an assessment. They will not
usually provide a service unless they have
assessed your needs.
If you are suffering from abuse, or you know of
an elderly friend or relative who is being
abused, you should contact social services and
Action on Elder Abuse. (See USEFUL
ORGANISATIONS pages 61 and 70.)
Sheltered Housing
Many local authorities and Housing
Associations provide sheltered housing which
offers the chance to live in self-contained
accommodation, with a warden on call to help.
Residential and Nursing
Home Care
Given the choice, most people would prefer to
remain in their own homes for as long as this
can be managed. But if you reach the stage
when you feel it is no longer possible, you
should contact your doctor, local Social Services
53
Department or a voluntary organisation
(USEFUL ORGANISATIONS pages 61-71) to
discuss possible alternatives. The Social Services
Department will arrange for a needs assessment
and may be able to help you if you think you
may need to move into a care home and will
need help paying the fees. They will assess your
needs and may be able to provide care that
allows you to remain in your own home.
MONEY MATTERS
Help for People with
Disabilities and their Carers
In addition to Retirement Pensions there are a
number of other benefits which are available for
help with particular problems.
These include benefits for disabled people and
those looking after disabled people. Disability
Living Allowance is available to people disabled
before reaching the age of 65, and who
claim before the age of 66, who need
help with getting around and/or with personal
care needs. Attendance Allowance is available
for people disabled after the age of 65 with
personal care needs. Both benefits are intended
to help with some of the extra costs incurred
due to disability. The emphasis is placed on an
individual's own assessment of how the illness or
disability affects everyday living. For more
information, contact your local Social Security
Office or Citizens Advice Bureau, or telephone
free on 0800 666 555.
There is also a Benefit Enquiry Line to give
advice to disabled people. Telephone free on
0800 88 22 00. Trained operators can also
complete claim forms over the telephone,
which are sent to you to check the accuracy of
completion.
1 elp with Housing Costs
You should apply to the housing benefit office of
your local authority if you are living on a low
income. Housing Benefit may be available to
help with the cost of rent and Council Tax
Benefit to help with the cost of your Council
Tax. Council Tax discounts and exemptions are
also available in certain circumstances, and if you
have a disability you may be entitled to a band
reduction on the valuation of your property. For
more information, contact your local authority.
Help with Fuel Bills
It is important to budget for gas and electricity
bills. British Gas and Electricity Companies
operate a number of schemes to help you spread
the cost of bills throughout the year. It is much
better to do this than wait until you can’t pay
your bill. Ask your gas or electricity company
about these schemes.
The fuel companies have promised chat any all
pensioner households will not have their
supplies disconnected between October 1 and
March 31 each year.
Gas and electricity companies have special
telephone lines providing advice on the efficient
use of gas and electricity, and gas and electricity
appliances. Local Energy' Advice Centres exist
in some areas of the country. They offer free,
impartial and independent advice on energy
saving measures in homes designed to help
reduce fuel bills. You can call the Energy Saving
Trust on 0171 931 8401 to find out whether
there is a centre near you.
HOW TO COMPLAIN
Doctors, Dentists, Opticians
and Pharmacists
Before making any complaint, talk to the person
concerned first of all because misunderstandings
can happen. Then, if you are unable to resolve
matters, you can take things further by
contacting the Family Health Services
Authority (Fl ISA), previously the Family
Practitioner Committee. Their address can
be found on the front of your medical
card, or in (he local telephone book and
local library, or you (an get it from the Citizens
Advice Bureau or <Community I lealth Council.
In the case of your doctor, if you are still
unhappy, you can change practices and you
don’t need to tell the doctor why. Lists of
doctors are available from the FHSA or from the
local library. If necessary, FHSAs can assign
patients to a GP.
A doctor can refuse to take any individual on his
or her list. Although some older patients may
require expensive medicines, this does not mean
that doctors should refuse to accept or retain
such patients on their lists, or refuse necessary
drugs. In case of difficulty, contact the FHSA.
Hospital Services
If you are unhappy about the services you or
a relative receive in hospital or as an outpatient,
after talking it over with the nurses on the
ward or the doctor concerned, you can make
a formal complaint.
Any member of staff can help you make your
complaint and if necessary a senior member of
staff will look into the matter and give you an
answer. Often there is a leaflet which will guide
you in making a complaint. Just ask a member
of staff for a copy.
If you are not happy with the way an NHS
authority handles your complaint, or with the
conclusion they reach, you can ask the Health
Service Commissioner or Ombudsman if he
will look into their actions. The Ombudsman
can be contacted at Church House,
Great Smith Street, London SW1P 3BW.
Subject to certain safeguards, you have a right
to see your own medical records. This is
highlighted in the Patient’s Charter.
The Patient’s Charter
The Charter sets out your basic rights to
treatment in all parts of the National Health
Service, including your family doctor services.
It also sets out the standards of service you can
expect to receive. These rights and standards
apply to everyone, no matter where they live.
Family Health Sendees Authorities have
published their own local patients charters,
setting out the standards of the local service you
can expect to receive from them.
Copies of the Charter are available from your
local District Health Authority or Family
Health Services Authority, or by writing to:
The Patient’s Charter and You, FREEPOST,
London, SE99 7XU.
Health Information Service
The National Health Information Service is
a freephone service on 0800 66 55 44. It offers
information on a wide range of health-related
subjects, including:-
58
• local NHS Services;
• local and national Charter Standards;
• common diseases and conditions;
• local and national self-help groups;
° how to complain about the NHS;
° how to maintain and improve your
own health.
So 'ia I Services
If you have a problem with the social services
provided by your local authority and you see
one of their staff regularly, ask them to help sort
it out. If this is not possible or doesn’t work,
you can ask for the matter to be dealt with
under a formal complaints procedure, which all
authorities operate. Your local authority’s Social
Services Department will be able to advise
about their complaints procedures, and will
usually be able to give you a leaflet about them.
59
1 FURTHER READING
Advice to
Older Drivers
Department of Transport
Information Division
2 Marsham Street
London SW1P 3EB
Alzheimer’s Disease Society
Gordon House
10 Greencoat Place
London SW1P 1 PH
Diabetes and You —
A guide for the older
person
The Driving Manual
British Diabetic Association
10 Queen Anne Street
London W1M OBD
The Health of the
Nation — A Summary of
the Strategy for Health
in England
Keep Warm Keep Well
Department of Health
also available from libraries,
Citizens Advice Bureaux,
GPs’ surgeries or
Freephone 0800 289 404
Mental Illness - Mental
health and older people
Relieving the Pressure —
Your Guide to Pressure
Sores
Both publications
available from:
Department of Health
P.O. Box 410
Wetherby LS23 7LN
60
Safe as houses — Living
alone with dementia
HMSO PO Box 276
London SW8 5DT
HMSO PO Box 276
London SW8 5DT
The Older Road User
Department of Transport,
Information Division
2 Marsham Street
London SW I P 3EB
The Patient’s Charter
and You
The Patients Charter and
You, FILEEPOST
London, SE99 7XU
Your Home in
Retirement
Department of the
Environment Distribution
Centre, PO Box 135,
Bradford, West Yorkshire
BD9 4HU
USEFUL ORGANISATIONS
Action on Elder Abuse
Astral blouse
1268 London Road
London SW16 4ER
Tel: 0181 679 2648
Aims to prevent abuse of
older people by raising
awareness and education
and promoting research.
Also collects and
disseminates information on
services for abused older
people around the country.
Action on Smoking and
Health (ASH)
109 Gloucester Place
London W1H 3PH
Tel: 0171 935 3519
Provides helpful
information and advice on
giving up smoking.
Age Concern England
Astral House
1268 London Road
London SW16 4ER
Tel: 0181 679 8000
Offers support for older
people and those who care
for them. Local groups
provide
services such
as day centres,
lunch clubs and transport/
visiting schemes. Runs the
“Ageing Well” health
promotion programmes.
Also produces information
on a wide range of topics
affecting older people.
Age Exchange Theatre
Trust
The Reminiscence Centre
11 Blackheath Village
London SE3 9LA
Tel: 0181 318 9105/
318 3504
Promotes educational
drama, mime, literature,
dance, singing and music
to improve the quality of
life of older people through
emphasising the value of
their reminiscences.
Age Resource
1268 London Road
London SW16 4ER
Tel: 0181 679 2201
Aims to promote the active
61
contribution of older
people to society through
an annual award scheme
and other initiatives.
Alzheimer’s Disease
Society
Gordon House
10 Greencoat Place
London SW1P 1PH
Tel: 0171 306 0606
Gives support to families
of Alzheimer’s Disease
sufferers; provides
literature; has a network of
local branches and support
groups.
Arthritis Care
18 Stephenson Way
London NW1 2HD
Tel and Minicoin:
0171 916 1500
Freephone helpline:
0800 289 170
Monday to Friday
12 noon to 4.00pm
A wide range of helpful
advice and information for
people with arthritis and
rheumatism. There are also
many local Arthritis Care
groups around the country.
62
Association for
Continence Advice
380-384 Harrow Road
London W9 2HU
The national organisation
of continence advisers —
contact them to find the
address of your local
adviser.
Association of
Crossroads Care
Attendant Schemes
10 Regent Place
Rugby
Warwickshire CV2I 2PN
Tel: 01788 573653
Local schemes provide care
attendants so that carers
can be relieved of caring
for periods of time. Head
Office can advise on
whether there is a
Crossroads scheme in
your area.
Association of Retired
Persons (ARP Over 50)
Greencoat House
Francis Street
London SW1P 1DZ
Tel: 0171 828 0500
Runs friendship centres
and arranges events and
activities for the over 50s.
Publishes quarterly
magazine.
British Association of
Cancer United Patients
(BACUP)
3 Bath Place
Rivington Street
London EC2A 3JR
Tel: 0171 613 2121
Provides an information
service and details of
developments in cancer
treatment.
British Association for
Service to the Elderly
(BASE)
1 19 Hassell Street
Newcastle-under-Lyme
Staffordshire ST5 1AX
Tel: 01782 661033
Provides a substantial
national programme of
courses and summer
schools in the field of care
for elderly people. BASE is
a valuable contributor to
the dissemination of good
practice and innovative
thinking.
British Dental Health
Foundation
Eastlands Court
St Peters Road
Rugby
Warwickshire CV21 3QP
Tel: 01788 546365
Provides a leaflet on oral
health for older people.
Promotes the benefits of
achieving and maintaining
the highest standards of
dental care to the public.
British Diabetic
Association
10 Queen Anne Street
London W1M OBDTel:
0171 323 1531
Provides a support and
information service for
people with diabetes and for
those who care for them.
Has many local branches
throughout the UK.
63
British Heart
Foundation
14 Fitzhardinge Street
London W1H 4DH
Tel: 0171 935 0185
Finances and encourages
research into the causes,
prevention, diagnosis and
treatment of heart disease,
promotes emergency life
support training, initiates
self-help support groups
for cardiac patients and
provides advice and
information on heart and
health matters.
Cancerlink
17 Britannia Street
London WC1X 9JN
Tel: 0171 833 2451
Provides emotional support
and information for cancer
patients and their families in
response to telephone and
written enquiries.
Cancer Relief
Macmillan Fund
64
Anchor House
15-19 Britten Street
London SW3 3TZ
Tel: 0171 351 7811
Provides an information
exchange and link for those
working in hospices, or
with terminally ill patients
and members of the public.
Carers National
Association
20-25 Glasshouse Yard
London ECIA 4JS
Tel: 0171 490 8818
Provides advice to carers
about what support is
available and how to get it,
puts carers in touch with
local self-help groups.
Care and Repair
Castle House
Kirtley Drive
Nottingham NG7 1 LD
Tel: 01602 799091
The national co-ordinating
body for Home
Improvement Agencies;
will advise if there is one
in your area.
Citizens Advice Bureaux
(Look in your local
telephone directory under
Citizens Advice Bureau).
Gives advice and
information on a wide
range of issues.
(Look in your local
telephone directory under
the name of the
COMMUNITY HEALTH
COUNCIL for where you
live).Gives advice and
information about local
health services.
Advice line open
10.30am to 4.00pm
Monday to Friday.
Provides a free
comprehensive advisory and
information service to
elderly people and their
carers on issues such as
accommodation, benefits
and respite care.
Contact the Elderly
Cruse Bereavement Care
15 Henrietta Street
Covent Garden
London WC2E 8HQ
Tel: 0171 240 0630
Provides companionship
for elderly isolated people
who live alone with
limited, inadequate or no
family support.
126 Sheen Road
Richmond
Surrey TW9 1UR
Tel: 0181 940 4818
Provides the following
services: bereavement
counselling, practical
advice, social contact and
publications.
Continence Foundation
Helpline
Dark Horse Venture
Community Health
Councils
You can ring the helpline
to obtain confidential
advice on bladder or bowel
problems.
Tel 0191 213 0050
Counsel and Care
Twyman House
16 Bonny Street
London NW1 9PG
Tel: 0171 485 1566
Kelton
Woodlands Road
Liverpool L17 0AN
Tel: 0151 729 0092
Aims to discover the hidden
talents of older people
through new activities.
65
Disabled Living
Foundation
380-384 Harrow Road
London W9 2HU
Tel: 0171 289 6111
Provides information and
advice about all aspects
of daily living for people
with a disability. Has
comprehensive information
on disability equipment and
can put you in touch with
a Disabled Living Centre
in your area.
District Health
Authorities
(Look in your local
telephone directory under
the name of the HEALTH
AUTHORITY where you
live.)
Responsible for local
hospital and community
health services.
Drinkline
Weddell House
7th Floor
13-14 West Smithfield
London ECIA 9DL
Tel 0171 332 0202
66
National alcohol helpline
which provides
confidential information,
help and advice about
drinking. Anyone who
needs information is
welcome to contact the
helpline including people
worried about someone
else’s drinking.
Elderly Accommodation
Counsel
46A Chiswick High Road
London W3 1SZ
Tel: 0181 995 8320
Has a database of all forms
of private and voluntary
accommodation for older
people. There is a small
charge for those who can
afford it.
Energy Action Grants
Agency
PO Box 1 NG
Newcastle Upon Tyne
NE99 1NG
FREE PHONE
0800 181 667
Administers the Home
Energy Efficiency Scheme
which provides grants
towards basic insulation
measures for low income
households.
Extend
22 Maltings Drive
Wheathampstead
Herts AL4 8QJ
Teh 0158283 2760
Aims to enhance the
quality of life for older
people and people with
disabilities by providing
scientifically structured
recreational movement
sessions to music.
Family Health Services
Authorities
(Look in your local
telephone directory under
the name of the FAMILY
HEALTH SERVICES
AUTHORITY or
FAMILY
PRACTITIONER
COMMITTEE where
you live).
Gives information about
general practitioners,
dentists, pharmacists and
opticians.
Health Education
Authority
Hamilton House
Mabledon Place
London WC1H 9TX
Tel: 0171 383 3833
Provides health education
books and leaflets on a
wide range of topics.
Hearing Concern
7/11 Armstrong Road
London W3 7JL
Tel: 0181 743 1110
Provides information and
advice. There are local
clubs.
Help the Aged
St James’ Walk
London EC1R OBE
Tel: (free) 0800 289 404
Provides a telephone
enquiry line dealing with
winter warmth issues, social
security and welfare
benefits, and health and
community care topics
appropriate to older people.
Literature and fact sheets on
various subjects available.
67
National Association of
Bereavement Services
20 Norton Folgate
London El 6DB
Tel 0171 247 1080
National Osteoporosis
Society
PO Box 10
Radstock
Bath BA3 3YB
Tel: 01761 432472
Provides help and support
for sufferers of
osteoporosis. Provides
information on the disease,
its prevention and
treatment.
Neighbourhood Energy
Action
2-4 Bigg Market
Newcastle Upon Tyne
NE1 1UW
Tel: 0191 261 5677
Helps to develop and
promote energy efficiency
services for low-income
households.
New Horizons Trust
Paramount House
290-292 Brighton Road
South Croydon
68
Surrey CR2 6AG
Tel: 0181 666 0201
Makes use of retired
people’s skills and interests
in order to benefit both
themselves and their
communities.
Parkinson’s Disease
Society of the UK
22 Upper Woburn Place
London WC1H ORA
Tel: 0171 383 3513
Self-help groups,
information and advice.
Partially Sighted
Society
62 Sainsbury Road
London NW6 6NS
Tel: 0171 372 1551
Gives general advice and
information. Provides
assessment or training with
low vision aids and
counselling.
Pre-Retirement
Association (PRA)
26 Frederick Sanger Road
Surrey Research Park
Guildford
Surrey GU2 5YD
Tel: 01483 301170
Provides training for
retirement preparation
trainers and also offers
courses direct to the
business community and
the general public. PRA
are also developing a role
in health promotion
through links with Age
Concern’s ‘Ageing Well’
programme.
Quit
Victory blouse
170 Tottenham Court Road
London W1P 3PH
Gives help and
information to people
trying to give up smoking.
You can phone
QUITLINE on
0171-487 3000 fora free
QUITPACK.
Reach
Bear Wharf
27 Bankside
London SEI 9DP
Tel: 0171 928 0452
Finds part-time “expenses
only” jobs for retired
business and professional
people who want to use
their skills to help
voluntary organisations.
The service is free and is
available throughout the
country.
Relatives Association
5 Tavistock Place
London WC1H 9SS
Tel: 0171 916 6055
Provides advice and
support services for
relatives of older people in
residential
accommodation.
Retired and Senior
Volunteer Programme
(RSVP)
237 Pentonville Road
London N1 9NJ
Tel: 0171 278 6601
Involves older people in
using their skills and
experience for the benefit
of their local community.
69
Royal National Institute
for the Blind
224 Great Portland Street
London WIN 6AA
Tel: 0171 388 1266
Provides general advice
and information on talking
books and Braille service;
low vision services;
walking canes, special
equipment and residential
care. Provides residential
care services for elderly
blind people.
Royal National Institute
for Deaf People
105 Gower Street
London WC1E 6AH
Tel: 0171 387 8033
Minicoin: 0171 383 3154
Gives general advice and
information. Can also
advise on special
equipment such as text
telephones, fire alarms and
listening devices. Provides
residential care services for
older deaf people.
70
Sense
National Association for
Deafblind People
11-13 Clifton Terrace
London N4 3SR
Tel: 0171 272 7774
Social Security,
Department of
(Look in your local
telephone directory for
the address and telephone
number of your local
office.) Provides advice and
information on retirement
pensions and benefits for
older people.
Social Services
Departments
(Look in your local
telephone directory under
SOCIAL SERVICES
for your local council
or borough.)
Responsible for social
workers, care assessment,
residential care, meals-onwheels, home care help,
day centres, equipment
loans and other services
depending on the area.
SPOD (The Association
to Aid the Sexual and
Personal Relationships
of People with a
Disability)
286 Camden Road
London N7 OBJ
Tel: 0171 607 8851
Provides leaflets on various
aspects of sexuality and
personal relationships in
relation to disability,
including those that can
be associated with old age.
A counselling service is
available.
Sports Council
16 Upper Woburn Place
London WC1H OQP
Tel: 0171 388 1277
Promotes sport and active
recreation. Has a network
of regional offices which
can provide advice on
sports provision in the
local area.
A London-based
organisation bringing
together minority ethnic
groups across London.
Works for and with the
community to promote
the care of ethnic minority
elders in the community,
and to improve services for
ethnic elders nationwide.
Stroke Association
CHSA House
Whitecross Street
London EC1Y 8JJ
Tel: 0171 490 7999
Provides literature and
advice. Has a network
oflocal clubs.
Standing Conference of
Ethnic Minority Senior
Citizens
5 Westminster Bridge Road
London SEI 7XW^
Tel: 0171 928 0095
71
The Beth Johnson
Foundation
University of the Third
Age (U3A)
Parkfield House
64 Princes Road
Hartshill
Stoke-on-Trent ST4 7JL
Tel: 01782 44036
Has an established Senior
Health Shop offering advice
and information for people
over 50 on diet, exercise
etc, combined with a
healthy eating cafeteria.
Actively promotes healthy
exercise groups for older
people and has a thriving
Leisure Association offering
rambling, swimming, etc.
1 Stockwell Green
London SW9 9JF
A self-help mutual aid
teaching/learning
organisation for older
people who are not in fulltime work and who wish
to keep their minds active.
U3As throughout the UK
run study, cultural and
recreational programmes.
Send SA.E for local details.
The Chartered Society
of Physiotherapy
14 Bedford Row,
London WC1 4ED
Tel: 0171 242 1941
The Society has a number
of free leaflets which coverback problems, falls,
arthritis and exercise,
including gardening.
72
OPH 2
For further copies of this
publication write to:
Department of Health
P O Box 410
Wetherby
LS23 7LN
©Crown Copyright
Produced by Department of Health
G34/011 3505 1P 225k Nov 95 (02)
CHLORINE FREE PAPER
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