Dignity factors - Practical assistance
Managing my own budget has enabled me to continue to attend things like theatre performances. Not only am I getting out and about and enjoying something, but I also feel as if I am still part of a world in which I once belonged
Practical assistance in practice
- Make use of personal budgets to provide people with the help they want and need.
- Help people to maintain their living environment to the standards that they want.
- Tap into or develop local services to provide help for people in the community e.g. gardening, maintenance.
- Make use of volunteers.
- To reduce risk of abuse through people being identified as not coping and subsequently targeted, encourage home owners and landlords to carry out external repairs.
What others are doing – Ideas you could use
These examples are taken from ‘the baker’s dozen’ in Joseph Rowntree’s ‘The older people’s enquiry: “That little bit of help”’ .
- Handy Help
- Welcome Home
- Help at Home
- Primary Night Care
- Befriending Service
- Sole Mates
- Cinnamon Trust
- Digging Deep
- RISE
- SMILE
- Activity and Social Centre
- Keeping in Touch
- Supermarkets and Retail Stores – an ideal
Practical assistance and dignity - key points from policy and research
- Having a clean home is particularly important to older women in terms of maintaining their dignity and self-respect (Godfrey et al., 2000).
- A little bit of help can make a big difference. This includes low-level, flexible services such as help with cleaning, ironing, garden maintenance, foot care and assistance with caring for pets (JRF, 2005).
- People receiving practical help such as ‘small housing repairs, gardening, limited assistive technology or shopping’ report significant improvements in quality of life (Henwood and Hudson, 2008).
- Providing support for people’s low level needs can prove to be cost efficient (PSSRU, 2009).
- A home in a poor state of repair can alert potential abusers to the person’s vulnerability (Thornton et al, 2003).
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Practical assistance and dignity - policy and research in more detailOpen
The Older People’s Inquiry, 'That little bit of help' (108kb PDF file) (JRF, 2005), found that: 'older people really valued support which enabled them to live in their own homes - for example, help with cleaning, DIY, gardening, care of pets, chiropody, transport and befriending’. The absence of such ‘low level’ support can restrict independence and undermine dignity. For people residing in residential care practical assistance to support the highest possible levels of independence can also support dignity.
Section 2 of the Chronically Sick and Disabled Persons Act 1970 placed a duty on social services to provide practical assistance to older and disabled people in need of support in their own homes. In recent years, however, there has been increasing concern about the difficulty in accessing such support. Resources for social care are increasingly stretched by the growing numbers of people needing services and, as a result, councils have raised thresholds for access to social care services. The application of Fair Access to Care eligibility criteria has frequently excluded the provision of low level support such as domestic support and practical help (Henwood and Hudson, 2008).
“People care about the state of their homes and gardens; when their world is reduced to little more than their four walls these issues become disproportionately important.” (Henwood and Hudson, 2008).
There is evidence to suggest that providing practical assistance to people improves quality of life (Henwood and Hudson, 2008) as well as making economic sense (PSSRU, 2009). For example, adaptations to the home or assistance with small DIY jobs could prevent accidents or falls that could have long term consequences for the quality of life of the individual and may be costly in terms of health and social care service provision.
The evaluation report of Partnerships for Older People Projects (PSSRU, 2009) reported on significant improvements in Health Related Quality of Life (HRQoL) for people receiving practical help such as ‘small housing repairs, gardening, limited assistive technology or shopping’. The study found that people using services of this type reported:
“a far higher change in their HRQoL than might be expected from such simple focused services. It could be argued that those services that provide simple aids and adaptations can change the ease of self‐care. A grab‐rail attached to a lavatory, bath or shower can make washing easier. Similarly, providing gardening services or making simple repairs can reduce user anxiety.” Furthermore there was evidence of “98% probability that such projects are cost‐effective compared with ‘usual care’. [and] Commissioners putting in place such projects could be reasonably confident that only around 0.2 projects in 10 would not be cost‐effective.” (PSSRU, 2009)
A clean and tidy house and a well-kept garden are important aspects of maintaining dignity in daily living and general wellbeing. Poor garden maintenance or a home in a poor state of repair can give out the message that a person is unable to cope and in some circumstances could highlight the vulnerability of an individual and increase the risk of abuse, for example distraction burglary (Thornton et al, 2003).
