RDC(3) P&D1
Older People: rural poverty and deprivation
Comments submitted by Age Concern North Wales Central (ACNWC)
The following comments have been compiled following discussion at an ACNWC staff meeting held on 25/02/2008 and attended by all but one of the organisation’s paid staff.
Poverty (measured in financial terms) and deprivation are by no means synonymous, and we have therefore regarded them as two separate, but nevertheless frequently inter-related, issues.
Arising from the above, we believe that rural deprivation amongst older people can be significantly exacerbated by poverty, and vice-versa.
We have resisted the temptation to reflect through rose-tinted spectacles on a "golden age” of rural living and/or neighbourliness and community. We believe that the gold was sometimes tarnished, and that, furthermore, society has changed to such an extent that reflecting on past generations is perhaps a somewhat meaningless and pointless exercise.
We have approached this exercise by defining "rural” as a smaller village, hamlet or more isolated and remote locality. We have not regarded large villages and small towns as being rural in this context.
We believe it is dangerous to generalise. Some rural communities are characterised by their unity, neighbourliness and effective support networks; others are less so. A further distinction must be drawn between living in a village (regardless of size) and living in a small hamlet or geographically isolated location. At one extreme is Cerrig y Drudion in Conwy, a small village that still has a bank, a butcher, two shops, a GP surgery, a garage and filling station, several thriving chapels, three public houses, a café and a tyre depot. Other villages of similar size have none of those businesses and services.
The opportunities for "serendipitous encounters”* are arguably increased when living in a village rather than in an isolated location. We subscribe to the desirability/importance of a "public fronts and private backs” in home design* to a property (*see Age Concern England’s excellent report "An enfolding community? Neighbourliness and older people”).
Physical isolation can have marked adverse consequences for older people. Research conducted in Australia suggests that the risk of Alzheimer’s Disease is twice as high amongst older people who are lonely and isolated.
A distinction must be drawn between indigenous older people who have been born into a rural community and lived there throughout their lives and those who have made a lifestyle decision to move/retire into a rural community (the rural idyll?) and have subsequently grown older there. Without the first group, that rural community would not have been sustainable; members of the second must accept a measure of responsibility for having made that lifestyle choice.
Rural dwellers are disadvantaged and discriminated against when needed supported housing or residential-based care. They will more often than not have to leave the community where they may have spent a lifetime. Sheltered housing tends to be provided in towns and larger villages only.
The location of care homes is very hit or miss; the overwhelming majority of older people from rural communities needing such care will have to leave their home communities, the nearest suitable placement frequently being many miles away. We regard this as an extreme form of deprivation that amounts to abuse and breach of basic human rights. Many such people will have lived and perhaps worked in the same community throughout their lives; they may well have contributed to that community over a period of many years, for example, Community Council member. They are forced to leave that community at a stage in life when they need it most. They will frequently be separated from spouse/partner, friends, neighbours and all they once took for granted.
Where care homes do exist in rural communities, attracting the right calibre of staff is difficult, especially those who are sensitive to, and speak, the Welsh language.
For older motorists, running a car is more expensive in rural communities. There is a dearth of filling stations, and, where they do exist, fuel prices tend to be significantly higher than in towns. Journeys to and from shops, banks, supermarkets, etc. are usually much longer and therefore cost more.
There is a further disadvantage inasmuch as people who are aged 65 or over when they acquire a disability are not eligible for the Mobility element of Disability Living Allowance. The disadvantage is even more marked if the individual does not live on or near a bus or rail route or cannot get on or off a bus or train.
Having to give up driving can result in tremendous deprivation, especially in more remote communities. It results in having to rely on relatives, friends or neighbour for lifts, especially for shopping purposes.
Whilst some rural communities in Conwy and Denbighshire are particularly well served by public transport (along the coast or down the Conwy valley and Vale of Clwyd), others are less so.
Many rural communities are not connected to a mains gas supply, and older people therefore have to use bottled gas, which is at least 3 or 4 times as expensive as mains gas, or solid fuel, which again is very expensive. Furthermore, the supply of bottled gas and solid fuel is at best patchy.
Broadband is not available in some rural communities, and mobile phone coverage can also be patchy. Older computer users are therefore deprived of an essential facility.
The closure of rural post offices (more often than not doubling as the village shop) deprives older people more than other sections of the community. It also deprives them of a venue for "serendipitous encounters.”
We know that relatively few older people are computer literate; the picture is even starker the older they are. Lack of computer literacy/lack of access to suitable training, coupled with the increasing use of the Internet to access information or to pay bills is causing particular deprivation amongst older people in rural communities. Post offices and shops have closed, and the ability to minimise the effects of the closures, e.g. Internet shopping, is denied to the vast majority of older people.
Even where there is a local shop, prices are significantly higher than in supermarkets and convenience stores.
There are fewer opportunities for older rural dwellers (especially if they are not car owners) to access lifelong learning opportunities. The nearest library or community college may be some distance away.
Hospital visiting (not as a patient, but to visit a relative or friend) can be a real problem for many older people living in rural communities who are non-motorists.
Very few rural villages have their own GP surgery or Health Centre. Older people will therefore have to rely on others to transport them to their GP surgery or rely on home visits by their GP.
The decline in chapel attendance in predominantly Welsh-speaking rural communities has hit older people very hard, and more than other sections of the community. Chapel attendance is not only about meeting spiritual needs, but also provides an active social life and sense of belonging. The demise of the chapel can have a marked negative effect on positive mental health and well-being.
Older people living in rural communities would naturally experience greater difficulty in accessing advice and information services. For example, they would not have ready access to a drop-in facility where they could receive advice on Welfare Benefits. Based on its own experiences, ACNWC knows that the effective targeting of older people in such communities calls for a high level of local knowledge, very localised outreach (village level, e.g. via groups and clubs of/for older people or primarily for older people, publicity via the local village shop, etc.), commitment and ingenuity, coupled with the ability to provide the service in the individual’s own home if rural poverty and deprivation amongst older people is to be minimised. ACNWC’s experience is that effective targeting results in the availability of services being effectively communicated to other potential users via word-of-mouth. We believe that the "roadshow” type event held in the nearest town is unsuccessful in targeting older people from surrounding rural communities; at best, when subjected to closer scrutiny, this type of event encourages networking amongst exhibitors only.
Bryn Williams,
Chief Officer,
25/02/2008
