Age And Stage – Details, episodes & analysis

Starting Thursday 6th March, a brand new series for those caring for elderly relatives and friends, or those about to embark on the complex journey, presented by Age Space's Annabel James alongside broadcaster and journalist Daisy McAndrew.

The series will cover everything from finding the right care, funding that care, the legal and financial practicalities of old age and much more, along with no-nonsense advice and guests who are experts in their field

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Welcome to Age and Stage, a new podcast for everybody, caring for or supporting their elderly, parents, relatives, friends, even neighbours. 

Do please get in touch with us:

You can email the show: ageandstage@agespace.org 

Record a voice note: https://www.speakpipe.com/ageandstage

WhatsApp message – 07982 360113

Please share Age & Stage with friends or those who would find this podcast useful. You can send them this link: https://pod.link/1798413657

More information on all this and more at www.agespace.org

Planning ahead - parenting your parents 

It's about paying a bit more attention when you go home, what's the fridge looking like? If things start to be out of their sell-by date, or there isn't much food in the fridge. And somebody who was always very house proud, it starts feeling different, smelling different. Is the post being opened? 

Questions to ask to start planning ahead for elderly care

There are three conversations to have with parents and relatives if you can:

1.Where do you want to live? Do you want to stay in your own home? Would you down-size or would you come and live with me? 

2. Thinking about if you're going to need care, what would you like? Would you have people living in? Do you want people who come in the day? Is there a care home locally that people recommend? 

3. How might this be paid for? 

The demographics of an ageing population

It's thought between seven and 10 million people provide unpaid care every week for an elderly parent or relative. 

Millions more in the next 10 years will be over 85 and all the issues this will bring. And the sandwich generation, teenage kids and a mother in her mid 80s with mobility issues and memory issues. Many of us have children later and our parents need help at the same time. 

Siblings and family dynamics

Every family is different. Try and share the responsibility before you need to. Somebody's living in Australia, maybe they can do the finances, or, if somebody's close by, they look after the home, and somebody else might look after the care decisions. It's about playing to people's strengths so that everybody does feel they have an involvement, but also responsibility to be involved. 

Loneliness in old age 

By the very nature of ageing your social circle gets smaller as your friends die. A friend of mum's said that every year she was determined to make a younger friend, because she wanted to ensure her future social life. But a lot of the older generation either find it too difficult to keep up with their friends, or want to rely on their nearest and dearest, but you do want to encourage a social life, and sometimes the pressure on you to be that social life as well as the carer is huge.

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The complexities of finding great care homes with Stephen Burke (www.hallmarkfoundation.org.uk), a care sector advocate. Stephen shares his personal experience and insights on the importance of planning for care needs.

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

Challenges Of Complaining

The importance of consumers commenting on care services, similar to other consumer products. The challenges families face when making complaints about care homes, especially for older relatives. The need for families to be aware of their rights and the importance of assessments by local authorities to understand care needs.

Initial Steps in Caregiving

Initial steps when a relative needs extra help, focusing on identifying needs and practical support, discussing needs with the relative and identifying what help is required, from basic tasks like cleaning and shopping to full home care. The stigma around the word "carer" and how it can be more acceptable to describe it as "help" initially. And the various types of care available, from housekeeping and companionship to overnight care and living care, and the importance of understanding individual needs.

Financial Aspects of Care

The role of local authorities in assessing needs and providing support and the financial assessments for care services.The importance of having an assessment even if the family is paying for care out of their own resources.The need to plan ahead to ensure the right housing and support as people age.

Geographical and Demographic Considerations

The impact of geographical location on care services, particularly in coastal and rural areas and the challenge of accessing those services. The need for housing options that support aging well, including staying connected and maintaining networks of friends and the importance of planning for care needs early to avoid making decisions in a crisis situation.

Hospital Discharge and Rehabilitation

The role of family members in facilitating a smooth transition, standing up for relatives in hospital and ensuring a proper discharge plan is in place. How the first six weeks after hospital discharge is critical and the importance of having the necessary support in place. The revolving door situation where people are stuck in hospital or leave without proper support, leading to repeated crises.

Choosing the Right Care Home

The process of choosing a care home, including spending time at the home and talking to residents and staff alongside using multiple sources of information, including reviews and local authority assessments, to make an informed decision. The importance of staff turnover and consistency in care, as well as the role of technology in monitoring care - and the need for good communication to ensure quality care.

Costs and Financial Planning

With current prices ranging from £1000 to over £2000 a week, the options for financial planning, including selling the home and using savings. The importance of planning ahead to cover care costs and the role of financial advisors in this process and the financial implications.

Final Tips and Practical Advice

Use local authority services, organisations like Age UK, and websites like Age Space for information and support. The importance of speaking to other families and the need the need for practical planning and early preparation.

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Dr Lucy Pollock is a Geriatrician and author, having written two books: The Golden Rule - Lessons In Living From A Doctor Of Aging https://amzn.eu/d/5Wnmdop and The Book About Getting Older https://amzn.eu/d/cGbBH0U. Lucy spoke to Annabel James from Age Space, giving advice on managing multiple conditions and medications, advocating for better conversations and practical conversations, and taboo subjects like incontience and whether it's time to stop driving a vehicle.

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

Terms Used In This Episode:

BRAN - Benefits. Risks. Alternatives. (What happens if I do) Nothing.

DNR - Do not resuscitate

ACP - Advance care plan

ADRT - Advance decision to refuse treatment

Learnings From This Episode:

Geriatricians are based in hospitals but an increasing number work in the community. Most problems with older relatives and friends are managed in primary care, but complex cases may require a geriatrician. Preventative care is incredibly important and helps reduce the risk of acute emergency admissions.

Lucy's motivation to write was a wish to fill a gap in information about geriatric care and helping families ask the right questions. Having key conversations with elderly relatives is important - and whilst taboo subjects like driving cessation and incontinence can be difficult, there are ways to approach this.

The BRAN test evaluates the benefit, risk, alternatives, and necessity of medications.

Polypharmacy (multiple drugs and medications) is a growing challenge for professionals, patients and relatives. Using the BRAN test, an unnecessary medication can be identified.

Incontinence is common but it isn't necessarily 'normal'. There are ways to manage it, including pelvic floor exercises, dietary changes and equipment.

Except in limited cases, you cannot ask the doctor to stop somebody driving, This has to be a conversation with the DVLA.

Lucy also discusses the benefits of hospital at home and virtual wards for elderly patients. She explains that hospital at home can be a safer and more comfortable alternative to traditional hospital admissions.

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Marking Hospice UK's Dying Matters Awareness Week (https://www.hospiceuk.org/our-campaigns/dying-matters) Liz Pryor from the Anne Robson Trust talks frankly about an essential conversation that is often avoided until it is too late. The Trust (https://annerobsontrust.org.uk/) provides advice, training and companionship, working alongside partner healthcare organisations, bringing support, comfort and compassion to those nearing the end of life, and those closest to them.

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

Liz set up the trust in memory of her mother, providing resources, workshops, and work with healthcare organisations to provide support for those dying. The most important thing to do for those supporting relatives and friends who are near end of life, is to have conversations as early as possible - rather than making hasty plans during their final days. There is a helpful "my wishes" checklist available on the Anne Robson Trust website.

Liz explains the process of dying, including physical changes and the importance of understanding these stages. She mentions the concept of "Cheyne-Stokes breathing" and other physical signs that indicate the end of life. She also highlights the importance of having a calm and supportive environment for the dying person.

Family members should ask direct questions about the expected timeline of death and to have early conversations about end-of-life care. it is also important to have advanced care plans, DNRs if appropriate, and other legal documents in place. Liz also explains the role of hospices in providing support both in hospitals and at home, and the importance of accessing these services.

Liz introduces the concept of death doulas or soul midwives, who provide spiritual support during the end-of-life journey. She mentions the Anne Robson Trust's new project to engage volunteers to support people in their homes as they die and highlights the importance of moving end-of-life care back into the community to reduce emergency admissions and provide better support.

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Holidays, vacations and excursions are the subject of a fun and upbeat conversation in this episode. Age Space's Annabel James and broadcaster & journalist, Daisy McAndrew speak to Silver Travel adviser, Kelly Gallagher (https://silvertraveladvisor.com/). They talk about the cost benefits to travelling out of season, the challenges of solo travel and the dreaded 'single supplement', and how travel companies and advisors are upping their game to encourage a mature customer base to holiday with them.

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

An aging population has influenced the travel industry with a growing popularity in long-stay holidays and a flexibility for older travellers, who are able to take advance of low or 'shoulder' seasons and avoid peak prices.

Another development is a 'SPIN' holiday - a 'special interest' trip. These holidays have increased by 64% in 2024 and can focus on cookery, language learning, walking, photography, bird watching etc.

Enquire about the availability of accessible rooms, assisted support on airlines, and fully assisted holidays. The important thing is to work with the right companies and operators to meet specific needs. Silver Travel Advisors work with Dementia Adventure which offers retreats for people living with the illness (https://dementiaadventure.org/)

Tips for solo travelers include starting with shorter trips, joining group tours, and choosing cruises that cater to solo travelers. It is important the there is an understanding of what the solo holidaymaker wants from their experience..

There are various options, including sharing rooms with same-gender travelers and booking with companies that offer no single supplements. The importance is to work with travel agents who can find promotional offers to reduce or eliminate single supplements. Some cruise lines offer solo cabins with no single supplement.

A number of cruises depart from the UK and reduce carbon emissions. The importance of considering the residents of the area you visit and being a respectful tourist is important, regardless of age.Cruise ships and hotels have made efforts to reduce their environmental impact, such as no plastic policies and water conservation efforts.

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Age Space's Annabel James and broadcaster & journalist, Daisy McAndrew have a long overdue catchup, two months into the podcast. This episode includes advice on the increasing costs but also the increased benefits available for parents and friends needing later life care. Plus, Annabel and Daisy review some of the key points from the show's interviewees to-date (with apologies for Annabel's dodgy microphone!).

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

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Dr Simon Adelman, consultant psychiatrist and leading expert in cognitive health and mental health, discusses what cognitive impairment is. We talk about impairment in old age, how it can affect our family and friends and practical advice on symptoms, prevention and treatment. Dr Adelman can be found here: https://halcyondoctors.com/doctors/

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

From the conversation:

Recognising & addressing cognitive impairment. There is an increasing recognition of mental health issues in older adults, including dementia. It's important to consult a GP for any health concerns, physical or mental. There is an overlap between mental illnesses and physical conditions, such as delirium, which can be caused by infections or other medical issues.

There's a difference between acute (sudden onset) and chronic (long-term) cognitive issues. Acute conditions, such as delirium, are often caused by physical conditions like infections and can be treated with antibiotics. Common symptoms of acute cognitive issues include disorientation, anxiety, hallucinations, and physical symptoms like urinary incontinence. Chronic conditions, such as dementia, develop over a longer period and require different approaches for diagnosis and treatment.

Dr. Simon Adelman differentiates between lifelong depression and depression symptoms that develops in older age. He explains that depression can be a symptom of dementia or other physical conditions, and it can be exacerbated by life changes like retirement or bereavement. It's advised to seeki medical help if symptoms persist for more than a few weeks, cause significant distress, or interfere with daily functioning.

There is a process of diagnosing dementia, including memory testing, blood tests, and brain scans. Memory clinics, which are part of older adult mental health services, conduct these assessments and provide diagnoses. Early diagnosis and treatment can slow down the progression of dementia.

Dr. Adelman provides practical tips for maintaining mental health, including addressing hearing and vision problems.He emphasizes the importance of controlling vascular risk factors, such as high blood pressure and diabetes, to reduce the risk of dementia. He also recommends engaging in activities that are enjoyable and mentally stimulating for maintaining cognitive resilience.

There is a link between sensory health (hearing and vision) and the risk of dementia. The brain is a muscle that needs stimulation to stay healthy, and sensory input is essential for this. Addressing hearing and vision problems can help prevent or slow down the onset of dementia.

While there is no cure for dementia, treatments can slow down its progression and improve quality of life. There needs to be better awareness and access to mental health services for older adults.

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Dan Skipper from Age UK Norwich (https://www.ageuk.org.uk/norwich/) outlines the resources available for older friends and relatives, both in his native Norfolk and as part of the wider Age UK network. Services include clubs and trips, health and wellbeing and advice on benefits and entitlements. We also discuss the challenges of funding care services in a cost of living crisis.

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

This episode briefly references suicide ideation. If you need to talk to someone, you can contact the Samaritans on 116 123 or go to https://www.samaritans.org/

Age UK is a federation of independent local charities, providing locally driven services with a national influence. Age UK Norwich itself has been around for 80 years, offering information and advice on various subjects, including money, welfare entitlement, care, health, loneliness, and social connection. The services are free and provided within people's homes or in the community, helping with practical support and completing application forms. Dan highlights the importance of physical health coaching, practical support in the home, and addressing issues like loneliness and social connection.

Nearly 60% of Age UK Norwich's clients come directly to them, while the rest are referred by friends, family, or professionals. It's important to address issues holistically, as problems like loneliness and financial difficulties often intersect. The organization aims to provide multiple services to clients, addressing various aspects of their lives

.

It's important to address frailty, which is a complex syndrome involving physical health, resilience, and social connections. Dan encourages planning for wills, power of attorney, and discussing long-term care preferences with elderly parents and relatives.

Age UK works with other organisations including the NHS, social care, and smaller local charities. Whilst volunteers are important, the majority of services are delivered by paid staff due to the complexity of the work. Sadly, there has been a decline in volunteering due to the cost of living crisis and the physical frailty of older volunteers.

Many clients seek help with financial issues, such as affording food, heating, and repairs. Age UK provides emergency hardship grants for essential items like food and fuel. Last year, they secured £2.87 million for Norwich residents, mostly for debt reduction and improving living conditions.

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Meirion Shaw, founder of thehomemover.co.uk shares her experience and challenges of helping older clients downsize, including the emotional and logistical hurdles, the need for early planning and preparation, family dynamics, and the role of third-party support.

Get in touch with your comments & questions

Email: ageandstage@agespace.org 

Voicenote: www.speakpipe.com/ageandstage

WhatsApp: 07982 360113

Share Age & Stage with friends & family: https://pod.link/1798413657

Age Space: www.agespace.org

From the conversation:

The decision to downsize can have multiple reasons; whether a move needs to be made to a care home, mobility issues making a larger house impractical, the need to raise funds for the cost of care and so on.

Plan ahead, preferably a number of years in advance. Often downsizing or moving occurs too late and is a more stressful experience for the older relative or friend.

If the house is being put on the market, do the first declutter before formally putting the house up for sale. 'Start with the sock drawer' or the cupboard under the stairs.

Never tackle something with anything that holds deep emotional value in that first declutter.

Make a list of all major items in the house and decide what to take to the new home.

Declutter in short, sharp bursts and perhaps invite a friend to talk to whilst you do it.

Bring in a valuer to assess the value of items. This can aid family negotiations and sibling rivalries.

Label all boxes clearly with the room they belong to, to make unpacking easier.

Research charities, organisations and local people in need, to make donations of unwanted furniture and other items.

Aim to recreate a familiar environment in the new home by reusing familiar furniture or the placing of items. This is especially important in cases of dementia.

Identify local organisations that can provide companionship and support for someone with dementia after they've moved.

Research removal firms and check their online reviews. It might be worth asking other people for their experiences or recommendations.

Moving a relative into the family home can be tricky. You're often moving them to an area where they don't know anyone. Meirion's recommendation is to bring them fully into family life, rather than them living in a separate 'annex'.

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