Under Attack: #UKStatePension

It was being reported this weekend that the UK Government is considering breaking a manifesto pledge on the triple lock for state pensions. The triple-lock was introduced in 2011 by the Conservative-Liberal democrat coalition government to check the decline in the real value of the state pension. Under the triple-lock, the UK’s state pension rises by a minimum of either 2.5%, the rate of inflation or average earnings growth, whichever is largest. In 2019, the Conservatives election manifesto said that they would keep the triple lock, which retains the value of the state pension ands also gradually increases its value in line with the UK economy.

Depending upon the circumstances, the UK’s 12.7 million retirees receive a state pension of between £134.25 and £175.20 per week – i.e. in the range of £7,000 and £9,110 a year. In comparison, the national minimum wage for someone over the age of 25 is £8.72 per hour i.e. around £17,000 a year. Many retirees therefore are living on almost half of the minimum wage.

The UK state pension is around 29% of average earnings, the lowest amongst industrialised nations, compared to the average of 63% in OECD countries. One method used by the OECD to compare the value of state pensions across the world looks at Pension Replacement Rates. This measures income from State Pension as a percentage of people’s pre-retirement take home pay. Figures from the OECD Pensions at a Glance for 2019 put the UK at the bottom of the table on this measure.

The proportion of retirees living in severe poverty in the UK is five times what it was in 1986. This is despite the UK requiring employees to save for their retirement through work related pension schemes. Inevitably, low wages have had the result that there are low savings made via private pensions. This has meant that for poorly paid employees, the state pension remains likely to be the biggest source of income in their retirement.

The trigger for possible abandonment of the triple-lock is the current furlough scheme under which the government is paying 80% of wages, up to a maximum of £2,500 a month, for around 9 million employees. When the scheme ends, and employees return to their jobs average earnings may dramatically increase which would trigger a big rise in state pension. It is claimed that removing the triple lock could save the government £10bn over 48 months. Although this sounds a lot, last year the government provided a subsidy of £7.1bn to privatised railways companies.

A big rise in the state pension in line with expected post-COVID wage rises could dramatically reduce pensioner poverty. Removing the ‘triple lock’ makes this a lot less likely.

We could afford to keep the triple-lock in place. The state pension being paid out of the UK’s National Insurance Contributions (NIC) which are accumulated in the National Insurance Fund (NIF). On the 31st. March 2019, the NIF had an accumulated surplus of £30bn. Maybe it is time to start spending some of this surplus. HM Revenue and Customs (HMRC) also admits that it fails to collect around £34bn-£35bn each year due to tax avoidance, evasion and errors. Other studies  put the amounts at between £58.6bn and £122bn a year. A focus on tax avoidance/evasion could easily raise plenty to provide decent pensions.

Rather than damaging an already poor state pension scheme, the government needs to ensure that eradication of poverty and a decent pension are part of the UK’s recovery plan. We need to take action now to ensure that current and future UK pensioners do not continue in potentially worsening poverty.

It’s time to write to your MP’s.

And I have not even mentioned the plight of WASPI Women.

Hidden By The Crowd: Covid Advice for the Learning Disabled and Others

I am writing this really to provide some assistance to some of the groups hidden by the current focus on the health of the population. Clearly the messages for everyone of us at this time#StayHome #StaySafe are really important but there are many people for whom that message is really challenging, for example those with Autism or a Learning Disability. What about those who are vulnerable and isolated or who have a dementia causing illness. So this is for them and those looking after them.

So the resources I want to highlight first are from the Social Care Institute for Excellence.  They ahve produced a set of guides for families and professionals supporting autistic adults and adults with learning disabilities during the coronavirus (COVID-19) crisis. There guides, released on April 17th can be accessed HERE

They have also produced a guide for supporting people who are isolated or vulnerable again release only last week that can be accessed HERE This resource contains a great list of things that you can do during lockdown so what it is suggesting applies much further than the groups it targets. Take a look and you’ll see what I mean.

Regarding people living with dementia and their carers, the Alzheimers Society updated their COVID-19 pages on the 16th of April so you can look at their latest advice by clicking THIS LINK

It is very difficult for society’s marginalised groups at this time. While I can’t cover them all I hope this helps a few people.

As for the @NurseBloggers challenge. It will have to wait until next week. The topic is retention… well that will  interesting when you consider what’s happening just now. Will this encourage people to join health and social care professions or will it put them off… what happens in the next month may well shape the whole sectors future.

Suggestions for Things to Do While Isolating

I am going be quite choosy here and not give a huge long list. So let’s start with a brilliant initiative called Luminate@Home. Luminate runs a diverse range of activities and events that celebrates our creative lives as we age. It holds avery successful annual festival here in Scotland that usually takes place in May. In response to the fact that lots of older people at home or in care homes right now who are having to isolate from the wider world for a while they have launched a new programme of online creative activities

Luminate@Home are uploading short films every Tuesday and Friday at 2pm, on Luminate’s facebook page and on their YouTube or Vimeo channels. The films are designed to inspire and guide you through a creative activity that can be done at home or in a care home. The activities are presented by professional artists and feature different arts forms including crafts, poetry, music and dance. The films will be left online so you can access them at any time.

My next suggestion is a Scottish Care initiative called Tech Device Network. They are inviting businesses, organisations and individuals with spare technological devices to donate them to care services. All you have to do is click here to get in touch and tell them what you are able to donate. Scottish Care will then connect you with care services who would benefit from receiving the devices and jointly will arrange delivery/collection. As they state at this time this could have significant benefits for mental wellbeing, reducing distress and maintaining connections with loved ones for a vulnerable population and those supporting them. A meaningful way to connect our communities at this time and hopefully one with long term positive outcomes.

Last suggestion is from the Centre for Better Ageing who put up a useful blog post about keeping active in isolation. Its at https://www.ageing-better.org.uk/news/how-we-can-all-keep-active-home-during-coronavirus-crisis

Remember everyone its important to keep up your strength and balance at this time. Let’s get back out fitter than we were when we got locked-down.

That would be a positive achievement!

 

 

 

Health Advice for Older Women: Diet

I am not really in a strong position to do this as a 55 plus older man but I am going to try anyway.

Having blogged recently about exercise its time to look at food. Specifically for women. I am inspired a bit this week by the book released last year called  “Invisible Women: Exposing Data Bias in a World Designed for Men” by Caroline Criado Perez Reviewed Here and by the fact that it was International Women’s Day last weekend. 

So this is not my advice, this comes from neuroscientist and nutritionist Lisa Mosconi the Director of the Women’s Brain Initiative and Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College (WCMC)/NewYork-Presbyterian Hospital, where she serves as an Associate Professor of Neuroscience in Neurology and Radiology. So her views are worth taking note of. In a recent Blog for IDEAS.TED.Com she outlined 8 steps to take if you want to adopt a brain-healthy diet, which she says is a powerful tool in maximizing cognitive health, helping prevent dementia and may even ward off common ailments that affect many women, from slow metabolism to insomnia and depression. So if you want to know more then click the link below:

https://ideas.ted.com/heres-what-women-should-eat-to-maintain-a-healthy-brain/

The link also takes you to her TED talk on how menopause affects the brain so two peices of health advice at once and not even a mention of COVID19. I’ll maybe save posting about that until next week.

#CelebratingDSILs What about Online Diagnostic Support

This is my first post to my own Blog in a while. During November, December and January my posts had been limited because I have been nursing my dad who had a terminal illness and died comfortably at home aged 93 in early February.

Explanation over and hopefully now the Blogging will resume on a more regular basis again.

This week I attended the NHS Education for Scotland’s event celebrating the success of the Dementia Specialist Improvement Leads (DSILs)   which myself and the team I work with in UWS played a part in educating.

This is one of the projects that DISL Maureen Crossar led that I had a particular interest in.

Caring for people with dementia in the community is one area which is currently expanding. Recently the Alzheimer Europe calculated that with an increasing, and increasingly ageing, UK population the overall numbers of people with dementia; estimated in 2018 to be 1,031,396 will by 2050 be 1,977,399. A rise from 1.56% of the overall population to 2 .67% in 2050. There is pressure therefore to get this right now ahead of this expansion.

There is no clear way to provide all the people and their carers who require support with what they will need, so new ways to provide effective care need to be considered. This is one of way. Tihs resource was the winner of the Scottish Digital Health and Care Award 2020; and is NHS Lanarkshire’s Online Post Diagnostic Support Website which you can access from HERE

Two things to be aware of before you go to the site. It might have been designed for people receiving post diagnostic support but the information and advice is far more extensive than this. It has been tailored to suit Lanarkshire, so some sections discuss services and processes available in Lanarkshire which may or may not be replicate elsewhere. The legislative framework used throughout but the infomration can be easily transferred to a wider UK context.

The advantage of using this resource is that the information that it provides is validated and conforms to NHS Scotland standards (the information sources and hwere to get more information are all ij the links given within the site). There is 24/7 access to information which you can return to easily. People living with dementia and their carers can all access it when desired. It can be used to enhance staff knowledge of dementia, post diagnostic support and the services which might be available to improve people’s support and experience.

Topics the resource covers include understanding the illness, Power of Attorney, Driving, Anticipatory Care Planning, support for carers and lots more. Please explore this resource and use as you see fit. Note that the easiest way to find the site is to type “Dementia NHS Lanarkshire” into Google.

Who Said That an Ageing Population is a Bad Thing?

I’ve missed another week, but here I am back again. This week I am bringing a new report by The International Longevity Centre (ILC-UK) called “Maximising the Longevity Dividend”.  While older people and an ageing population are often painted as a risk to our economy, this new research shows that the UK’s ageing population brings economic opportunities through older people’s growing spending, working and earning power.

Their research has found that households headed by someone aged 50+ have dominated total expenditure (excluding housing costs) since 2013. And spending by older consumers will continue to rise significantly over the coming decades, from 54% (£319 billion) of total consumer spending in 2018 to 63% by 2040 (£550 billion).

Those 50+ also shift their spending towards non-essential purchases such as leisure, transport, household goods and services.

People aged 50+ are also making an increasingly significant contribution to the economy by continuing to work.. The share of the workforce aged 50 and over rose from 26% in 2004 to 32% in 2018, and it could account for 37% by 2040. People aged 50 and over earned 30% of total earnings (£237 bn) in 2018 and this is expected to rise to 40% by 2040 (£311 bn). The ILC have said that supporting people aged 50 and over to remain in the workforce could add an additional 1.3% to the UK GDP a year by 2040.

To read and download the report CLICK HERE.

AS David Sinclair, Director of the ILC, says

As the population ages there are enormous economic opportunities, but these are currently being neglected. We’ve become accustomed to hearing our ageing population talked about as a bad thing – but the reality is it could be an opportunity. However, we won’t realise this ‘longevity dividend’ through blind optimism about ageing. Instead, we need concerted action to tackle the barriers to spending and working in later life.”

Improving Well-being Exercise Again!

So twice within a month I am going to post about the same thing and yes you’ve guessed it its exercise. The National Institute for Health and Care Research (NIHR) have released their latest themed review looking at physical activity today.

Their report brings together recent evidence on ways to influence physical activity behaviours in individuals and populations. It focuses on studies funded by NIHR so it is not a comprehensive review. However this is a UK organisation and its research conducted in the UK aims to raise awareness of their collective findings and relate to them to a broader body of research relevant to this country. The breadth of their work is also quite impressive when you consider that the report covers Early Years, Children of Primary School Years, Adults, Older Adults, Workplace Changes, and Changes to the Built and Natural Environments.

What is says about older adults is quite revealing. The review states that

“We don’t know enough from the research about the kind and intensity of intervention which works best, but qualitative evidence suggest the importance of social aspects of exercise, and reassurance around safety and health beliefs. More effort needs to be directed at certain groups most likely to benefit and least likely to take part in initiatives, including those with lower starting fitness and health problems or with weaker social networks.”

Time for health professionals to take heed and focus on these groups then.

To read the report online or download a copy go to: http://bit.ly/2Nm8LGD

I promise that next week I’ll look at something else!

Improving Well-being: Step 1-Physical Activity

Public Health England have recently published new evidence and online guidance to help healthcare professionals embed physical activity into daily life.

Called Physical Activity: Applying All Our Health  the resource aims to help health professionals prevent ill health and promote well-being as part of their everyday practice.

The information provided aims to help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of physical activity. It also recommends important actions that managers and staff holding strategic roles can take.

It includes examples to help healthcare professionals understand specific activities or interventions which can:

  • prevent physical inactivity
  • protect through physical activity
  • promote healthier more active lifestyles

Also in the post is a link to an eLearning version of the information provided by eLearning for Healthcare (Worth signing up to because of the number of resources you can access).

The NHS Scotland equivalent page can be found at http://www.healthscotland.scot/health-topics/physical-activity/physical-activity-overview

but its perhaps not as interesting.

Older People Are Concerned About Climate Change Too!

Thousands of young people are taking part in school strikes across Scotland and around the world today to demand urgent action on climate change. The protests are the latest in a series of strikes started a year ago by 16-year-old Swedish schoolgirl Greta Thunberg, which have have now spread across 150 countries. Today’s action is the largest so far. Events are planned in all of many of the UK’s major cities, many towns and some islands including Iona and Skye.

What is often forgotten though is that older people are disproportionately affected by climate change.

The relationship is very clear. In cold weather extremes and in heatwaves and in any other kind of extreme weather or natural disaster, its older people that experience the most morbidity and mortality. Essentially older people have fewer resources to deal with disaster and they can’t get out of harm’s way fast enough.

For an example nearly half of the individuals who died during Hurricane Katrina in 2005 were 75 or older. When Hurricane Sandy hit New York in 2012, almost half of those who died were over 65.

A New York Times article, reproduced recently in the Independent called them the “forgotten generation”. Not just because they were forgotten in disasters but also because they were an untapped resource. Baby boomers, because of their huge numbers and voting power have great potential to make a difference to this protest movement.

Age International and Help Age International have been very aware of the problems of older people during disasters and even a quick look at Age Internationals Emergency Aid page (CLICK HERE) and this article by Help Age International (CLICK HERE) will give you a clearer idea of just how disproportionately they are effected.

Rather ironically the best resource that I could find explaining the impact of climate change on older people’s health is from the United States Environmental Protection Agency. Called ‘Climate Change and the Health of Older  Adults’ you can download it here!  

Reducing Type 2 Diabetes Through Weight Loss Alone

This is a bit of a departure for me as I have picked something that’s not necessarily relevant to older people but more relevant I think to the people who might read this Blog. Thanks to UNIVADIS for bringing this to my attention.

We often hear that Type 2 diabetes (T2D) can be avoided by losing weight and altering your diet, See Understand Your Risk but what if you have Type 2 diabetes already!

How much weight reduction is required to achieve T2D remission?

A recent paper published by a team from the University of Cambridge, School of Clinical Medicine, conducted a study that looked at this question and found that achieving weight loss of ≥10% within a few years of getting a T2D diagnosis is strongly associated with remission at 5 years. About a third of people who managed this achieved remission.

Why this matters

  • About 422 million people worldwide have diabetes, a number likely to more than double in the next 20 years. Type 2 accounts for around 90% of all diabetes worldwide. Reports of Type 2 diabetes in children have increased globally (WHO 2019)
  • Previous studies have shown that T2D remission is possible with intensive caloric restriction/lifestyle intervention, but few have addressed less-intensive interventions.

Study design

  • Prospective cohort study of 730 people aged 40-69 years newly diagnosed with T2D

Key results

  • Diabetes remission (HbA1c <48 mmol/mol; 6.5%), without any diabetes medication or bariatric surgery, was achieved in 257 participants (30%).
  • Those achieving remission were more often male, smokers, and with full-time education beyond age 16 years.
  • Compared with no weight change and after adjustments, people who lost ≥10% of body weight in first year after diagnosis were significantly more likely to achieve T2D remission at 5 years (risk ratio, 1.77; P<.01).
  • Remission likelihood was non-significantly increased for 5%-10% weight loss (risk ratio, 1.24; P=.17).
  • In subsequent 1-5 years, ≥10% weight loss was also associated with remission (risk ratio, 2.43; P<.01).
  • No consistent patterns of associations between unit changes in health behaviours (energy intake, physical activity, etc.) and T2D remission.
  • The study was conducted within a primarily white population.
  • Funding was published by Wellcome Trust; Medical Research Council and the UK National Institute for Health Research.

You can access the whole paper via

Dambha-Miller H, Day AJ, Strelitz J, Irving G, Griffin SJ. (2019) Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study. Diabetic Medicine. 2019 Sep 3 [Epub ahead of print] at  doi: 10.1111/dme.14122. PMID: 31479535