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Planning for retirement and later life Ref no.: OS138 Jill Manthorpe Kritika Samsi EVIDEM www.evidem.org.uk www.evidem.org.uk __________________________________________________________________________________________.

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Presentation on theme: "Planning for retirement and later life Ref no.: OS138 Jill Manthorpe Kritika Samsi EVIDEM www.evidem.org.uk www.evidem.org.uk __________________________________________________________________________________________."— Presentation transcript:

1 Planning for retirement and later life Ref no.: OS138 Jill Manthorpe Kritika Samsi EVIDEM __________________________________________________________________________________________ NIHR: Programme Grant for Applied Research Hosted by Central and North West London NHS Foundation Trust In collaboration with University College London, Kings College London, St. Georges, University of London, Kingston University, London School of Economic and Political Sciences and The University of Hertfordshire

2 Study context oEviDEM: Evidence-based interventions in Dementia oFive year research programme funded by National Institute for Health Research owww.evidem.org.uk oEviDEM-MCA nested within programme of research oOne sub-sample presented today EVIDEM __________________________________________________________________________________________ NIHR: Programme Grant for Applied Research Hosted by Central and North West London NHS Foundation Trust In collaboration with University College London, Kings College London, St. Georges, University of London, Kingston University, London School of Economic and Political Sciences and The University of Hertfordshire

3 Background oCurrent legislation (i.e. Mental Capacity Act 2005) encourages older people to plan in advance for later life oAmong other things, encourages appointment of proxy decision-maker and pre-specifying preferences in case of future loss of capacity to make ones own decisions oEncourages advance planning and decisions, including refusal of treatment oEnables the granting of a Lasting Power of Attorney, capable of making decisions on financial and personal welfare issues oStudies show people value autonomy and retention of independence for as long as possible EVIDEM __________________________________________________________________________________________ NIHR: Programme Grant for Applied Research Hosted by Central and North West London NHS Foundation Trust In collaboration with University College London, Kings College London, St. Georges, University of London, Kingston University, London School of Economic and Political Sciences and The University of Hertfordshire

4 Research Questions oWhat are the planning patterns of older adults living in the community? oHow do they approach planning for later life? oWhat issues do they take into consideration prior to setting out formal arrangements? oWhat sources of support and information assist with this? EVIDEM

5 Methodology & Recruitment oRecruitment was through established community groups (social clubs, lunch clubs) and flyers put up at these venues oFollowing introduction of the topic by moderator of group, information sheet handed, study explained and permission to set up an appointment sought oMost visit were in peoples homes, some in day centres too oCapacity assumed and consent sought oSnowballing technique also used EVIDEM

6 Sample oQualitative interviews with 37 participants oMean age 71.4 years (range – 53 to 86 years) oMostly female (30 people; 81%) oEthnic group described oWhite British: 21 oBlack Caribbean: 6 oAfrican origin: 3 oIndian origin: 3 oGuyanese: 2 oIrish: 1 oScottish: 1 EVIDEM

7 Findings oTypes of plans oIndividual inclination to plan oIrrelevance of planning oAdvice and support with planning EVIDEM

8 Types of plans oA will was common and been fairly straightforward to draw up oFuneral plans also fairly common oAbsence of consideration of health and social care plans EVIDEM

9 Individual inclination to plan oLifelong personality habit oReligious beliefs oFamily reliance I dont care if I am dying tomorrow, I said to people look, if it is my turn that God said I should come and join Him, I said I am prepared, what is the use of going to plan, what is the use of worrying? – Female, age 65 EVIDEM

10 Single people living alone This is one of the problems I have been dealing with to do with Power of Attorney for personal health and welfare, well I dont know what you feel about that, to me it is just a load of rubbish. I have got all those documents from a solicitor, but it just does not work for people with no families. What the Government has to realize is that as I get older my friends get older. No way can I ask a friend my age. Younger friends lead very busy lives and they have got family problems of their own. - Female, age 74 EVIDEM

11 Irrelevance of planning oPerceived and enacted support from family oPerceived support from medical professionals oNothing to leave to future generations EVIDEM

12 Perceived and enacted support from family Yes Families would be left with difficult choice Yes, [I have] a Living Will, my doctor, my lawyer, the children know, the point of my doing that is, say I was like a cabbage somewhere, do we pull the plug? Well which one [of my children] has to decide? I dont want any of mine to do that, I would hate to have to do it myself.. – Female, age 85 No Family could be relied upon to make decisions Well I have got children, I have two daughters, two sons, and they will look after me, well they are looking after me at the moment you know. Interviewer: What about if you had to move, or if you needed treatment? I dont know, my children would decide, yes. Well, I know my children dont want me to move out of my home at all, they know what I want with treatment. – Male, age 80

13 Perceived support from medical professionals No Medical professionals could be trusted to do the right thing I have a very good doctor, there is a group of doctors, and they are very good and the hospital is very good. Well my plan is – I have to work with my doctor and consultant – yeah that is the only plan, to work with my GP. And I mean if I need treatment, I wouldnt want them to say dont give her treatment or not because I am not one of those. I would leave it to them. – Female, age 78 Yes If diagnosed with a debilitating illness If I made plans in the future, well I could think of an event immediately that would save me the trouble – if my doctor tells me I have only six months to live, something like that. Or, I think if a doctor told me that I had dementia, then yes I would be making plans in that case – Male, age 70

14 Awareness & Understanding of MCA oMixed levels of awareness of health and social care oCommon-sense understanding of its principles, rather than legal definition Oh now, is it while you are still alive… choices about your house and all that… in case you go into care and somebody has to pay the bills? Yes, thats it – Male, age 60 oPlanning conceptualized entirely in terms of finances, not health or social care oLiving Wills Advance Directive/Decisions inaccurately understood –Associated with euthanasia; aware that it was against the law in UK EVIDEM

15 Implications oLevel of planning is specific to each individual oNot part of everyones culture or personality oFinancial advice more widely available; health and social care advice more event-driven oReliance on family and other situational factors may result in disinclination to plan oPlans usually made in best interest of surviving family oInformation might be targeted towards single people EVIDEM

16 Disclaimer This study has received financial support from the National Institute for Health Research (NIHR) Programme Grants for Applied Research funding scheme. The views and opinions expressed therein do not necessarily reflect those of Central & North West London NHS Foundation Trust, the NHS, the NIHR or the Department of Health.

17 Thank you! For further information, please contact: Jill Manthorpe, Kritika Samsi,


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