Embrace geographical challenges
Rural isolation, loneliness and stigma are only some of the issues around the profound inequalities that need to be addressed in rural areas:
- Understand that rural areas probably have demographic profiles that impede normal services and support. Rural demographics usually equate to an upside down triangle of support, i.e. fewer working people at the bottom supporting an unprecedented volume of older or more vulnerable people at the top which results in too many people trying to access limited services and support.
- In small rural communities the lack of resources and infrastructures may be challenging, but using that situation can work to your advantage – local knowledge and influence often rests by necessity with just a few people wearing a number of different hats, so tapping into the resources of those local pillars of the community can mean connections are made quicker. Also, by working with key personnel who share similar problems and are close at hand, it may be easier to find creative ways around those problems.
- Transport can be an issue in rural communities, investigate the availability and opportunities for options for local transport.
- Technology like video conferencing, interactive screens, GPS tracking, and the use of websites and social media are essential tools to address issues around inequalities in older people. Technology is not only about home aids: technology can be a key vehicle to support older people to live within their communities for longer, especially since the next generation of ‘older people’ are so familiar with IT, i.e. the internet, mobile phones etc.
Freedom to roam
The use of GPS tracking devices to maintain quality of life for people with long term health conditions has been hotly debated in the media, on the grounds that it is inhuman to tag people like criminals. On the other hand people with conditions such as dementia want freedom to roam and carers want peace of mind knowing their loved ones can be found if their safety is at risk.
This debate triggered a trial of satellite trackers, but more importantly the ethics of using these trackers was essential if professionals were to accept the findings. There is sufficient evidence confirming that trackers give people with dementia marked increase in quality of life (with individuals describing how much they have enjoyed new-found independence), and carer peace of mind. It is really all about semantics i.e. people don’t want to be ‘tagged’, but do want freedom to roam.
The Dementia Friendly Communities, Helmsdale initiative worked in collaboration with legal professionals to draw up a code of ethics which confirmed that while incapacity laws differ between countries, the fundamental principles of the European Convention on Human Rights remain the same i.e. people with dementia have distinct human rights irrespective of their dementia diagnosis or where they live. Also key to ethically using tracking devices, is the fact that they should be used for the person’s safety, not for checking up on them: something carers need to be aware of.
Windows of the World
Allied Health Professionals (AHPs) in rural mental health services face extra challenges. With huge areas to cover, they often spent much of their time travelling, resulting in less time with those needing their support. Using digital technology can bridge this gap. The Windows of the World project developed by DFC Helmsdale has seen people with dementia using an interactive screen to access a range of creative pursuits and therapeutic interventions. Not only have they contributed to a photographic bank of images of specific interest to rural community groups but have also learned to become active users of social media, email, tablet devices and many other forms of technology.
The introduction of the interactive smart television screen to community Well-being Hubs can be immensely valuable, with the screens being used for instinctive reminiscence work, access to shopping, films and entertainment as well as the remote delivery of health programmes around exercise, nutrition and diet for those attending Well-being Hubs. More importantly, these activities are helping to reduce isolation and loneliness for local people.