About the researchThe way that society talks about older people and debates the challenges of our ageing population is often couched in extremes and based on assumptions about the millions of people who are aged over 65 in the UK today. These assumptions often include ideas of ‘big houses’ and ‘big pensions’, however the evidence shows that many people aged 65 and over are facing significant challenges and significant inequalities exist. For example:
- More than half of people over 65 have at least two chronic health conditions
- Just over 2 million older people are living in poverty and this is more likely to be the case for single women, ethnic minorities and the over 80s
- There are 1.2m chronically lonely older people in the UK
Research funding and partners
- National Development Team for inclusion (NDTi)
- City, University of London
- Independent Age co-production group
Initially, we commissioned researchers at NDTi to conduct a literature search on how older people were talked about in research. We chose the themes of ‘Health and Wellbeing’, ‘Financial Security’ and ‘Social Connections’.
Our findings were based on three main strands of research:
- A scoping review by the National Development Team for Inclusion, which explored the extent to which specific groups of older people appear to be represented in research and policy thinking. This stage of the work also informed our decisions about which specific groups of older people we would focus on.
- In-depth interviews with 45 older people across England, which focused on health and care, financial security and social connectedness. This qualitative workstream was delivered by Humankind Research.
- Analysis of data by City, University of London, which included a review of the representation of older people in national statistics and in-depth exploration of the Understanding Society survey. This provided specific insight on the groups we focused on and comparisons across the life-course.
We chose the Understanding Society dataset over the English Longitudinal Study of Ageing (ELSA) dataset primarily because it gave us the option of comparing subgroups of older people not just with the ‘average older person’, or other subgroups, but with younger age groups in the same subgroup.
The researchers found that older people were often homogenised into broad age groups and found very little discussion of ‘subgroups’ of older people, such as LGBT older people, BAME older people, or older people with mental health conditions.
Our analysis attempted to create a snapshot, rather than tracking over time. We were keen to spotlight voices from subgroups of older people who are often absent from mainstream debates and don’t appear in conceptions of what being ‘older’ looks like. We wanted the quantitative data to provide context alongside our interviews and case studies, and highlight that not only are these groups often absent from discussions, but from statistics as well. Even quite simple statistics on older Black Asian and minority ethnic people, carers, and LGBT+ people are not easily accessed, and we wanted to shine a light on them.
On the qualitative side, we commissioned Humankind research to conduct in-depth interviews with 45 older people across England.
We put together a coproduction group of older people to input at key decision points in the project. The group reviewed the methodologies of bidders for the qualitative side of the research, and were instrumental in the selection of Humankind research. They also provided substantial input into the discussion guide for the in-depth qualitative interviews. This was the first time we had used a coproduction group in a research project at Independent Age.
Data used from the UK Data Service collection
We grouped the findings from the research into six main themes:
- Assumptions and stereotypes – overarching assumptions and stereotypes about older people persist and can have a significant negative impact. Across the people who shared their stories with us, there were widespread feelings that they weren’t regarded as individuals. There was also a sense that they were hemmed in by society’s expectations of how ‘older people’ should behave and what their limitations are.
- Limited expectations – people can also have limited expectations of their own lives, and of the support they are entitled to. The research highlighted a range of points around people’s expectations including whether older age was what they had envisaged, about their future and about what was ‘due’ to them.
- Social connections – vital social connections that can combat loneliness and ensure people are supported are often fragile. For many people, having strong social connections was the number one indicator of living a good life. But, in lots of cases, these connections weren’t in place or were diminishing, and there was a sense that this was just something that would inevitably happen as people get older.
- Lack of choice – people often experience a disempowering and damaging lack of choice and control in their day-to-day lives, and there were examples of how precarious people felt their lives were.
- Interconnected challenges – the challenges people face overlap and are interconnected, with one problem often leading to another. It is well established that difficulties in a person’s life can have a knock-on effect and create other problems. This project provided a chance to consider the issues lying behind – and often driving – people’s vulnerability or poorer outcomes, and how certain events and challenges can combine to create considerable difficulties for people in later life.
- Protective factors – certain protective factors can help people build and maintain their resilience. Our research highlighted a number of factors that could be seen as protective – helping people to stay resilient and more able to cope with challenges – or that could potentially slow a decline in their resilience.
While some findings were expected, based on what we hear from our frontline services, some of the more specific findings were unexpected and intriguing. For example we found that older people in the lowest income group are less likely than any other age group in the same financial situation to describe their financial situation negatively. This matched with our interviews where older people in severe poverty were very reluctant to identify themselves as ‘struggling’, even those in very dire situations felt that they ‘shouldn’t complain’ and that ‘others were worse off’.
Findings for policy
Based on these findings, we developed ‘6 tests’ that we will apply to policies and programmes.
|Themes from our research||The tests we will apply to policies and programmes|
|Older people aren’t seen as individuals and ageist assumptions persist about their needs, capabilities and preferences.||Is there a clear and comprehensive understanding of what older people need, want and are capable of, and that looks beyond the average or majority?|
|Older people can find it difficult to navigate changes in their lives and access the support they are entitled to.||Are people getting the right information, advice or advocacy at the right time?|
|The complexity of systems and processes can be overwhelming and reduce any sense of choice, control or agency.||Are approaches being redesigned to be more person-centred, and to see people as active participants rather than passive recipients?|
|Older people’s opportunities for social contact can be fragile and can be hindered by factors such as limited public transport.||Are joined-up approaches being taken, and the impact of decisions on all groups and all aspects of their lives being considered?|
|The challenges people face can reinforce or create more difficulties.||Are opportunities to prevent issues developing or escalating being seized?|
|Older people often contribute actively to society and manage their own resilience.||Are people’s assets being recognised and nurtured?|
|And, cutting across all of these, are older people defining what success looks like and how it is measured?|
We published our In Focus report, plus individual factsheets for each subgroup, which can be found on our website: https://www.independentage.org/in-focus
We have taken multiple opportunities to ensure the voices of the people who featured in In Focus are heard more widely. Data and stories have underpinned reports and briefings that we have published on a range of themes including social care, mental health and financial poverty. The findings have also informed our policy consultation responses to government and other decision-making bodies, including inquiries by the APPG for Loneliness, the Women and Equalities Committee, and the Health Foundation. The sheer amount of data we were able to obtain in a curated form allows us to produce very tailored statistics that are uniquely from Independent Age.
Our 2020 report on mental health Minds that Matter, sought to build on our In Focus work that looked at older people with anxiety and depression. Rather than having to commission an entirely new piece of quantitative research on older people’s mental health, we were able to use the detailed stats from In Focus as our quantitative base. As a result, we were able to spend money and time we usually would have spent on commissioning research on qualitative interviews with older people about mental health, as well as some in-house analysis of Increasing Access to Psychological Therapy (IAPT) data.
We are currently exploring a follow-up to the financial security side of the In Focus project, featuring a deeper dive into different experiences, causes, and indicators of pensioner poverty. The work already done during In Focus has allowed us to identify the subgroups we are particularly interested in, with a strong evidence base.
Impact on our approach
The experience of working with commissioned research partners on a large scale was relatively new to Independent Age, and provided us with valuable experience in tendering, working with researchers, and choosing useful research objectives, questions, and indicators. Since the In Focus project, we have commissioned other work using longitudinal datasets, including research on the impact of low uptake of Pension Credit on associated health and social care costs. This research used ELSA, the Family Resource Survey, and Understanding Society in combination, and easy access to these datasets provided by the UK Data Service meant that the project could be turned around in a very short space of time.
The success of the coproduction element of the project was also encouraging, and along with Humankind we won the Market Research Association’s inclusive research award. We are now exploring how we can build co-productive elements into future policy and research projects.
Minds that matter: Understanding mental health in later life (October 2020)