The West Lothian Approach to supporting independence and keeping well in your community Table of Contents 2 Introduction 4 Health & Well-being 30 Crime & Community Safety 35 Housing 43 Transport/Travel 49 Community Life & Leisure 56 Training & Employment 59 Care & Carers 62 Counselling 66 Advice & Advocacy 75 Debt Advice 79 Income Generation/Pensions/Benefits 84 Services to Promote and Maintain Independence 87 Sensory Impairment Keeping well in your community 1 Introduction West Lothian identifies with the re-focusing on the role of public services and promotion of the sharing of responsibilities. West Lothian has decided to encourage and promote this by developing a document of this nature to make it easier for people to find out what is on offer for themselves or for a person they are caring for. At the 2001 Census, there were 1.1 million individuals aged 60 and over in Scotland. The picture for West Lothian from the 2001 census demonstrates that, 25,800 lived in West Lothian. Those aged 60 and over comprise 16.2 per cent of the West Lothian population, substantially below the Scottish figure of 21.1 per cent. Thus West Lothian has a relatively young population compared with Scotland as a whole. However, the projected rate of increase of the older population in West Lothian is the highest in Scotland. Between 2004 and 2024, those aged 60 and over will increase by 72 percent in West Lothian, compared with only 39 per cent in Scotland as a whole. This tells us that West Lothian will face proportionately greater challenges in its care provision compared with the rest of Scotland in coming decades. Access to services is becoming increasingly determined by eligibility criteria. In 2009 the Scottish Government and COSLA introduced the National Eligibility Criteria The eligibility criteria sits alongside other current relevant policy, including, for example, improving and sustaining the well-being of older people and the strategic shift towards early intervention and prevention for all adults. Eligibility criteria are a method for deploying limited resources in a way that ensures that those resources are targeted to those in the greatest need, referred to now as individuals with critical and substantial needs. This will pose some challenges to councils on how to respond to those individuals who do not currently have high needs and present with lower level need now referred to as moderate or low needs. Re-ablement, Early Intervention and Prevention are key areas for supporting people to continue to live independently. In recognition of this West Lothian has decided to develop an overarching approach /strategy to improve independence and well-being and to ensure that those people identified with ‘moderate’ and ‘low’ needs are supported to live within the community for as long as possible. This means looking further than at physical problems and promoting well-being through a range of service which includes health, social care, housing, information and advice, leisure activities and employment. Keeping well in your community 2 Key Priorities/Areas of Activities The long-term vision for West Lothian is set out in the many strategic planning and development documents that cover the following service areas: o Older People o Dementia o Learning Disability o Mental Health o Physical Disability The guiding principles of which are: o Inclusion o Respect o Choice o Independence o Sharing o Involvement Key priorities for West Lothian include: o A greater emphasis on personalised or individualised services and a move to increased service user/ carer responsibility and control over their care and support provision o The maximization of independence and capacity – including improving employment and social opportunities o A focus on shifting the balance of care more towards community and home-based care o A move towards outcomes focused approaches and frameworks in service commissioning and delivery o A focus on rehabilitation and re-ablement to be delivered as locally as possible. For some time a key priority for West Lothian has been re-ablement. Our definition of re-ablement: “Re-ablement is a time limited intervention that supports you and/or your carer to achieve set goals that support you in maximising your independence and community involvement whilst reducing reliance on traditional form of social care support”. The approach focuses on re-abling people so that they achieve their potential in terms of a stable level of independence with the lowest appropriate level of ongoing support or care. From 2011 onwards there will be a review and re-design of the current re-ablement services to optimise the capabilities of all adults. This document contains information on what we think is important for you to know and is designed for: o people aged 16 or over who live in West Lothian o people who are not currently getting health and social care services. Keeping well in your community 3 Health and well-being Keeping Well – Mental Health Well-being Eating for Health Physical Activity Foot Health Preventing Falls Occupational Therapy Oral Health Sexual Health Keeping Well in Winter Mental Health Self Harm & Suicide Bereavement Addictions/Substance Misuse Community Pharmacies NHS Inform Libraries & Health Information Keeping well in your community 4 Health and wellbeing Keeping Well – Mental Health Well-Being Mental health affects every area of our lives. Mental health means our ability to enjoy life and cope with its challenges. Recent research suggests that mental health consists of two dimensions: o positive mental health (mental well-being), for example life satisfaction, positive relationships with others and purpose in life; o mental health problems (mental illness or disorder, psychiatric morbidity), for example depression and anxiety. What does mental health mean to you? Does it make you think of someone who has a mental health problem like depression or schizophrenia? Or does it make you think of that very personal quality which describes the way you think and feel about yourself, your experiences, your confidence, your resilience and sense of control over your life? Good mental health is therefore much more than the absence of mental health problems. Everyone feels down or under stress from time to time. Apart from the normal ‘ups and downs’ of daily life, many people face extra problems, perhaps having no job, nowhere permanent to live, not enough money, they feel lonely or are constantly arguing with their partner. Pressure is normal and is the result of the demands life places on us. Some stress can be good for us, giving us energy to deal with these elements. But too much or too little pressure can lead to stress. What is stressful to one person may not be to the next - it all depends on how we deal with things. There are lots of things you can do to improve mental well-being and help prevent mental health problems in the first place. There are also plenty of things you can try if you (or those around you) do encounter problems. Here are some top tips to help you feel good everyday: o Keep in touch as much as you can with friends and loved ones o Talk about your feelings with people you trust o Be as active as you can be o Eat a variety of foods and drink in moderation o Listen when others talk about their feelings o Do something for YOU (not to impress others) o Take a break! o Do something creative o Do something that helps you feel good about yourself. Keeping well in your community 5 Eating for Health Ensuring that you have a healthy, balanced diet is an important step towards good health for all people. Good health is essential for leading a full and active life. The word ‘diet’ is often used to describe an eating plan that is intended to aid weight loss. However, diet really refers to the food that a person eats during the course of a day or a week. The more balanced and nutritious your diet is, the healthier you can expect to be. A balanced diet means eating the right amount of foods from all the food groups. No single food contains everything the body needs, so it is important that your diet is varied. Eating a balanced diet can: o increase your life expectancy by keeping your heart and body healthy o prevent many long-term illnesses o help maintain a healthy body weight . Diet and Health as we get older The rate at which we age, become frail or disabled is influenced in part by our genetic make up. However, what we eat, stress levels, mental well being, alcohol use, smoking and physical activity also influence the rate of ageing. In addition to this, outside factors like our social well being, involvement in local community activities or groups, hobbies, family and social circles all play an important part in maintaining physical and mental resilience and enjoyment of life. Many of us will remain well as we get older, but as we age we all undergo changes in our bodies. Disorders affecting our digestive system, heart and circulation, kidneys, brain and nervous system become more common. Our sight, hearing, ability to smell and taste things may also deteriorate. As we age we also see changes in body composition and in metabolism. Bone loss accelerates and muscle weakens, causing increased risk of bone fractures. We tend to lose muscle and our proportion of body fat increases. These changes all happen at different rates in different people and none of us are the same but the risks are as we get older we have more episodes of ill health that can take longer to recover from, that is why it is important to maintain our health by keeping active and eating a balanced diet.