Marco de Referencia

The ways in which older people responded to receiving help was complex, and in part was related to their individual support needs and past experience of receiving help. These feelings were also linked to their understandings of independence (see Section 3.2). A crucial aspect of this was asking for help and the discomfort this could cause, which often provided a major barrier to receiving help. Feelings about receiving help also related to the source of support, and the same types of help, provided by the state, family, private services or neighbours, were not perceived in neutral terms. Additionally those with fewer resources, and more disabled generally, reported more problematic feelings about receiving help, in large part because they had less choice about the forms in which these were provided.

Glennis’s experience provides insight into the complexity of these relationships. She clearly had mixed feelings about receiving help from her friends, and this related to the way in which help had been offered. She described how one friend, ‘really has been a great friend since [husband] died’, providing the kind of thoughtful responsive help that had been just what she had needed during her bereavement. She contrasted this with another friend, who had offered support, but only on an asked-for basis, which made her feel uncomfortable and unlikely to approach her:

‘she never asks me to go anywhere. But she was saying to me, “If you want to go anywhere just ask me,” well, I couldn’t. If she wanted me to go somewhere with her she will ask me, won’t she?’

Generally interviewees’ feelings about receiving help were much more positive if it was provided by a family member to whom they were emotionally close. Marriages in particular provided a comfortable way of receiving help for many pensioners, since partnerships offered a taken-for-granted assumption of mutual support (Parker, 1992), and couples’ expectations had often been based upon an expectation of interdependency. As Leo explained, ‘Well, obviously we help one another, you’ve got

to help one another, else you don’t survive.’ Riana’s response illustrated a normative expectation

regarding the nature of support between husband and wife, ‘because he’s my husband and I love him.’ Similarly, transfers of support between daughters and their older mothers, more often than cross-gender familial relationships, were described in terms of an environment in which interviewees felt comfortable receiving support.

However, an important issue for many pensioners was their worry about being ‘a nuisance’ or ‘a

burden’ upon their loved ones by asking for help. Patience, who was a wheelchair user and who had

recently suffered a stroke, was being cared for by her son and felt guilty about ‘depriving him of his

life’. She asked that someone come and take her out for a day as a ‘wheelchair pusher’ to give him a

break. Paradoxically, while support relationships which offered an emotional closeness (that is, largely, family and friendship-based ones), were valued precisely on account of those aspects, the fact that these relationships were imbued with layers of meaning could also complicate older people’s feelings about becoming overly reliant upon informal forms of support. There could also be an issue of uncertainty relating to the boundaries of informal social support, in that older people sometimes felt that because family or friends were helping them on a goodwill basis, rather than because they were ‘entitled’ to this support, as with statutory services, they felt uncomfortable asking them to do things which they would like to have done for them. Isabelle, a woman in her 80s, who relied upon a mixture of family, neighbours and paid help for support, explained how she felt about asking for help from her brother, ‘other times I think no, is he just saying it, or this, you know, am I being a

nuisance?…I don’t want to feel that I’m pushing my luck.’ Others commented that relying on

themselves for as long as possible was a matter of pride, an attitude that seemed to be little linked to their capabilities. Ruth, a divorced woman in her 60s with mobility problems, explained:

‘Independence means everything to me, because if I have to ask someone to do something for me, I don’t know how I will feel. I don’t want to ask anyone to do anything for me.’

As described in Chapter 3, some older people noted that they preferred to pay for support, such as domestic help and carers, because commodifying these relationships made them less problematic and diminished their sense of being dependent upon others. Ruth explained, ‘I can pay them, and

they’re not doing me any favours. It’s terrible isn’t it?’ Isabelle reiterated that she felt a shift from

informal to more formal forms of support would have important psychological benefits, ‘I would love

to be able to pay, that would make me feel even more independent.’ Such a strategy, of course, was

only available to those with sufficient funds to pay for private support. In particular, private services seemed to provide a continuity of care that could not be guaranteed through social service provision. Indeed, Ungerson (2003) has drawn attention to the significance of ‘hot’ and ‘cold’ forms of care services. However, older people often found that informal social support offered the most comfortable environment for receiving support, and enabled them to maintain a quality of independence that would not be possible otherwise. For example, Brenda and Bernice, long-term widows, both lived with their children, and explained that the level of support they received from their families was vital in enabling them to continue to think of themselves as independent people. Indeed, without this support, both felt that they would be forced to move into residential care.

The most entrenched care needs were often met by statutory care, perhaps because pensioners lacked alternative forms of support, and older people felt very differently about this relationship. Esther welcomed statutory services as something she felt entitled to and in control of, preferring this form of delivery to relying upon friends, to whom she felt she ‘owed’ something. For her, statutory provision promoted her sense of independence. However, problems were also experienced with statutory services, particularly those subcontracted to and delivered through private agencies, through which pensioners sometimes received care from a number of different people. This could lead to instability in older people’s care and a lack of specialist knowledge of their care needs and preferences, which inevitably compromised their sense of independence. Unis described the inconvenience caused to her daily routine by a care assistant who insisted on working to her own timetable and ignoring Unis’s own established routines:

‘But she was just too quick. She wanted to get out you see. I mean I understand, I used to have to go to bed at seven, I’d get up at seven ... it’s a bit off, isn’t it, going to bed at seven, get up at seven every morning…When I get as old as what I am, you want to [have a] little rest don’t you?’

In this way, Unis’s sense of autonomy over the care process was compromised. Miriam, a widow in her 90s, commented on the statutory care she had received, ‘the thing is, you never knew which day they

were coming, and who was coming and all that.’ She had subsequently invested a substantial part of

her income in paying for two private carers, an arrangement which worked much better for her, having developed a personal relationship and sense of trust with them. Others, such as Lynne, did not feel that they would be entitled to statutory support and so did not apply for it, or like Leo, had bad experiences of using particular services in the past, and so avoided contact with external agencies as much as they could.

The way interviewees felt about receiving help often displayed a degree of relativity. Several pensioners commented that while they were comfortable receiving family or statutory support with domestic tasks, that they were more uneasy about the prospect of the same person helping them with personal care. For example, Patience lived with her son, and relied heavily upon him for cooking, shopping, and sometimes also, financial support. However, the emotional closeness of their relationship and their gender difference made relying upon him for intimate tasks more problematic,

and a series of carers came in every day to help her with washing and toilet needs. Others, like Noreen, ordered things differently; she explained that, ‘It’s when you get strangers in your house, I think, that

I’d feel awkward,’ and that while she would happily ask friends for practical help, she felt that she

would be unable to concede control of personal care herself, ‘probably [a] psychological thing, I don’t

know. Probably me.’

Similarly, some people displayed a sliding scale of willingness to ask for or accept help, depending on the situation. These differences were particularly highlighted in relation to questions asked in the second tranche of fieldwork, when interviewees were asked who they would go to for help in the event of a fall, if their transport had broken down, and if they found themselves faced with an unexpected bill. In particular, it emerged that older people were less willing to approach friends and family about a financial crisis, seeing it as something they should be capable of dealing with alone, the implication being that such a situation was shameful. This was often related to lifelong attitudes to finances and ‘coping’. Conversely, people were far more willing to accept that they would need to approach someone to help them after an accident, the overall sense being that health is relatively uncontrollable and that it is normatively acceptable to require support in circumstances of compromised health.