Older Women – What we already know


The below content sets out the Scottish Government’s position on the topic of older women.

The Minister for Older People and Equality has lead responsibility for older people and wanted to provide a supporting structure for our work with older people, with equality at its heart. The Older People’s Framework has provided that structure and highlights the positive contributions of older people and challenges the negative perceptions they face. It was published on 3 April 2019. The Framework has been influenced by evidence and OPSAF members also captured the views of their networks to help identify barriers and provide solutions to overcome these. The Framework has identified over 50 key actions that the Government and others can take to maximise contributions and remove barriers, but importantly, the actions have been based on the priorities given to us by older people themselves. The Framework is the start of a journey to improve the lives of all older people in Scotland, so that everyone can have a thriving third age.

Carers

The Scottish Government recognises the huge impact unpaid carers have not only on the lives of the people they care for, but also to the country’s economy.  It is estimated that unpaid carers save the economy around £10.8 billion per year in care costs. A disproportionate percentage of unpaid carers are women.

Who are our carers? In Scotland, a carer is anyone who provides (or intends to provide) care to someone else due to an illness, disability, frailty or addiction issue. This does not include the paid care workforce or care provided through formal volunteering.  The care provided can be practical, physical or emotional.

There are an estimated 790,000 carers in Scotland. Overall, 59% of carers are women. Working age women are much more likely to be carers than men and for those women in their late 50s and early 60s, nearly a third are carers. (Following retirement age, the difference between men and women balances out with 19% of both men and women in the 65-74 age group providing care)

Around 4% of identified carers in Scotland come from an ethnic minority background – there are particular cultural challenges around identifying as a carer from these backgrounds. Older South Asian women are likely to be the predominant carers within their communities.

Policy response – Carers Act

The Carers (Scotland) Act came into effect last April.  It puts in place a system of carers’ rights designed to listen to carers; improve consistency of support; and prevent problems – helping sustain caring relationships and protect carers’ health and wellbeing.

This legislation represents a major step forward in carers’ rights. It includes each carer’s right to a personalised plan to identify what is important to them. This may include their wishes to, for example, return to work or undertake studies or training.

Carers also have the right to support to meet their eligible needs. Local authorities must consider whether that support should include a break from caring.

Carers can find out more about their new rights under the Act through the Carers’ charter and the Coalition of Carers in Scotland has developed Carers Act “What to expect leaflets”.

National Carer Organisations

The Scottish Government funds a number of national carer organisations to engage with carers and represent carer interests at a national level.  This includes:

Dementia – Context

In common with other countries, dementia is one of our biggest health and social care challenges.

There is estimated to be up to 90,000 people in Scotland living with the illness, with an estimated 20,000 new cases diagnosed in Scotland yearly by 2020.

Age is one of the biggest risk factors in developing dementia and so as more women live into very old age than men, a disproportionate percentage of people living with the illness over 75 are estimated to be women.

Policy response – National Dementia Strategy

Scotland’s third 3-year Dementia Strategy was published in 2017, focussing on post-diagnostic support, integrated home care and palliative and end of life dementia care.

Everyone newly diagnosed with dementia in Scotland is entitled to be offered a minimum of a year’s worth of dedicated post-diagnostic support, coordinated by a named and appropriately trained Link Worker of Care coordinator. This non-medical service helps individuals and families understand the illness, connect more effectively with the range of local, national and on-line services and supports available and plan earlier for future care options. The Scottish Government is supporting local partnerships in increasing access to this service.

Housing

In 2011, the Scottish Government, in partnership with COSLA published Age, Home and Community: A Strategy for Housing for Scotland’s older people aimed helping older people live independently at home. We published a mid-point review in 2017 to highlight progress on the original commitments.  Following on from this we refreshed the original strategy and in August 2018 published Age, Home and Community – The Next Phase. This sets out our vision for the next phase of the strategy and has been developed using what we have learned from the experiences of older people and the insights of organisations who work with them. Our vision is for older people in Scotland to enjoy full and positive lives in homes that meet their needs. To achieve this aim we have identified three principles: Right Advice, Right Home and Right Support. The strategy will focus on these three key areas to achieve the changes required to enable our growing population of older people to live safely and independently at home for as long as they chose to do so.

It is important that our older people’s housing strategy connects with other policies that affect older people, with clear outcomes and measureable actions. Ageing is an important cross-cutting policy issue and work is ongoing in a number of other areas such as dementia, and social isolation and loneliness. The strategy takes a person centred approach to achieving our aim of older people enjoying full and positive lives, in a home that meets their needs. This allows individuals to have their say about what they want from their home; the size, location, community, technology, access to transport and the many individual requests that make their home ideal for them.

We know that Scotland’s population is getting older and that this will have important policy implications for housing. Using demographic trends enables us to plan public services including health and social care provision as well as additional or different forms of housing that will be suitable for people as they age. We have already begun work on Housing Beyond 2021, our vision for how our homes and communities should look and feel in 2040 and the options and choices to get there. The Scottish Government wants this to be a lasting legacy that is not just about new homes but to make the best use of our existing buildings too. 

The Scottish Government is committed to supporting projects that provide timely, high quality advice to those in need. Advice services can play an important role in helping people understand their rights and to find solutions to a range of issues. Access to the right information and advice at the right time ensures people can make an informed choice about the type of home they live in now and in the future.

Making sure everyone has the right home – safe, warm and affordable – is central to this Government’s drive to make this country fairer and more prosperous. As people get older their circumstances may change and they may have to consider if their home still meets their needs and can enable them to continue to live independently. Deciding whether or not their current home is the right home is not easy and it helps to have as much information as possible. Currently the majority of older people own their own homes and many live in social housing with small but increasing numbers privately renting.  

Equally important is ensuring people have the right support to enable them live independently at home and, in most cases, at costs lower than the alternative residential care options. Local authorities and housing associations have a long tradition of providing low level, preventative support services such as housing support, telecare, handyperson services, Care and Repair and community support. Technology, including telecare services, can provide significant benefits for older people and carers to help support and maintain independence and wellbeing. Technology can help provide care but can also provide additional benefits, e.g. reducing isolation and loneliness. With a growing number of older people the provision of support services is currently being considered as part of the reform of adult social care. Staff training and raising awareness are key elements to ensuring that older people are receiving the right support for their specific needs.

While the Scottish Government embeds gender equality across policy in housing, as people age there continues to be more older women than men due to longer life expectancy.

The implementation of the Age, Home and Community strategy is overseen by a Monitoring and Advisory Group whose members are drawn from a variety of stakeholders.

OLDER WOMEN AND HOUSING – STATS

  • Mid-Year 2017 Population Estimates ( National Records of Scotland (NRS) website) Data shows that overall, of the population in Scotland in 2017 51% were women and 49% men. However there were 182,495 men aged 75 and over but for women this figure was 265.476 which equates to 59% of this particular age group
  • Overall, women have longer life expectancy (in number of years) and are expected to live more years in poor health compared to men. This trends is confirmed across all age groups, but the difference diminishes for people above 85 years old. There is a strong link between the level of deprivation in an area and healthy life expectancy.
  • More than 90,000 people had dementia in Scotland in 2017. Women had higher chances of developing dementia than men for age groups above 85 years old
  • Women tend to out-live their partners and are more likely to live alone as they age. In 2016, older women were more likely to live alone compared to older men.  People living alone may have higher support needs.

Housing Tenure of older households

  • 76.8% of men in households with the highest income householder aged 75 and over years old owned their home, compared to 65.9% of women in similar households.
  • 18.7% of men in households with the highest income householder aged 75 and over years old lived in social housing, compared to 28.1% of women in similar households.

Older women and Screening

Within the National Screening Programmes there are a number of screening programmes which are aimed exclusively at women including Breast, Cervical and Pregnancy Screening.

Breast Screening, which is offered to women from the age of 50, can find breast cancers at an early stage, when they are too small to see or feel. If changes are found at an early stage, there is a good chance of a successful recovery. We are supporting an innovative breast cancer risk reduction trial (Actwell) which aims to reduce women’s risk of developing breast cancer by working with them to help make lasting changes focused around physical activity, diet and weight.

Cervical Screening is offered to women aged between 25 – 64 and is an effective method of reducing the incidence and mortality of cervical cancer. In 2017, we announced the introduction of HPV Primary Testing into the cervical screening programme. Implementation is underway and the new test is expected to be available within the programme by early 2020. HPV Primary testing is a more accurate method of identifying women at risk of cervical cancer and the technology allows for possible future developments, including self-sampling, to increase the likelihood of uptake of screening by hard-to-reach groups of women. We strongly encourage all eligible women to take-up their screening invite, and to continue to participate in screening as they get older. Regular smear tests are the best way to detect cells that could turn into cervical cancer.

Under our £100 million Cancer strategy we are investing up to £5m in our national screening programmes to reduce inequalities in access to screening. This includes supporting the work of charities like Jo’s Cervical Cancer Trust to increase awareness and address some of the barriers to participation. We have funded their innovative new outreach service targeting women less likely to attend, as well as their first ever Scottish roadshow. We are continuing to raise awareness via our hard-hitting cervical screening awareness ‘flower’ campaign across digital platforms.  In addition, the Detect Cancer Early programme has supported activity across breast, lung and bowel cancers, as well as the recently launched Survivor campaign that aims to highlight that more people are surviving cancer and early detection plays a big part.