We need to talk about caring: dealing with difficult conversations

This report summarises research looking at how and why families avoid talking about challenges they may face in older age. It draws on an online poll of 2,066 people conducted by ComRes and a series of focus groups and interviews.

Findings

• The topics people find most difficult to discuss are:

  - My preferences for end of life care
  - Who will care for me when I am older
  - Where I’d like to live if I could no longer live at home
   

• While nearly four out of five people judge each of these conversation to be important, less than a quarter have actually had them with family members.
   
• There are around 7 million people aged 65 and over who have never had a conversation with family about these key topics.
   
• There are more than 3 million people over 65 could be categorised as ‘delayers’ – they are planning to have this conversation but haven’t done so yet.
   
• And there are more than 3 million people over 65 could be categorised as ‘deniers’ – they have not had these conversations with family and do not intend to.

Recommendations

• Addressing the information problem

  Key agencies, from information providers, to local authorities, to the NHS, must make their care information more accessible, so that people have the tools to navigate a complex care system.
   

• Addressing unwillingness to consider residential care

  - There should be an anonymous survey of staff working in care homes, asking them to identify the extent to which they have witnessed neglect or abuse.
  - Care homes needs to increase their outreach to show more people what living in a care home is like.
   

• Addressing the denial problem

  - We would like to see more health and care professionals consciously encouraging families they work with to think about key conversations relating to ageing and care.
  - We need to make conversations about care in later life more natural and normal. We want to see conversations about ageing, dementia and care included in Personal social health and economic education (PSHE).