Citizens Advice Powys - supporting mental health inpatients

Yasmin Bell is the Chief Officer at Citizens Advice Powys, the charity which “provides the advice people need for the problems they face and improves the policies and practices that affect people's lives.”

The charity recently launched a new pilot project to benefit the inpatients on the mental health Felindre Ward at Bronllys Hospital in South Powys. We spoke to Yasmin to find out more about this important work.

Tell us more about the project

Owen Griffkin, the Powys Patients’ Council facilitator, and the Occupational Therapy (OT) team on Felindre Ward, had been talking to us over the last year about setting up an inpatient advice service. We want to support patients with various issues which are acting as barriers for them wanting to return home and on their recovery process generally. We will continue supporting them once they are at home.

One of the OTs said that some patients, escorted to their homes on day release, had become more anxious upon arriving at a freezing cold home and finding a huge amount of mail / bills. It’s not a very welcoming scenario!

In the long term we would ideally provide support so that people don’t go on the ward in the first place.

How does the support work?

We did a similar project on Felindre Ward about 10 years ago and staff remembered how useful that was supporting people on their recovery journey. At that time a Citizens Advice advisor from Brecon went onto the ward to see people. With Covid we are using video appointments. The ward has iPads available and supports patients to access the platform and then we take it from there.

There’s quite a lot of work we do with the team before we meet the client – every individual can be different. Some people can be uncomfortable about speaking to someone about their issues. In that case the OT will work closely with us to find out what kind of help is available before going back to the person to give a flavour of the advice that could be provided. This usually results in the person then taking an appointment and with a better insight of what help can be provided.

Some of the original project outcomes included – less hospital staff time spent on advice issues, improved patient engagement with treatment, reduced barriers to patient discharge, clients feel more able to stay in their own home and in control of their lives, and improved mental health. The support enables independence, self-management and clients receiving all benefits they are entitled to.

Why was the work of Powys Patients’ Council invaluable in setting up this project?

Owen and the PPC volunteers had been speaking to people on the ward and through this helped identify the need for a direct advice service to support people.

We’ve had a lot of positive comments. One patient said: “I had an appointment with Citizens Advice today and they were excellent. They were able to help with my pet and some money issues.”

How is the project funded and for how long?

This pilot project is funded by a recent Powys Teaching Health Board Small Grants scheme. It lasts for 4 months so will end at the end of May. Through this pilot we will determine the level of demand and the feasibility of the service.

Tell us about some of the everyday issues facing people on the ward and how your service can help?

We identified that it was particularly important to help patients report their change of circumstances with regard to any benefits. Once discharged their benefits can be reinstated with our help. Citizens Advice Powys can also take responsibility for contacting any third parties and putting a hold on any action pending, for example, debt repayments, until that person is able to deal with them. It’s also important to inform the third party that Citizens Advice is helping the person.

We also make sure people are getting all the right benefits – we carry out an Income Maximisation Check – looking at the person’s whole situation. In many cases it can be quite complex – other benefits can be triggered or stopped. We act to make sure there is no detrimental impact on the person.

What is Attend Anywhere?

That is the video platform we use – it is used by the NHS across Wales for consultations with specialists. It’s similar to Zoom or Microsoft Teams but it’s almost like an office set up with a reception, and five interview rooms. It does mean people can have a family member or support person with them in the interview. Language interpreters, including British Sign Language interpreters, can also be included as part of the free service we provide.

Has Covid had an impact on people’s concerns / issues?

There has been a huge increase in people receiving Universal Credit which is a very complex benefit – so people do need support with this. Employment enquiries have also gone up. We are encountering people who have never had to claim benefits or ever had financial difficulties before – so people could become patients on a mental health ward because they’ve never had to deal with that level of poverty before.

Issues are much more complex than they were ten years ago. For example, with a debt client, the level might be the same but the client may owe debts to numerous different creditors where previously it would have been one or two. Then there is the added issue where creditors sell the debt on and on – and trying to unpick it all is a lot of work.

Covid has also added a level of frustration through not being able to get through to departments they need to speak to like the Department for Work & Pensions and energy providers. We can help speed up the process.

We also support people on three-way video or telephone calls with the Citizens Advice advisor doing all the necessary work whilst the client sits in the call. There is no cost to the person themselves for this support.

If people don’t receive the support they need, what could happen to them?

People who have been stressed previously can feel much more optimistic and calm about the situation. Long term if we receive continuation funding we would like to start looking at whether people go back into the hospital if they have received support. If issues have been going on too long it is harder to resolve them so we want to do more preventative work, help people understand what we do and just basically say – don’t be scared about getting in touch.

If we are supporting someone with a Personal Independence Payment (PIP) claim we have to talk about their physical and mental health. We also support people through tribunals and hearings. People open up and perhaps admit for the first time some of the issues facing them which can be very traumatic for them to accept.

What are Citizens Advice Powys’s main priorities outside Felindre Ward?

It’s about early intervention, about making sure our services are accessible and available to everybody in different ways and working out the different access options. We want to build a service where we don’t assume everyone wants face to face or telephone. So we offer video also, some web chat, and contact by email. We want to raise awareness and stop people getting to really complex situations – it’s about averting a crisis.

Which other Powys organisations do you work closely with to provide support to people?

This is happening more than ever before. We’re working with Accessibility Powys to facilitate appointments and advice sessions that are accessible to people with physical or sensory impairments – trying out different methods and equipment. There are a lot of people out there who, if not in receipt of this service, would not have had any advice. There are people who have been shielding and isolating who have not had any support for the past year or so.

In the last 3 months we have had a 20% increase in formal referrals (statutory and third sector agencies) and also seen a 50% increase from mental health teams. So we’ve done a lot of raising awareness sessions – every Wednesday we invite someone to come and talk to our team about the work they do which has been really beneficial – this means we can signpost to other services confidently too.

What are the main challenges of the project?

Client engagement is one of the biggest challenges generally if someone is struggling with their mental health. Sometimes people feel less anxious if they can turn their video off. So it can be small things that help. We try and think outside the box constantly to come up with a solution that works best for that person.

Some of the appointments can be lengthy so we split them into two sessions. If it’s a complicated PIP application you could spend up to 3 hours on that – so it’s managing the length of the appointment to suit the person.

Another challenge is ensuring we have all the right consent forms and paperwork completed. The OT team on the ward have been acting as our administrators in respect of these. It’s still a benefit to them though as they can then concentrate on the work they do best and leave the advice for us. It’s all about team work! So that’s a positive really!

Tell us about some of the most rewarding aspects of this project

The feedback from patients has been very rewarding: for example, one man said after receiving support he felt he was able to go home and contact the utility company and sort out the issue himself. (We would, of course, follow up afterwards to ensure it all worked out).

Knowing that people understand where they can seek help and are better able to manage.

One person was helped to reinstate a PIP claim and said of the advisor: “She was very kind, clear and helpful about my concerns. I found this extremely helpful over a subject I have been worrying about over the last years.”

When you are not working for Citizens Advice Powys how do you enjoy spending your time?

I do a lot of coastal path walking. My aim is to walk the whole coastal path of Wales. So far I’ve done a third of it.

I also volunteer as a Cadet Leader for Newtown Police Cadets and assist the cadets doing their Duke of Edinburgh Award. I recently completed my DoE expedition assessor qualification.

If you want to find out more about Powys Citizens Advice you can contact Yasmin by ringing 01686 617641 or email: manager@powyslca.org

What do people ask the Powys Mental Health Information Service?

Recently I was tasked with looking at our stats to identify some of the most common enquiries we receive at our Mental Health Information Service. I thought it would be interesting to share my findings with a wider audience. I’ll also provide some typical responses to the queries and who knows, there may actually be an answer to a question that a reader has wanted to ask for ages!

Enquiries come in to our service via telephone, email or in person – and from absolutely anybody with an interest in mental health in Powys. We also receive a lot of enquiries from people outside Powys surprisingly, but these usually relate to services available within Powys, and are made because Powys residents are currently living away from home, for whatever reason, but still have links with providers of the health services in Powys or family and friends here.

Sometimes we are asked a question which totally throws us – and then in our team we have to don our private eye deerstalker caps and do a little bit of investigative work. But those unusual and often intriguing topics are really probably the subject of another post!

So, without further ado, here are some of our most common enquiries:

I’m concerned about the mental health of a close family member. What should I do?

Whether a mother, sister, son or nephew – or any other relative for that matter – spotting that a close family member is struggling can be upsetting and hard. What can you do to help? The person concerned may not be ready to accept help. They may have received support in the past, recovered and now relapsed. They may already have put mechanisms in place to help themselves, or they may be really struggling and crying out for help in all kinds of ways.

One thing is sure. Families are all different and relationships within any of them can be complex. No two enquiries about families will ever be the same, but there are many common themes:

• How do we get help from statutory health services (the NHS)? The first port of call is the GP. After that – there are various options which are outlined on Getting help & support in Powys.
• Where can my relative go to meet people going through similar experiences? There are mental health orientated voluntary groups all around Powys running all kinds of activities and training sessions – find the one nearest to you. They welcome new members.
• I really want to help, but I’m exhausted myself. Family members who provide an informal caring role can find support in Powys at Credu Connecting Carers.

Where can I find counselling in Powys?

That there are long waiting lists for talking therapies in all parts of Wales is generally well known, but people still need to talk and will go to great lengths to investigate all the options. One of our guest authors wrote Finally receiving treatment – a personal view which documents one journey. We were being asked so often about alternative options that we decided to set up a webpage dedicated just to this – How to find talking therapy or counselling in Powys. Here you can find links to the charities locally offering counselling, plus an extensive list of counselling directories – everything from the Buddhists’ Therapy Database to the Hynotherapy Directory.

I think I need a mental health advocate – what do they do and how do I find one?

If an individual in contact with mental health services feels they’re receiving the wrong treatment, or wants someone to support them at a meeting or tribunal, for example, then they may be eligible for free support from an independent mental health advocate.

Advocacy is all about taking action to help people say what they want, secure their rights and obtain the services that they need. Mental health advocacy in Powys is available to:

• Those residents who are currently inpatients on a mental health hospital ward. That could be within Powys (Felindre Ward at Bronllys Hospital) or in another county (for example, North Powys residents may be at the Redwoods Centre in Shrewsbury in England). This service is provided by Conwy & Denbighshire Mental Health Advocacy Service. Don’t be put off by their service name – CADMHAS do cover Powys!
• People in contact with what are known as “secondary” mental health services, so they live in their community but receive support from, for example, a community psychiatric nurse or psychiatrist. There are advocates in the North and South of the county provided by the Powys Independent Mental Health Advocacy Service who can support them.

I’m moving to Powys soon and need mental health support (or my family member does)

Moving is one of the most stressful things we do, so combine that with pre-existing mental distress and understandably people are keen to find out what they can do to make the move easier.

• If someone is already receiving support from a Community Mental Health Team in another part of the United Kingdom, then it’s a really good idea to liaise with that team well before the move takes place. That way the old CMHT can link up with the new team and the transfer will work so much more seamlessly.
• Otherwise, the route for a newcomer to Powys into mental health services is pretty much the same as it would be for anyone already resident in the county – a visit to the GP will be top of the list. However, there is an exception to this – which is available for people moving to Powys from another part of Wales. The mental health law in Wales (Mental Health (Wales) Measure) states that if people have been discharged by secondary mental health services during the past three years then they can go straight back to the mental health service which was looking after them before and ask them to check whether they need any further help or treatment. 

Can you tell me the contact details for the Powys Community Mental Health Team

And to round off this post, one of our all-time top asks! How do you find your local CMHT? Especially when there are five different teams covering this enormous county which is Powys, not just one?

If you didn’t already know, the five teams are based in Welshpool, Newtown, Llandrindod Wells, Brecon and Ystradgynlais.

And the best way to find each CMHT’s contact details is by checking out our webpage Getting help and support in Powys.

And that's the end of this round up of some of our top questions! If you have a question for our Information Service which isn't answered in this blog post, then please get in touch by ringing 01686 628300 or 01597 822191 or email: mailto:mentalhealth@pavo.org.uk 

PS: We have our deerstalker caps at the ready!

Our Alternative Christmas

For the last few years our December team meeting has morphed into a pre-Christmas mini-binge – turkey and nut roast sandwiches, warmed mince pies, mulled grape juice…. And Havin’ a Laugh.

This year – in the spirit of recognising that Christmas isn’t always an easy time for some of us – we decided to try something completely different.

We thought about surfing at Borth… climbing to the source of the Severn… exploring the sculpture park at Lake Vyrnwy… or kayaking the rapids of the River Wye… In the end we went to Rock Park in Llandrindod Wells (home to a former spa centre established in the Victorian era) and spent 2 hours litter picking and leaf collecting. It was wet. A bit muddy. But also exhilarating. We laughed a lot. We learnt stuff. It was genuinely team building. And the best December team meeting ever.

Amongst other things, we discovered that the leaves of the park’s ginkgo tree contain ginkgolides, which could improve blood circulation to the brain …. And that a lithium well was discovered at Rock Park in 1906 by Mr Heighway… (it's housed in the shed in the photograph).

Afterwards over lunch we exchanged more ideas about how to go about creating the Christmas Festival Fringe at home on the Big Day itself…

Anne: wishing for a festival of light!

For me, Christmas is a trigger for feelings of anxiety, which starts several weeks before with worrying about buying presents that people will like. As a result, I tend to put it off, leaving it to the last minute, which then creates more stress. It’s hard not to get caught up in the commercialisation and put pressure on myself, which doesn’t come from family and friends. So I suppose my fantasy Christmas would have less emphasis on giving and receiving material gifts. Or I’d employ a personal shopper!

I’ve often considered creating spiritual rituals that are meaningful to me at this time of year. My fantasy Christmas might include being outside in nature (weather permitting!), making the most of the light in the day and a bonfire in the evening. One year, I went to Stonehenge at dawn on the Winter Solstice, and then to Avebury Stone Circle, as it felt important to mark the shortest day. I like the idea of a festival of light to counteract the long, dark, winter evenings; something that has a big impact on my mood at this time of year. If money was no object then I would go away somewhere warm and sunny in the winter to top up on vitamin D until the days start getting longer again.

Carla’s No Cooking Christmas!

In our family, we did away with slaving over a hot stove for days on end and have exchanged turkey and trimmings for deli platters and paper plates. Essentially, this means that shopping for Christmas food doesn’t involve battling crowds in the supermarket but does involve spending a leisurely afternoon browsing small independent shops or jamming a queue at a deli counter somewhere. The kids and I pick salamis and cold meats, sample different cheeses before buying, choose which items to splash out on for the special ‘treat’ items (stuffed baby peppers are my favourite) and only have to pop to a big store to buy the fancy paper plates and crackers. I set a budget before we go shopping and when it’s gone - it’s gone.

On Christmas day, everything is put out on the table on throw-away foil platters from the pound aisle, the oven goes on to heat the ‘bake at home’ bread and paper plates are handed out to whoever the guests are - this can change at any point throughout the day as people drift by to say Happy Christmas and have a drink or two!

We eat, we snooze, we drink, we eat again and then all plates are put in the bin, leftovers stuck in the fridge and the next day we can get back to ‘normal’ - or just do it all over again with new plates! No stress, no fuss, no waste, no turkey sandwiches/curry/soup and buying the food can suit even the tiniest of budgets. One year, I bought everything we wanted from our local supermarket on Christmas Eve and it came to about £20.

Christmas doesn’t have to be a chore nor does it have to be the same every year - this year our family are NOT ‘magicing’ our Christmas tree and may have to resort to more conventional methods - but that’s another blog post . . .

Jackie: Digging Christmas!

Ever since moving to our house in the Upper Severn Valley 20 years ago I have been a bit of a mad keen gardener… and tradition now has it that every Christmas Day involves gardening in some form or other. Depending on the weather this could be chipping parsnips out of frozen compost in a style not dissimilar to that used on an archaeological dig… rescuing a willow bean tripod from the top of an ash tree in a gale… or scraping snow off the polytunnel before the metal hoops crumple under the weight….

But the highlight of all Christmas Gardening Days past was the one where I found an old Victorian sixpence dated 1875 in the ground whilst digging out self-seeded holly trees. I would have rushed off to order a metal detector there and then (well in the Boxing Day sales anyway) except the ground all around was found to be full not of treasure but buried refuse – not exactly the Staffordshire Hoard – rather the site of some 1950s fly-tipping…half-bricks galore.

Christmas in our house is a time for planning the gardening season ahead. Full of hope. Anticipation. And some concerns… Will the heritage seed beetroots finally plump up…? The spring frosts stay at bay…? The million hungry rodents be herded up and dispatched by resident cats …? The recycled tin baths moisture retentive and slug-proof for carrots to thrive…? The elusive horse manure finally appear magically at the end of our drive…?

Whatever 2017 brings in the world outside my valley… I can’t wait to get my hands dirty again in the confines of my garden oasis. (If you fancy gardening and don’t have a patch of your own, there are community gardens all around Powys).

Jane: Fantasy Christmas meets Reality!

My fantasy Christmas would be one where I had actually got my act together and was well prepared! Each year I stubbornly refuse to even think about Christmas until December - and then I am surprised by how quickly it seems to arrive! We would book an enormous house so that all the extended family could come, everyone would get on well, there would be harmonious sharing of chores and all the various traditions would miraculously work together so that everyone felt that they had had a part in such a wonderful shared time - so that should show what a general fantasist I am!

I’ve never done anything that out of the ordinary at Christmas myself - last year I was proud of my daughter and husband who took a car-load of donations to the refugee camp in Calais and volunteered there for a few days in between Christmas and New Year.

On balance I think that having a time of coming together and sharing food, gifts and conviviality at the darkest point of the year is a good thing - and if you are a Christian then it’s a good thing to celebrate the birth of Christ too. There isn’t any easy way to balance that with the fact that for a lot of people it is also a very difficult time - I am inclined to think that the gross (to my mind) level of consumerism, the overcomplicating of it all and the relentless emphasis on the fun, party side of Christmas with no mainstream, non-religious acknowledgement of the importance of reflection and quiet thought as a component of the rest of the festive season adds to the sense of isolation and loneliness that some people feel at Christmas.

And finally...

These ideas and approaches may or may not work for you. But perhaps they could kickstart a different way of thinking about the traditional Christmas. And if you opt for the alternative approach, we would love to hear from you in the comments box below.

Most important of all, do something that makes you happy. And if you need extra help over the festive season – it’s out there. Wellness and Recovery Learning Centres around Powys are open at some point over Christmas and the New Year and would welcome your visit. Check their opening times on websites, details here. You can link to national helplines here.

If you need help urgently find information here.

Happy Christmas, whether Traditional or Alternative suits you best. And see you in 2017.

Photos feature Newtown's Christmas-themed town centre in December 2016

Havin' a Comedy Christmas 2015

"Tis the season to be jolly....." 

Yes, it's that time of year again. It's unbelievable how quickly it turns up each December.  In 2014 we posted Top 10 Tips to Survive Christmas, as we recognise that the festive season is not everyone's favourite period.

For Christmas 2015 our team have been inspired by local comedian Owen Griffkin's new comedy workshops to think how laughter has kept us going over Christmases past.

Each of the team has come up with a book, or film, or memory that has made them laugh in Christmases gone by whilst wondering whether to embrace the holly (ouch) and mince pies with family, friends or even complete strangers, or just run and hide.

"Fa la la la la, la la la la...."

Angharad

Many things remind me of Christmas and the laughs I’ve had, such as watching classic 1990 Christmas film ‘Home Alone’ with Macaulay Culkin. But the highlight of any recent Christmas was watching my dog, Bella (a fluffy white bichon frise) open my mum’s Christmas presents for her. As the centre of our little family, she is without a doubt put on the highest pedestal, treated like a human and the focus of me and my mum’s lives. I’ve had the blessing of owning Bella since my last year in primary school, which makes Bella around 14 years old (an old lady!) yet she still has the personality of a puppy and hasn’t lost any of her diva like qualities yet. She is spoiled, and rightly so!

Last Christmas, the buzz and excitement of smelling her Christmas dinner and her presents under the tree were too much to bear, and she began like a puppy, tearing the corners of the wrapping paper off. We normally get her to help open a small section of our presents, but last year, she came into her own! Without any warning she took centre stage and started unwrapping presents in the middle of the living room, swinging the paper around with her mouth as best she could, determined to find out what was inside! After some playful growling, swinging wrapping paper and presents and holding them down with her paws, she had unbelievably managed to open two well wrapped presents! This memory always makes me laugh at how loving and funny animals can be, who enjoy Christmas as much as anyone else! It also made me and my mum hysterically laugh, along with us clapping and cheering her along!

‘Animals are such agreeable friends - they ask no questions; they pass no criticisms.’ George Eliot

Anne

When Jackie suggested this topic for a blog, my heart sank slightly. Call me Scrooge but Christmas isn’t one of my favourite times of year. 

But then I remembered my favourite scene from "The Wrong Trousers", an Aardman Animations film starring Wallace & Gromit that was first shown on Boxing Day in 1993, and will be forever associated with Christmas for me. It’s the train set chase scene where Gromit is attempting to stop criminal penguin Feathers McGraw escaping after a diamond heist. When Gromit grabs the box marked spare track and frenetically starts to lay track to keep the toy train on the rails, I was in hysterics. It’s well worth watching the clip on YouTube. I defy anyone not to smile whilst watching it.

Jackie

Way, way back in 1982 I ripped open a Christmas present whilst on holiday in Dorset. It was a copy of the now legendary Adrian Mole book by Sue Townsend - “The Secret Diary of Adrian Mole aged 13 ¾”. I started reading, was hooked after two pages, and didn’t stop until I’d finished a few hours later. The Christmas pudding was long since cold, the mince pies just crumbs swimming in spilled alcohol, and my elbows had turned black and blue from lying still for so long. It was the funniest book I’d read in ages by a classic writer of comedy fiction. Who hasn’t heard of Adrian Mole?

Sue Townsend went on to write a total of 8 books about Adrian Mole, taking him from angst-ridden teenager in the Thatcherite years of the 1980s to the brink of middle age in the The Prostrate Years and Gordon Brown’s New Labour era of the late noughties. I haven’t read the later volumes - so there is more laughter to look forward to yet.

Here are a few of my favourite quotes from the original classic:

“I must say that I take my hat off to Sainsbury's, they seem to attract a better class of person. I saw a vicar choosing toilet paper; he chose a four-roll pack of purple three-ply. He must have money to burn! He could have bought some shiny white and given the difference to the poor. What a hypocrite!”

“It is the first day of spring. The council have chopped all the elms down in Elm Tree Avenue.” 

“I have never seen a dead body or a female nipple. This is what comes from living in a cul-de-sac.”

Jane

Some years ago my mother came for Christmas. She was (she died this year) a very difficult person and there was always a fair amount of tension with her around. During Christmas Eve she snapped at one of my teenage children for not doing, in her eyes, sufficient washing up. A general shouting match ensued with my mother shouting at said child and ripping up the Christmas present she was going to give to this offspring - who obviously shouted back that no-one had wanted Granny to come anyway and me shouting at my mother in defence of my children. 

Meanwhile my husband was at his work’s Christmas booze-up - which was legendary. My daughter rang the most likely pub, found him and summoned him back. Eventually he wove his way home and into this maelstrom, lay on the floor and declared “I love you all!”. I can’t actually remember what happened next - but I found a mention of this in some notes after my mother moved out of her house into a nursing home - she had written “Christmas with Jane and children, least said”. For us this is now a traditional family Christmas story, and I guess it goes to show that Christmas can be difficult and tense and also, at least in retrospective, hilarious too.

Support over Christmas

Wellness and Recovery Learning Centres around Powys are open at some point over Christmas and the New Year and would welcome your visit. Click here to find their contact details and links to their own websites.You can link to national helplines here.

If you need help urgently find information here.

Have a Happy Comedy Christmas and we look forward to hearing from you in 2016!

Oh, and there's a dog...

Sandra Ward, Information and Advice Manager for Age Cymru Powys, talks to us about older people in rural communities and her vision for help and support that could make a real difference.

Tell us about your day job

I have been an adviser for 30 years – that makes me feel very old.

It really is a strange way of earning one’s living, but it can be both rewarding and interesting. I never know what the day will bring – it can range from the sublime to the downright heartbreaking. From advising how to deal with a bee swarm lodged in a chimney, to supporting a lady of 92 coping with losing her lifelong partner and for the first time having to deal with banks, benefits and all the paperwork which follows a death.

I know we all suffer the distress of easing information from, and giving help to, those who are in a ‘bad’ place. But in the midst of these problems are lighter moments. One of my longest days was when I was with the Citizens Advice Bureau. I was helping a young family who were homeless. It was a Friday, especially relevant because one is aware that the problem has to be solved that day – nothing will be open over the weekend. Panic time then! I had spent most of the day finding this young couple somewhere to stay, and this was before the 3 young children came out of school. But at 4pm I was triumphantly standing at the door of the Advice Centre ready to speed them on their way to a booked and funded bed and breakfast. The young father suddenly turned and said; “Oh, and there’s the dog!” (An Alsatian, of course!) I often mutter to myself in times of stress - when I need a giggle - ‘and there’s the dog’!

Powys is a rural county, what does this mean for older people?

As Manager of Age Cymru Powys (formerly Age Concern) I see a great many people with problems which are aggravated by the fact that they live in a rural location. For my clients the additional rural problems are the following: difficulties in accessing help and advice; support services are either stretched by distance or non existent; lack of transport – whether that is limited public transport or simply that due to age and/or disability they have lost the use of their own transport. This of course, affects access to health services especially in Mid Wales where we are often sent to Telford for hospital appointments. All these limitations can cause acute loneliness – something the majority of the people I speak to suffer from. My job in Powys is almost completely different to that of an Information and Advice worker in an urban area where supporting services are near at hand.

Powys (my patch) is the 9th most rural county in the whole of the United Kingdom and the least most populated in Wales. The average population in Wales is 147 people per square kilometre, in Powys it is 26. Also we are ¼ of the area of Wales, so some of my outreach service advisers can travel for 1½ hours just to get to their destination. So you see I really do know about rural poverty.

Is there anything causing real concern to older people in Powys at the moment?

At present we are finding that the Government Welfare Reforms are causing us a great deal of work. Don’t get me wrong, I agree that a fit and able person of working age should be employed. It is only when knowing that one is valued and worthwhile that you gain self respect and self esteem. However, if you are 50+ and have health problems – maybe a stroke or an accident at work; you are actually less likely to be able to work. Possibly the job you trained for and have always done is now physically beyond you, so your whole life has to change. This is fine if you are fit, alert and mentally able to cope with complete change, but if you are depressed and unwell to suddenly find yourself in a minefield of forms and interviews it becomes impossible to find the impetus to navigate onwards. My colleagues and I help them do this and it can be both difficult and very, very sad. People are angry because they can’t work at their chosen trade, depressed because their life has changed for the worse and very frustrated that the Welfare State, far from helping them, seems intent only on making them slot into a ‘fit for work’ category.

I had a client, a gentleman of 64 who had previously worked on the land; he had had a stroke and was quite disabled. However, he was found by the Employment and Support Allowance Team to be fit to do office work. This chap was unable to use one side of his body and was incontinent. I explained the ruling and possible options for him. He sat quietly in my office, then said; “I would rather be dead than sit in an office smelling of urine.” This man had worked constantly for 35 years and had never expected to rely on state benefits. Not the type of unemployed scrounger that some of the politicians and the popular media portray. I am on a few national committees, not because I have the time but because people like that man are unable to verbalise their frustrations – but I try to make their feelings known and understood.

What other challenges do you face in Powys?

The challenges of communication both in reaching those who are vulnerable and for older people to participate in social activities are vast. Public transport is very limited, many of the bus routes are weekly services or limited to one or two buses a day – a large number of villages are not visited at all. We have recently lost even more of these routes. Over ½ Powys households are classified as being in area 8, ranked the worst 10% in Wales for access to services on foot or by bus.

Interestingly we also find that language causes a barrier. We run a bi-lingual service but find that the majority of our work on the Welsh border is requested in English. As we ‘go west’ across the county it becomes more predominately Welsh. Because my main office is in Newtown some people consider our service ‘English’ and hesitate as to whether they would find help there. In fact some of my ‘main language Welsh’ clients are additionally vulnerable because they have scant knowledge of the help they could access.

I have over the last 5 years piloted and run an elder abuse project for Powys County Council. I chose primarily to visit Lunch Clubs because these are the older people who are just coping but needing some support and therefore beginning to be at risk. It involves a positive and upbeat talk; firstly about older people’s rights – such things as ‘You have a right to be wrong!’ So many elderly people keep silent, terrified that if they make a mistake they will be ‘put in a home’. We fight to give them control over their lives, without making the judgement of ‘what is best for them’. We then go on to discuss scams and abuse, in an open and safe environment. Sadly 60% of the 300 people I spoke to had been a victim of scams or abuse. If people are living in isolated rural areas they are far more likely to be at risk of unreported abuse. There is a desperate need for our advice service to reach these isolated and vulnerable people.

How would you like to be able to help older people in Powys more?

I started thinking about the problem from the bottom up, so to speak! I am involved in rural church life and have been for my whole life. As a child our church was the hub of our rural community and many problems were supported therein. Now I believe this supporting network has changed – the age range in our communities is unbalanced. Despite all our best efforts to attract the young, many of our congregations are made up of older people. A few of the more successful churches use their buildings completely and offer crèches, welfare advice and community projects like cafes.

I had this in mind when I thought about my new project. As advice workers we need to be out there helping the lonely and vulnerable but I cannot sanction the expense for my advisers travelling 80 miles for a home visit, even if it is essential. So I thought that if I had a volunteer in each community and a paid adviser in a main office, whether it be Newtown, Llandod or Brecon then the volunteer could listen to the problem and phone for advice. The Bishop of Bangor informed me that the Church in Wales is keen for their buildings to be fully utilised - so churches, and maybe chapels, community centres and schools could be used at set times every week. My plan is that this would form a network of people to be a core community and therefore support their population who were at risk or in need. I’m just at the stage of trying to get funding for this but hopefully it could plug a little hole in the dyke!

What I see at present is that many people living in rural areas are being subjected to increasing stress and anguish as a direct result of decisions made in Westminster and elsewhere. It is necessary that we speak out – without prejudice – to inform those whose upbringing and life style leave them ignorant of the challenges of rural Wales. Reaching those who need help remains my priority and frustrating though it often is, I feel very privileged and honoured to be in a position to attempt this.

If you would like to discuss this idea with Sandra or offer her some support, you can get in touch with her on 01686 623707 or sandra@acpowys.org.uk or leave a comment below.