CAFÉ Older women’s

thoughts about, and use of,

food support servicesTransforming Care Copenhagen, 26-28th June 2008Drs Lee Hooper & Kathleen Lane, University of East Anglia

CAFÉ – changes around food experience Policy and focus Methodology Participants Patterns of service use Urban/rural differences Changes in use over time What do women value? How did women find services? What services were missing?

CAFÉ – changes around food experience

Policy focus – 40 years of promoting care at home in UK

Study of women aged 65+ living at home but who do not cook from scratch (basic ingredients) most days

We intended to look at care, help, support needed, but women voted with their feet

didn’t feel they needed care - wanted to discuss services and support

Vulnerable women’s perspective

CAFÉ methodology a qualitative study in Norfolk, England, with

women aged 65 years and older (mean 82) exploring:

the meanings of foodhow these meanings alter over time feelings around cooking lesspotential for intervening to restore greater

contact with foodservice and service needs

qualitative data: semi-structured interviews; meal observations;

small group interviews

CAFÉ participants Purposive sample:

20 individuals/20 in focus groups20 lunch group/20 no lunch group31 urban/9 rural including lower socioeconomic groups (30

non-professional occupation, 27 council or housing association home)

34 living alone (not all had children, many living a great distance away)

19 in sheltered /residential accommodation17 rely on others for shopping

CAFE- Patterns of service use

Jayne (rural)

Sunday pub meal with friend

Ready made meal, 3-4/week

Wiltshire Farm Foods

Weight Watchers or

M&S

Visits sons for lunch (2-3x/year)

Chinese take-away meal,

1/monthLunch club,

1/month

Blue – informal

Red – state

Green – market

Purple - voluntary

Thanks to Susan Baines - categories

CAFE- Patterns of service use

Jayne (rural)

Sunday pub meal with friend

Ready made meal, 3-4/week

Wiltshire Farm Foods

Weight Watchers or

M&S

Visits sons for lunch (2-3x/year)

Cooks from scratch, 2/week

for self

Chinese take-away meal,

1/monthLunch club,

1/month

Blue – informal

Red – state

Green – market

Purple - voluntary

Tesco’s free shopping

bus (not used)

Cooks for daughter,

widowed friend

CAFÉ– services issues Older women juggle a large number of different

services From the state, voluntary, private and informal

(relatives, friends, neighbours) sectors They are organised and in control of these

services and feel in control of their food provision, NOT in need of care

They also provide many services to friends, relatives and neighbours

Women in rural areas have fewer service choices and transport in particular is more difficult

CAFÉ– choosing a service Margaret: “I enquired after the sort of door-

to-door thing, but I didn’t take it any further because it seemed, I didn’t get the feeling they really loved their job”

Abigail: [Wiltshire Farm Foods] “I used to, but I don’t, not now…I got a bit fed up with them…same-ish. But I usually get some microwave meals from Tesco’s”

Helen: [meals on wheels] “one of the reasons eventually why I gave up. Because they came out here at five past eleven and I didn’t want my lunch at five past eleven”

CAFE – what services exist – around food shopping?

State – lunch club transport, scooters, carers

Market – busses, taxis, supermarket busses, shops deliver, supermarket wheelchairs, doorstep milk delivery

Informal – neighbour, relative, friend Voluntary – community transport systems Issues

Portions Help - reaching shelves, wheelchair,

sitting down

CAFE – what services exist – around food shopping?

Those who miss out: Ella: “transport’s getting a bit dodgy” and “I look

forward to going and sometimes they’re very, very late in coming and are they coming? And you’re sitting there with your coat on all ready to go…”

Helen: “I can’t [go to the shop].. I’m wheelchair bound you see. I’ve got no-one to push my wheelchair regularly…”

Honey: “I just don’t feel like going down there [to the bank]. If I had the scooter I’d be there and back, …but I can’t park it here, so I can’t use it.”

CAFE – what services exist – around cooking & preparation?

State – carers help with cooking, washing up, opening tins, adapted equipment

Market – microwave oven, higher oven, lower shelves, new fridge or freezer, stools, walkers

Informal – daughter helping with formal meal Voluntary – accompanying with cooking and

preparation Issues

Kitchen adaptation is expensiveSheltered accommodation kitchens often very

small, poor storage facilities

CAFE – what services exist – around cooking & preparation?

Support levelsMeals on wheels or lunch clubDelivered ready meal (company, family)Ready meal (frozen or tinned) bought

locallyReady main dish plus fresh or frozen vegSeveral frozen components Fresh foods plus cook-in sauces Cooked from scratch with support Cooked from scratch on own

CAFE – what services exist – eating? Lunch clubs and day centres Pubs, cafes, restaurants Eating with friends, neighbours,

relatives

CAFE – what do women value? Women valued (almost universally):

Lunch clubs and day centresTransport services

Mixed reactions to:Ready mealsShopping by carers, neighbours,

familyMeals on wheels

CAFE – how to find services Deena: “if I see something, I … scribble down the

telephone number… then ring them up “ Helen: “the adverts often being better than the

programmes…I take note the things I seen on there…Home Farm, I had a leaflet through the door, that was why I thought I’d try them. The County Council one was advertised in the newspaper…often the nurses are quite helpful with things”

Jemima (blind): “several of them… had Meals on Wheels – and they said to me, ‘Why don’t you have Meals on Wheels, Jemima? You’ll get a good meal.’ So that’s when I changed”

CAFE – how to find services Women vary in how they collect service

information Several women Kathleen met did not know

about important services, such as delivered ready meals or transport systems

As women are actively managing their services they need a comprehensive, reliable information source

CAFE – what is needed? Information centre

to gather and give out information on services from ALL sectors – ideally run by older people and which can feed back into the services and mould them

Importance of women shopping in personWomen need and want to see what is on

offer, get out of the house, choose their own apples

Services for rural women are crucial

Contact detailsDr Kathleen Lane (kathleen.lane@uea.ac.uk)Centre for Applied Research in EducationandDr Lee Hooper (l.hooper@uea.ac.uk)School of Medicine, Health Policy and PracticeUniversity of East AngliaNorwich NR4 7TJwww.cafeproject.co.uk