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1561-Bromley OPH:6521-Cornwall 7/8/14 10:19

This handbook has been put together by local healthcareprofessionals. We want to celebrate age, provide answers abouthealth, ageing, services available locally and we want you to knowabout them too. We want to ensure that there are opportunities for usall to age well and experience a more positive and healthier older age.

The population of Bromley is growing older and it is increasinglyimportant for older people to take an active role in looking after theirhealth and well-being. Give yourself a head-start by protecting yourselfmentally and physically, by learning to recognise the possible signs ofillness and by having regular health checks and screening tests.

This handbook does not have all the answers but it can help point youin the right direction. It cannot replace specialist care, so you need toseek medical advice if you are worried. We hope this information willhelp you to choose the best services for you and your needs.

ContentsWelcomeA guide to services 4

Integrated care 6

Aches & pains 8

Cancer 10

Dementia 14

Healthy heart 16

Incontinence 18

Keeping mobile 20

Keeping well in winter 22

Lifestyle & well-being 24

Long-term conditions 26

Mental health & well-being 28

Support for carers 30

Trips and falls 32

Help with daily living 34

End of life care 36

Loss and bereavement 38

Your entitlements 40

Loneliness and socialising 42

Keeping yourself safe 44

Safety at home 46

What to do in an emergency 48

Useful contacts 50

3

1561-Bromley OPH:6521-Cornwall 7/8/14 10:19 Page 3

5

Occupational TherapistAn Occupational Therapist looksat problem areas that patientsmay have in their everyday lives,such as dressing or getting tothe shops, and will help them towork out practical solutions.

PhysiotherapistPhysiotherapy aims to restoremovement and normal bodyfunction in cases of illness, injuryand disability. Physiotherapistshelp and treat people of all ageswith physical problems causedby illness, accident or ageing.

Aids and Adaptations

Social CareBromley Social Services advisesand/or supports people withsocial care needs. For informationvisit www.bromley.gov.ukor call 020 8461 7777.

DentistA Dentist will treat and preventdental and oral health problems,such as tooth decay and gumdisease. They can also offeradvice and tips on how to carefor your mouth and teeth andcan help with dentures. For out-of-hours Dentists call NHS 111.

PodiatristsPodiatrists (also known asChiropodists) treat a widevariety of conditions of the footand lower leg. They play animportant role in helping olderpeople stay mobile andindependent.

Accident & EmergencyFor immediate, life-threateningemergencies, please call 999.A&E and 999 are emergencyservices that should only beused when you are badly injuredor show symptoms of criticalillness such as choking, chestpain, blacking out, or blood loss.

Urgent Care CentresIf you have an urgent andsevere but non life threateningillness or injury then attendyour local Urgent Care Centre.They have access to x-ray andother services to treat urgentconditions that are not criticalsuch as a wound, cut, burn,sprain or suspected break.

NHS ChoicesNHS Choices is a good startingpoint for information aboutwhat services are available inyour area. Visit www.nhs.uk

Older people and their carerscan access equipment to helpyou live at home safely.Equipment ranges from thingslike a simple handrail, or rampto a wheelchair or stairlift.Call 020 8461 7777

4

GPYou will need to register with aGP - to find a GP in your area,use the NHS Choices FindServices System on:www.nhs.uk/Service-SearchYour GP can advise, givemedicines and information onother services. You will need tomake an appointment butmost GPs will see an olderperson quite quickly if you areworried. After 6.30pmweekdays, at weekends andpublic holidays most servicesare covered by a GP out-of-hours service call NHS 111.

PharmacistYour local Pharmacistscan provide advice onmost common healthissues and review yourmedications. They cansuggest and dispensemedicine and otherhealth products. Thereare often Pharmacistsin supermarkets andmany are open late.Visit www.nhs.uk tofind the Pharmacistnearest to you.

NHS 111 is the service which makes it easier foryou to access local health services. Calls are freefrom landlines and mobile phones. If you needurgent healthcare, you should call NHS 111before you go to any other service. By callingNHS 111 you will be directed straightaway to thelocal service that can help you best. It isavailable 24 hours a day, 365 days a year.When should I call NHS 111?• When you need help fast but it is not life

threatening.• When you are unsure if you need to go to A&E

or another NHS urgent care service.• When it’s outside of GP surgery hours.• When you are visiting the area.• When you do not know who to call for

medical help.

A guide to services

NHS 111

Here in Bromley we have a wide range of healthcare services. See which service or professional is best to help you.


What does it mean?

76

Integrating care in Bromley Bromley Healthcare offers integratedcommunity teams including DistrictNurses, dedicated CommunityMatrons, Physiotherapists, andOccupational Therapists, who all workclosely with you and your GP. Enhanced end of life care through theBromley Care PartnershipCoordination Centre, delivered bySt Christopher’s Group - providessensitive, practical and emotionalsupport to patients, families and carersand helps people die with dignity andin a place of their choice.Working closely with the LondonBorough of Bromley to offer moreintegrated health and care services,including community champions andbetter access to social care.

Integrated carePeople tell us that, where possible, they prefer to receivecare at - or closer to - home, with support to live asindependently as possible. Integrated care starts from theneeds of the whole person. It is about:• Prevention of poor health by enabling people to look

after their own health whether through self-care or expertpatient programmes.

• Empowering people to make choices, together withhealth and care professionals, when they need care ortreatment (‘co-production’).

• Intervening early before health problems deteriorate.• Maintaining independence.• Providing more care at, or closer to home.

NHS Bromley Clinical Commissioning Group isbringing together an inclusive partnership across primary,community acute and mental health services, localauthority social care, and the local third sector, with a jointcommitment to improve the health and independence oflocal people and bring about a fundamental change in theway we provide care across the borough.

Help managing your medicinesPeople may sometimes need support to make sure the medicines theyhave been taking are still the correct ones, especially when they have beentaking them for some time. If this is something you are interested in, speakto your local Bromley Pharmacist about a review. Local Pharmacists cananswer all sorts of questions about dosage, how and when to take yourmedicines and any possible side effects. Medicines management can alsoform part of a personalised self-management plan which you would agreewith your GP.The Medicines Assessment and Support Service (MASS) is aservice for you if you have a long term condition and are notmanaging your medicines.MASS is provided by a team of pharmacy technicians employed byBromley Healthcare. The team will assess all patients who are identified asrequiring support with their medicines by health and social careprofessionals. The team will then make recommendations for the best wayto support patients with their medicines and refer patients onto anappropriate service; ensuring patients have access to all support available.Tailored Dispensing Service (TDS)TDS is being provided by a selection of community pharmacies across theborough of Bromley. Following referral from MASS the pharmacist willmake the recommended dispensing adjustments each time yourprescription is dispensed. You will be offered a choice of which pharmacyyou get your prescriptions dispensed at when you are initially referred.Your GP will be informed of the referral so your prescriptions can beamended if necessary.


Don’t ignore them

As our bodies age we can often suffer from minor achesand joint pains, but by leaving this pain unchecked, over60s could be putting themselves at risk. Do not dismissaches and pains as simply a sign of ageing. Whilst it isprobably nothing to worry about, if the pain is persistentand severe do talk to your GP.

Back and shoulder pain is a common condition that affectsmany people at some point during their life.

There are many things you can do at home to help such assimple movements and exercise.

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Arm raises while sitting:Breathe out as you raise arms andin as you lower. Repeat five times.

Sideways bend:Bend to the left keeping arms atsides. Repeat to the right. Holdeach stretch for two seconds.Repeat three times on each side.

ArthritisArthritis is a common condition thatcauses pain and inflammation within ajoint. There are many differentsymptoms which may vary dependingon the type of arthritis. Common symptoms include:• Joint pain, tenderness and stiffness.• Inflammation in and around the joints.• Restricted movement of the joints.• Warmth and redness of the skin over

the affected joint.• Weakness and muscle wasting.

Your GP may refer you to anOccupational Therapist who can assessand suggest practical ways to help youcontinue with your normal routine. Theymay also suggest specialist equipmentand aids for use around the home.

Aches and pains


A scary word

CancerYou can reduce your risk of cancer by leading a healthylifestyle. It is never too late to make healthy lifestylechanges. There are no proven ways to prevent cancer butyou can reduce your risk of getting it.

It is important to know your body and recognise anychanges, such as lumps or unexplained bleeding and to getadvice about whether they might be serious. Check yourselfregularly. The most important thing is not to ignore somethingyou notice. Take advantage of the free screening available.Screening aims to pick up cancer at an early stage whentreatment is likely to be more effective. Many cancers can becontrolled and cured if caught early on. Some of the mostcommon forms of cancer are Breast Cancer, Lung Cancer,Prostate Cancer, Bowel Cancer and Skin Cancer. See thefollowing pages for more details on these types of cancer.

Lower your risk of developing cancer by:• A healthy balanced diet and keeping to a healthy weight.• Drinking less alcohol.• Stopping smoking.• Protecting your skin from harmful sun damage.

11

GP saysScreeningIf you are aged 60 to 69 you willautomatically be invited for screening for arange of cancers every two years. Peopleaged 70 and over can request screening ifthey have not been automatically invited.Over 70s can request a Bowel Cancertesting kit by calling the free helpline on0800 707 60 60.

All women aged 25-64 are invited forsmear tests and women aged 50 to 70are invited to attend mammograms everythree years at a hospital or mobilescreening unit. After the age of 70,women can make their own appointmentsfor screening every three years.Call 0800 022 4332 or visit

www.smokefree.nhs.uk

10


FACTS:There are different types of SkinCancer but most Skin Cancers arecaused by long-term exposure to thesun. Fair skin is more at risk of sundamage. As we age our skin hasmore time to build up sun damage.

SYMPTOMS:• Unusual lumps and sores.• A spot or sore that does not heal

within 4 weeks.• A spot or sore that continues to

itch, hurt, scab, crust or bleed formore than 4 weeks.

• Areas where the skin has brokendown or become an ulcer and itdoes not heal within 4 weeks.

SKIN CANCER

FACTS:Prostate Cancer generally affectsmen over 50. It is the mostcommon type of cancer in men. Itdiffers from most other cancers, inthat small areas of cancer within theprostate are common and may staydormant for years.

SYMPTOMS:• Problems passing urine.• Lumps or changes in testicles.• Painful ejaculation.• Blood in urine or semen.

Not everyone experiencessymptoms of Prostate Cancer. Manytimes, signs are first detected by aDoctor during a routine check-up.

PROSTATE CANCERWish you knew the signs?Look closer, talk sooner.

FACTS:Breast Cancer is the most commoncancer in the UK. About 46,000women get Breast Cancer in theUK each year. Most of them (8 outof 10) are over 50.

SYMPTOMS:• Breast Cancer can have a

number of symptoms but usuallyshows as a lump or thickening inthe breast tissue (although mostbreast lumps are not cancerous).

• Lumps or changes in breast(s) -size, shape and skin.

• Discharge from either nipple (whichmay be streaked with blood).

• A lump or swelling in either armpit.

BREAST CANCERWish you knew the signs?Look closer, talk sooner.

FACTS:Lung Cancer is more common inthe over 50s. Finding it earlyimproves the chances of successfultreatment. Not only smokers getLung Cancer (around 1 in 8 ofsufferers has never smoked).

SYMPTOMS:• Coughing for 3 weeks or longer.• Repeated chest infections.• Ache in the chest.• Coughing up blood.• Breathlessness.• Feeling extra tired.• Losing weight.

LUNG CANCER

FACTS:Bowel Cancer is more common in theover 50s. Finding it early improves thechances of successful treatment.

SYMPTOMS:• Blood in your poo or it’s been

looser for 3 weeks or longer.• A pain or lump in your tummy.• Feeling extra tired.• Losing weight for no obvious

reason.Not all symptoms mean it is BowelCancer, and other conditions suchas piles have similar symptoms.

BOWEL CANCER

WHAT TO DO: Go to your GP. Most cancers if diagnosed early on are easier to treat and have a greater chance of being treated successfully.

13

GP saysThere are over 200 types ofcancer which can cause anumber of different symptoms.Often these symptoms are notcancer at all but it is far betterto get checked out ‘to besafe’, and if it is, get earlytreatment.

Lung and Bowel Cancer arethe most common types ofcancers in both sexes.

www.nhs.uk/be-clear-on-cancer

12


Why am I being so forgetful?

Dementia is a general term used to describe a range ofillnesses with different symptoms that affect the brain. Thereare many kinds of dementia but the most common areAlzheimer's disease and Vascular Dementia. What all typesof dementia have in common is that they damage brain cells,so that the brain cannot work as well as it should.

However, a healthy lifestyle may reduce your risk ofdeveloping dementia, so keep your body healthy by eatingwell, being active, keeping a healthy weight and watchingyour blood pressure and cholesterol. Also don’t forgetstress and anxiety, depression, lack of sleep and the sideeffects of some medicines can affect your memory.

You should seek advice if you have symptoms such as:• Finding it hard to follow conversations or programmes

on TV.• Mood changes, depression and emotional upsets.• Difficulty planning and completing simple tasks, for

example making a meal.• Difficulty concentrating and becoming easily distracted.• Feeling confused even in familiar surroundings.

15

GP saysConfusion or forgetfulness does notmean you have dementia. Otherconditions such as infections cancause similar problems, so visit yourGP as soon as you can.

If your GP thinks the reasons for thesymptoms are not clear or wouldbenefit from further investigation, theymay refer you on to a specialist service.Early diagnosis is so important andsome treatments may be availablewhich help some people with thesymptoms of some forms of dementia,particularly Alzheimer's disease. Getthe help and support you need. Thereis practical and emotional adviceavailable providing options, includingequipment, that can support you andyour family with day-to-day living.

Dementia1

Do you have difficultiesin thinking clearly,understanding words,recognising people orcommon objects as wellas loss of memory?

2

Confusion or forgetfulnessdoes not mean someonehas dementia. Otherconditions such ascommon infections cancause similar problems.

3

Seek advice from your GP.Help and support is therewhen it is needed.

14

For more information on dementia call the Alzheimer’s Society Bromley 0208 460 9245Call MindCare Dementia Support on0208 663 0499or visit NHS Choices www.nhs.uk


Love your heart

Healthy heart Lifestyle has a big impact on our health as we grow older.People who are physically active, eat well and maintain ahealthy weight are less likely to get heart disease or have astroke. We should all be thinking about our heart healthand what we can do to keep as healthy as possible.

A fatty diet can raise your cholesterol, increasing your risk ofheart disease and stroke. You’re twice as likely to have aheart attack if you smoke. If you have family history ofcardiovascular disease, make sure you tell your GP. Theymay want to check your blood pressure and cholesterol.

17

Top ‘Love your Heart’ tips:1. Get checked. Ask your GP about having a health check toassess your risk of developing heart disease. 2. Stop smoking,now! 3. Get moving. 4. Lose weight if you need to.5. Change shape. Your shape matters as well as your weight, if you have excess fat around your middle (apple shape) youare at higher risk of heart attack. 6. Drink wisely. Drinking a littlealcohol regularly may be good for your heart, but make sureyou stay within the recommended limits. 7. Balance your diet.8. Cut down on salt. 9. Manage your stress.

What is a stroke?A stroke is a serious medicalcondition that occurs when the bloodsupply to part of the brain is cut off.Strokes are a medical emergencyand fast treatment is essentialbecause the sooner a personreceives treatment for a stroke, theless damage is likely to happen.

Symptoms:The Face-Arm-Speech-Time (FAST)test lists the main symptoms to lookout for:• Face. Has the person's face fallen

on one side? Can the person smile?Has their mouth or eye drooped?

• Arms. Can the person raise botharms and keep them there?

• Speech. Is their speech slurred?• Time. It's time to call 999 if you

see one or more of these signs.

Prevention:Eat a healthy diet, exercise regularly,do not smoke (or quit now) and becareful with alcohol.

What is a heart attack?A heart attack is a serious medicalemergency in which the supply ofblood to the heart is suddenlyblocked, usually by a blood clot.Lack of blood to the heart canseriously damage the heart muscle.

Symptoms can include:• Chest pain: The chest can feel like

it is being pressed or squeezed bya heavy object, and pain canradiate from the chest to the jaw,neck, arms and back.

• Shortness of breath.• Feeling weak and/or lightheaded.• Overwhelming feeling of anxiety.

Prevention:There are five main steps you cantake to reduce your risk of having aheart attack (or having another heartattack): Eat a healthy diet, loseweight if you need to, exerciseregularly, do not smoke (or quit now)and be careful with alcohol.

Call 0800 022 4332 or visitwww.smokefree.nhs.uk

16


Surprisingly common

Incontinence GP saysThere are several forms of effectivetreatment, including:• Lifestyle changes, such as losing

weight.• Pelvic floor muscle training (exercising

your pelvic floor muscles bysqueezing them).

• Bladder training, so you can waitlonger.

Your GP or the Continence Service 020 8462 1255 can assess whether youhave incontinence, decide which type ofincontinence you have, give generaladvice on controlling symptoms, giveinformation on pelvic floor exercises andbladder training and give treatment withprescribed medicines. Regular clinics are held across the Bromley area on anappointment basis.

If lifestyle changes and treatments donot solve the problem, you may bereferred to a Continence Adviser orspecialist.

Incontinence is surprisingly common. Embarrassmentstops many people from talking to their GP.

Whilst it is more likely, it is not inevitable, that we may losesome bladder control as we get older.

In general, urinary incontinence affects twice as many womenas men and becomes more common with increasing age.

It is normal to go to the toilet four to seven times a day andpass up to a pint of urine at a time. People with urinary(wee) incontinence get the urge to go far more often andpass a lot less urine each time. Bowel incontinence can bea bowel accident, when you don’t reach the toilet in time,or leaking from the bowel that you are unaware of. Makesure you do not stop drinking, this can lead to dehydration,bladder infection, dizziness and other complications.

If you have incontinence, don't be embarrassed abouttalking to your GP. The symptoms can be improved, andoften cured, with simple methods. Your GP can also checkthe symptoms for other complications.

19

1

I have incontinence andhave stopped drinking asmuch so I do not wet thebed accidentally.

2

Could drinking less waterbe bad for my health?

3

In drinking less water youmay become dehydrated.Talk to your GP and getthe problem sorted out.

18


Put your best foot forward

Keeping active into older age is the key to staying fit,mobile and independent. Foot care is one of the mostimportant aspects of personal healthcare whatever yourage. However, painful and uncomfortable feet need not besomething to ‘put up with’ as we grow older.

Foot care problems tend to happen if you are less mobilethan you used to be. Poor eyesight and stiff hands, canalso make it harder for you to look after your feet.

Keeping feet clean is an essential part of any good healthyfeet regime. Wash feet daily in warm soapy water, rinsewell and dry well. You may need to apply a foot cream,massage the cream from the toes upwards to the knees.Trim toenails regularly, cutting straight across and makingsure you do not cut too short. Wear well fitting shoes thatprovide good support, are wide enough and allow feet tobreathe. Exercise feet regularly to tone muscles,strengthen arches and improve blood circulation.

If you have diabetes it is even more important to take careof your feet.

21

Podiatrist saysPodiatrists (also known asChiropodists) treat a wide variety ofconditions of the foot and lower leg. If you want NHS Podiatry treatment,the first step is to see your GP orPractice Nurse who can refer you to anNHS Podiatrist if you qualify for freetreatment. You may want to see aPodiatrist for advice and treatment ifyou have painful feet, thickened ordiscoloured toenails, cracks or cuts inthe skin, growths such as warts,scaling or peeling on the soles or anyother foot-related problem.

Podiatrists can also supply orthotics(tailor-made insoles, padding and archsupports).

Keeping mobile1

My feet are painful.

2

If you don’t get help itmay affect your mobilityand stop you being ableto do everyday things.

3

Talk to your GP aboutyour feet and get adviceon Podiatry services.www.bromleyhealthcare.org.uk/find-a-service/podiatry

20


Keep warm, keep well

Keeping well in winter

Key tips to staying warm• Keep your home warm. Your main

living room should be betweenaround 18-21°C (64-70°F). Use a hotwater bottle or electric blanket (butnot both at the same time) to keepwarm while you're in bed.

• Wrap up warm, inside and out.Several thin layers of clothes arebetter than one thick layer. If possible,stay inside during a cold period if youhave heart or respiratory problems.

• Keep active. Move around at leastonce an hour and don't sit down forlong periods of time. Even lightexercise will help keep you warm.

• Eat well. Eat warming hearty andhealthy meals. Porridge makes areally filling, warming and healthy startto the day.

In the winter, colds and flu are circulating and older peoplecan be particularly vulnerable to the effects of coldweather. Certain health conditions are more obvious whena cold spell takes hold - more people experience chestproblems, such as infections and breathing problems.

Winter health - Winter can affect our health in all sorts ofways. Lack of natural daylight can lead to the winter blues,winter health risks like colds, flu and falls on ice, and winterweight gain is common.

Get the jab - The best time of the year to get a fluvaccination is in the Autumn from September to earlyNovember. It is free for over 65s or those with long-termconditions and it is effective against the latest flu virusstrains. Even if you've already had a flu jab in previous years,you need another one this year. GP practices in Bromleyoffer flu clinics, contact your GP surgery for details.There are three main ways of preventing flu:• Hygiene - handwashing • Flu jab• Antiviral medicines (Relenza or Tamiflu)

23

Coping with fluTry to rest, eat well, and drink plentyof fluids.

Going to your local pharmacy couldsave you time and avoid a trip to yourGP. You can get professional adviceand treatments without anappointment. There are manymedicines that you can buy over-the-counter which will ease the symptoms.• Painkillers such as paracetamol,

ibuprofen or aspirin, can bringdown your temperature and helpwith aches and pains.

• If you have a stuffy nose,decongestants can help. Theyreduce the swelling inside yournose so you can breathe moreeasily. You could also inhale steamwith a decongestant in it which willhelp clear a blocked nose.

Contact your GP if:• You already have a heart or chest

complaint, diabetes, a seriousmedical condition, or if you areworried.

22


Make these 4 simple changes now

Lifestyle & well-beingGiving up smoking will:

• Eliminate carbon monoxide from yourbody within 24 hours.

• Reduce your risk of heart attack by halfin just a year.

• Reduce your risk of Lung Cancer.• Improve your appearance - skin loses

its greyish pallor and becomes lesswrinkled within 1 month!

• Reduce coughing and wheezingwithin 3-9 months.

Giving up smoking has huge health benefits. It is never toolate to give up. Just because you’ve tried to give up beforeand not succeeded, does not mean you can’t do it. Manypeople make several attempts before they succeed.Stop Smoking Service 0845 601 3116 or ask your GP.

Cut down on alcohol. It is recommended that men drink nomore than three to four units of alcohol a day and womenno more than two to three units of alcohol a day (with twodays off per week). Older people may be more susceptibleto the effect of alcohol, so drinking less is recommended.If you are taking medication and drinking alcohol, checkwith your GP or Pharmacist that it is safe.

Your diet should include starchy foods such as rice andpasta, protein such as meat, fish, soya products and dairyproducts such as milk and cheese and fruit and vegetables.Try to avoid too much fat and sugar. Balance is the key.Five portions of fruit and vegetables per day.

Increase physical activity.25

1

I want to be generallymore healthy and enjoymy old age.

2

There is no secret towell-being. Follow the 4lifestyle changes.

3

1. Stop smoking.2. Cut down on alcohol.3. Eat well.4. Increase physical

activity.

It’s simple.

24

1 pint lager/beer/cider

(ABV 3.6%)2 units

1 pint lager/beer/cider

(ABV 5.2%)3 units

1 large wine(250ml

ABV 12%)3 units

Single shotof spirits

(ABV 40%)1 unit

How many units?

1

2

3

4Call 0800 022 4332 or visitwww.smokefree.nhs.uk


Management and education

Long-term conditions include heart disease, arthritis,diabetes and respiratory disease, which cannot be curedbut can be controlled by medication and other therapies.

Living with a long-term condition or having a partner who isaffected can be a daily challenge. Keeping on top of thecondition, understanding it and managing it helps. Visit yourGP to review your condition and medication regularly.Knowing about and understanding your long-term conditioncan really help and there is plenty of information available.

Whether your diagnosis is recent or you have had yourcondition for some time there is lots of support available.There are many ways to help manage your conditionincluding training, support and counselling, and aids andadaptions for your home.

For more information on self care and personalised care andplanning for people with long-term conditions visitwww.nhs.uk/yourhealth

27

Around 15 million people in England, oralmost one in three of the population,have a long-term condition. Half ofpeople aged over 60 in England have along-term condition which can oftenresult in having more than one long-term condition.Your GP or Practice Nurse will supportyou by helping you develop your ownpersonalised Care Plan. By talkingabout or reviewing your Care Planregularly, you decide together whatcare and support you need and how itwill be provided.Everyone with a long-term conditioncan have a Care Plan - just ask.

Long-term conditions

For information on money matters,benefits, keeping healthy, travelling,working and more, contact Age UKBromley and Greenwich 020 8315 1878www.ageuk.org.uk/bromleyandgreenwich

Call 0800 022 4332 or visitwww.smokefree.nhs.uk

26


Taking control of your mental health

Mental health & well-being Coping with depression

Recognising symptoms of depressionand getting help early is important.Depression can just happen, but oftenit is ‘triggered’ by things that happenlike losing a partner or illness.

Symptoms may include loss of appetite,being unable to sleep, weight loss, andhaving little energy. Talk to your GP ifyou are affected by a combination ofsymptoms for a period of time.

DementiaDementia is a common concern formany as they grow older. Symptoms,such as forgetfulness, confusion, andemotional outbursts may not berecognised as dementia at first, but maygradually worsen. If you think you oryour partner are being affected bydementia (see page 15), talk to your GP.

General tips

• Look after your health by eating a healthy diet, taking someregular exercise and taking medication correctly.

• Keep yourself busy and occupied - gardening, crosswords,keeping up with current affairs, cooking, libraries,computers and social networks, outings and events.

• Keep learning - try something new or rediscover an oldinterest.

• Keep in touch - chat to friends and family on the phone orarrange for visits and outings together.

• Get a pet if you feel it would benefit you and if you are ableto look after it.

• Ask for help if you need it.

Mental well-being means the positive ability to enjoy lifeand cope with its difficulties and challenges.

Ageing does not have to mean a decline in mental health.There are many ways in which you can maintain goodmental health, even if physical and health issues aremaking life more of a challenge. Just as we care for ourbodies, we need to look after and exercise our minds.

Being a bit forgetful can often come with age, and doesnot mean you have dementia.

We all feel a little sad or down from time to time but feelingdown is not the same as being depressed or havingdepression. Take steps to help prevent depression.Depression can affect older people. Many older peopleexperience psychological or emotional distress associatedwith factors linked to old age, including loss ofindependence, loneliness and losses of many kinds,including bereavements. If you feel unable to cope it isimportant to tell your GP, don’t suffer in silence and get help.

29

1

My husband seemsreally confused.

2

Could this be a sign ofdementia?

3

The Dementia Care Advisercan help call Alzheimer’s SocietyBromley 0208 460 9245Bromley & Lewisham Mind01689 811222Bromley Working forWellbeinghttp://bromleyworkingforwellbeing.org.uk/

28


They need care too

You are a carer if you are looking after someone elsebecause of age, illness or disability. This could be yourspouse, partner, parent, another relative or a friend.

Being a carer can be very rewarding, but it is also hardwork. You may face issues you may not have had to dealwith before and it can be hard to adjust to having someonedependent on you for support.

Being a carer can mean major changes in your life as wellas the life of the person you are caring for. You may needto make practical changes with adaptations andimprovements to your home such as bath rails or making ahome suitable for wheelchair access.

If you feel under pressure there are people who can help.Make sure you do not miss check ups and healthappointments, if you are unwell you cannot be a carer. It isimportant that you make sure you are cared for too.

Contact Carers Bromley 0800 015 7700 or visitwww.carersbromley.org.uk

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1

Are you a carer?

2

You may not think so.‘Hidden’ carers care fortheir family or partner aspart of everyday life anddon’t access the helpavailable.

3

If you are feeling underpressure, get support. Youare entitled to help too.

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You are not alone• One in ten people are carers.• Let your GP know you are a carer so

they can support you by looking afteryour health.

• You are not alone. Ask for help.• Looking after yourself - your health

(emotional and physical) and well-being are very important.

• A carer’s assessment is a way offinding out what help you need withcaring, help to maintain your ownhealth and well-being with your life,work and family commitments.

• Financial support may be available.• Try to keep doing your hobbies and

meeting friends.

Support for carers


Staying steady on your feet

Trips and falls Keep your home safe:• In the bathroom - Test your bath

water to prevent scalding. Use a non-slip rubber mat. A handrail is usefulfor extra support. It is a good idea toleave the door unlocked in case youneed help.

• In the bedroom - Always switch offyour electric blanket before gettinginto bed and check their cordsregularly for scorch marks. Have yourelectric blanket tested annually.Before getting into bed, make surethat anything you need is within easyreach - a lamp, drink, medicines andperhaps a torch by the bedside. If youfeel dizzy when you first sit up, wait acouple of minutes before standing up.

• In the living area - If rugs are frayed,it is safer to remove them. Securetrailing wires and have heatingequipment checked regularly. Checksmoke alarm batteries. The FireService do home safety visits and willfit smoke alarms free of charge forolder people. Consider having apersonal alarm so you can get helpwhenever you need it.

There are many simple things that you can do to help staysteady on your feet. It is very common to feel anxious ifyou have had a fall or feel unsteady.

Regular physical activity such as walking or gardening canhelp keep you fit and healthy. There are also specificexercises to strengthen the muscles of your legs andimprove your co-ordination and balance. Vision plays animportant role in your sense of balance too so have youreyes checked regularly.

Some medicines can make you feel faint or unsteady. Letyour GP know if you ever feel like this.

Foot problems can have a major effect on our balance andstability. Wear shoes that fit you well. Avoid loose slippersor those with no backs, sandals and high heels.

Always take care on the stairs and consider an extrabanister or handrails to make everyday activities safer.Keep the floor free from clutter, which you may trip over. Ifyou fall and are worried ask your GP to refer you to theFalls Service.

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1

I had a bad fall and I amnot sure what to do tomake things safer.

2

Ask your GP about theFalls Service.

3

The Falls Service holdsworkshops and clinics.For more informationcontact the service on0300 003 2321 who candirect you to a local clinicor contact your GP.

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Maintaining independence

Help with daily livingSupport

The types of support you areoffered may include:• Home support - such as

washing, getting dressed andpreparing meals.

• Day support -opportunities toget out and participate in activitiesat a day centre or similar.

• Personal Alarm Schemes andassistive technology - alarmmonitors if you have a fall or needhelp and adaptations to yourhome.

• Respite care - If you are a careror are being looked after byanother person, respite care offersthe chance of a short break.

• Meals at home - you may beable to have meals delivered toyour home if you are havingdifficulty cooking for yourself.

Staying independent for as long as possible is important, but itcan be more difficult to look after yourself and your home asyou get older and you might want help with daily living tasks.Often it can be a simple thing like getting a seat for the bath,purchasing adapted cookware or fixing handrails on the stairs.Seeking help early on is important and there are lots of servicesprovided by many organisations in the voluntary and privatesector. With this in mind Bromley Council have developed arange of information and advice on Bromley Mylife, its socialcare website, to help you and your family manage any supportand care needs you might have.

Your financial situation and level of care needs could mean youare eligible for council funded support. You can contact socialservices and ask for an assessment and if appropriate they willarrange for a care manager to visit to help you find out whatyou need and explain what services they provide. If you areeligible social services will tell you how much you have tospend on your care needs and any financial contribution youmight have to make. This money is called your personal budgetand you can manage this yourself using Direct Payments.

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1

I want to stay living athome but I am finding ithard to cope.

2

Have you discussed thiswith anyone? There islots of support and helpavailable.

3

If you want more adviceand information visithttp://bromley.mylifeportal.co.uk/home.aspx or callBromley Social ServicesDirect on 020 8461 7777

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Attendance AllowanceThis is a benefit for people aged 65 orover who are ill or have a disability andneed help or have difficulty withpersonal care - this means tasks suchas washing, dressing and getting in andout of the bath. You may be entitled toclaim Attendance Allowance if youneed someone to keep an eye on youbecause, for example, you may fall orhave a bad turn.Claiming Attendance Allowance -Benefit Enquiry Line 0800 88 22 00.

The Supporting PeopleProgramme

Funds housing-related support to peoplewho need some assistance to continue tolive independently. They help with thingslike making your home safe and secure,helping you to find new accommodation,helping you to manage your money, andhelp with benefits. Supporting PeopleTeam 020 7820 1343.


If you have a terminal illness, or are approaching the end ofyour life, it may be a good idea to make plans in advancefor the future of your care. Planning ahead in this way issometimes called advance care planning. It involvesthinking and talking about your wishes for how you arecared for in the final months of your life.

End of life care helps you to live as well as possible untilyou die, and to die with dignity. It also includes support foryour family or carers.

If you have an incurable illness, palliative care will help tomake you as comfortable as possible while providingpsychological, social and spiritual support for you and yourfamily or carers.

Many healthcare professionals can be involved in providingend of life care. Most hospitals have special palliative careteams who co-ordinate all these services. When end of lifecare begins depends on your needs, it may last a fewdays, or for months or years. End of life care begins whenyou need it, and will continue for as long as you need it.

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Why not make a plan?If you are not approaching the end ofyour life, you may still want to thinkabout your wishes for your own end oflife care. This could include:• If you don't want certain kinds of

treatment in the future, you can makea legally binding advance decision.

• Where you would prefer to die, yourwishes for your funeral, who youwould like to make decisions aboutyour care if you are not able to decidefor yourself.

• Find out how to legally appointsomeone to make decisions aboutyour care in the future if you becomeunable to make decisions yourself(Lasting Powers of Attorney).

• Make a will to ensure your propertyand finances are dealt with accordingto your wishes after your death.

St Christopher’s Bromley provideend of life care and Bromley CarePartnership’s Coordination Centre01689 825755 is central to this,offering a single point of contact forpatients and carers bringingtogether the full range of healthprofessionals, providers andBromley Council.

End of life careSupport for people and their families


Your changing emotions

Loss and bereavement Being practical

There are a number of practical things to bedone following a death. If you can, ask afamily member or friend to help.• A Doctor will need to issue a death certificate.• You should appoint a funeral director to

make the arrangements. You may beentitled to help with funeral expenses.

• You must register the death within five days.You need to take the death certificate withyou.

• Tell family members, friends and colleagues.• There may be organisations to notify. If the deceased was receiving welfare benefitsyou should inform the Benefits Office. Otherorganisations to inform are the DVLA, the UKPassport Agency, the Inland Revenue and anyBank or Building Societies.You may also need to contact their personalor occupational pension provider, insurancecompanies, mortgage provider, housingassociation or council housing office, socialcare services and utility suppliers.

Losing someone close to you is a highly traumaticevent. Although each person will deal with loss intheir own way, there are several recognisableemotions and reactions that people go through. Thisis an entirely normal part of grieving.

You may think you should be able to cope, especiallyif the death was expected, but you still find you can’t.You may think you’ve done all your grieving and thenfind you haven’t. You may think that having otherpeople who care for you will make everything alrightbut it doesn’t. If other people were not aware of thenature of your relationship with the deceased youmay feel excluded.

Anger is a common part of grieving - anger atyourself, anger at the person who died, anger atfriends and family, anger at the system and/or angerat your God. Talking helps. Allow yourself to expressyour feelings and talk about the person who hasdied. Dealing with the practical aspects involvedwhen someone dies can also help.

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1

Losing someone closeto you is a highlytraumatic event.

2

Talking about death andthe person who diedhelps as does dealingwith the practical aspectsof your new life.

3

Speak to your GPBromley BereavementService 020 8768 4591Cruse Bereavement 0844 477 9400.

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The benefits are out there

Your entitlementsAttendance Allowance

This is a tax-free benefit for over 65swho have an illness or disability andneed help with personal care. Gettingan Attendance Allowance may increaseother benefits that you already receive.

For further assistance call Age UKBromley and Greenwich 020 8315 1878.

Council Tax reductionsYou are entitled to a reduction of 25%in your Council Tax if you live alone. Youmay also be able to claim a reductionto your bill if your home has beenadapted for a disabled person.

Disability Living AllowanceThis allowance can be claimed bypeople who need help in caring forthemselves or in getting around becausethey are ill, disabled or terminally ill. Youare not eligible to make a new claim forDisability Living Allowance if you are over65. In this case you should claimAttendance Allowance instead.

There are many benefits, allowances, discounts andconcessions you may be entitled to, even if you havepersonal savings. Some benefits are based on yourfinancial circumstances (but not the value of your home).Others are based purely on your age. Others are based onyour care needs.

Understanding your entitlementsThere may be other benefits you are unaware of so askyour benefits advisor to check for you. These may include:• Pension Credit.• Working Tax Credit (if you have not retired).• Housing Benefit.• Council Tax Benefit.• Social Fund (such as Winter Fuel Payments, or to help

cover extra costs, such as paying for a funeral). You maybe entitled to financial allowances if you need someoneto help care for you, if you have a physical or mentaldisability or if you are a carer. At 60, you will also beentitled to other concessions such as reduced entry toleisure centres or adult education classes.

41

1

Many older people are notgetting the entitlementsthey are due.

2

Don’t miss out - even asmall extra payment eachweek can make a bigdifference.

3

All you have to do is ask -you should seek specialistadvice.

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Socialising keeps us well and happy

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Over a third of people aged 65+ in Great Britain feel lonelyaccording to research from Age UK.

Loneliness can have a huge impact on both physical andmental health. As well as depression, persistent lonelinesscan also cause stress. Loneliness makes it harder to controlhabits and behaviour which can lead to health problems.Lonely older adults drink more alcohol, have unhealthierdiets and take less exercise than the socially contented.

The Internet is a vital tool in tackling isolation and lonelinessbut don’t just keep in touch on-line. Face to face contact isvery important too. Taking the first step can be difficult, butthe long term benefits can be enormous. If you are lonely,try and involve yourself in some social activities. Find outabout older people’s forums, partnerships, befriendingservices and groups or take up a new hobby.

To help combat loneliness try to get out. Even walking tothe local shops if you are able, will bring you into contactwith people and help boost your confidence.

Why do we become lonely?• The loss of a loved one.• Physical limitations like illness or poor

mobility can affect a person’s ability togo out and meet people.

• Redundancy or retirement can lead topeople becoming more isolated, asthey adjust to new roles.

• Sensory impairment can also be abarrier to social contact as manypeople are concerned that they willnot be able to communicate.

• Incontinence can also be an issue forsome people and make them fearleaving the house (see page 19).

• Older gay and lesbian people haveexperienced fear about 'coming out'or have never done so.

• Financial issues can lead to isolation.Make an appointment with yourCitizens Advice Bureau to ensure thatyou are receiving all the benefits youare entitled to.

Age UKIf anyone is suffering from loneliness or feeling isolated, helpis available from Age UK. A friendly chat over the telephoneor meeting each week can really cheer you up if you livealone, and that's the principle behind the Age UK Bromleyand Greenwich Befriending Service. Maybe you couldbecome one of Age UK’s volunteers and not only helpyourself but others too. Call Age UK Bromley and Greenwich020 8315 1878 www.ageuk.org.uk/bromleyandgreenwichSource: www.ageuk.org.uk

Loneliness & socialising


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What to do• In an emergency always

call the Police on 999• Bromley Social Services

020 8461 77770300 303 8671 (outside ofoffice hours) if you areworried that someone youknow is vulnerable and isbeing abused and want toreport it.

Keeping yourself safe

Types of abusePhysical abuse: Causing physical harm either deliberately or through reckless manner.Psychological or emotional abuse: Behaviour that makes you feel anxious, frightened orintimidated, including verbal abuse or demeaning, threatening or intimidating language.Financial abuse: Includes theft, fraud or exploitation. It may be someone using or puttingpressure on you to use your money in a way that you don’t want to or isn’t in your best interests.Neglect: Includes ignoring or failing to meet a person’s medical or physical care needs or notproviding necessities such as medication, nutrition and heating.Sexual abuse: Sexual touching or an act of a sexual nature which you do not want or consentto. It can include language/innuendo.Discrimination: Being treated less favourably because of your race, sex, age, disability, sexualorientation, religion or role in society. (Sometimes known as hate crime).Institutional abuse: Using systems or routines which cause neglect/abuse to a person receivingcare in a formal setting.

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In vulnerable circumstances

You can be vulnerable for many reasons. This might be because youare unable to look after or protect yourself or you are dependent onothers to meet your needs. You may not be able to get away fromthe situation in which you are being harmed or abused.

It is recognised that adults can be abused in some circumstances.Abuse of people who are vulnerable may not always be deliberate,but sometimes happens when others try to do their best but do notknow the right thing to do. Whatever the reason for abuse, it stillcauses harm to the person who has been abused and it is wrong.

Sometimes people are even abused by those they trust or thosewho are providing care for them so it can be hard to speak out.They may be worried about what will happen if they tell someone.Everyone has the right to be safe and if you tell us about what ishappening to you or someone you know, we will help.• In an emergency always call the Police on 999. • If you are worried that you or someone you know is being abused

call the 24 hour Domestic Violence Helpline on 0808 800 0340.• Bromley Social Services Direct on 020 8461 7777, for emergency

out of office hours on 0300 303 8671.


Reducing the risks at home

Safety at home

Useful contacts• Bromley Trading Standards

Rapid Response 07903 852090

• Bromley Citizens Advice 020 8315 1940

• Action Fraud 0300 123 2040 (if you are avictim of fraud or to reportsuspected fraud).

• Your Local Police 999

Secure windows and doorsMake sure windows or doors are not unlocked when you are outor sleeping. All external doors should be fitted with five-levermortice locks. Window locks can be fitted by a qualified locksmithor in some circumstances, through a Home Improvement Agencysuch as ‘Care and Repair’. Make sure you have a chain on yourfront door and ensure it is in place before you open the door.

Bogus callers and doorstep salesSometimes people may try to gain entry to your property bypretending they are from a reputable organisation. Always ask foridentification and check it carefully. Telephone their company toconfirm their identity if you have any doubts or call the police.

Don’t feel pressurised into paying for things sold at the door. By lawyou must be given time to think about any purchase made on thedoorstep. You could ask them to come back when someone else iswith you. If in doubt, call Trading Standards Rapid Response.

If you are dissatisfied with work that you have paid for, contactBromley Trading Standards or Citizens Advice Consumer Helpline0845 4040506.

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Tips for staying safe• Secure your home so you feel safe.• Don't let strangers into your home.

Set up passwords with utilityproviders and check identificationthoroughly.

• Don’t buy from doorstep callers - getquotes for all work on your homeand use recommended contractors.Do not part with money before anywork has been satisfactorilycompleted.

• Keep your keys safe.• Don’t leave money or important

things by the window or leave doorsunlocked.

• Don’t borrow money from doorsteplenders - it’s expensive and stressful.Contact Bromley Plus Credit Union020 8778 4738.

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Staying in control of an emergency situationStay calm and don’t panic. Give the emergency services a summaryof the situation briefly and clearly. Remember - if there is a fire callthe services from a safe distance.

If you smell gasOpen the windows and doors to clear the air. This should reduce thesmell, as well as any danger. If it’s dark don’t turn on lights (to avoidthe risk of sparks) and never use a naked flame or smoke. Checkyour gas appliances have not been accidentally turned on. If not,shut down all your gas appliances and turn the gas off at the mainssupply. Call the National Gas Emergency Number 0800 111 999.

If your pipe burstsTurn off your stop tap (it may be under the sink) by turning itclockwise. It could take a few moments for the water to stop.

Medical emergencyAn emergency is a critical or life-threatening situation - dial 999 foran ambulance. Call NHS 111, your GP or a Pharmacist for non-urgent medical attention.

If there is a fireStay calm and leave the building immediately and stay outside at asafe distance. Call the Fire Brigade on 999.

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Useful Contacts• Emergency Services

999(Police, Ambulance, Fire Brigade)

• National Gas Emergencies 0800 111 999

• NHS 111

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• Try to remain calm, think before actingand try to reassure others.

• Make sure 999 has been called if peopleare injured or if there is a threat to life.

• If you call 999 and you have a choice oftelephones, avoiding delay, try to use alandline so services can locate youquickly if you get cut off.

• Know where and how to turn off water,gas and electricity supplies in your home.

• Keep essential items in a place you caneasily locate, such as a torch, essentialtelephone numbers (family/friends/ GP),small first aid kit, keys and cash.

• Know your postcode - if you are at homeit will assist the emergency services inlocating you.

What to do in an emergency


National contacts Local contacts

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Age UK 0800 169 6565 www.ageuk.org.uk

Alcoholics Anonymous0845 769 7555www.alcoholics-anonymous.org.uk

CrossroadsCaring for Carers 0845 450 0350www.carers.org

Carers UK CarersLine 0808 808 7777www.carersuk.org

Cruse Bereavement Care0844 477 9400 www.cruse.org.uk

Drinkline0800 917 828224 hour Confidential AdviceNHS 111If you need urgent medical help oradvice but it's not life-threatening.

Emergency Ambulance999

NHS Smoking Helpline0800 022 4 332www.smokefree.nhs.uk

Royal Society for the Preventionof Accidents (RoSPA)0121 248 2000 www.rospa.com

Podiatrist (Chiropodist)General enquiries regarding NHSPodiatrist (Chiropodist)01473 275 204

Alzheimers Society020 7423 [email protected]

British Heart Foundation0300 330 [email protected]

Diabetes UK0845 120 2960 - careline0843 353 8600 - peer support [email protected]

Age UKBromley and Greenwich020 8315 1878www.ageuk.org.uk/bromleyandgreenwichBromley Bereavement Service020 8768 4591www.bromleybereavementservice .org.uk Bromley MyLifehttps://bromley.mylifeportal.co.uk/ Bromley Social Services Direct020 8461 7777Carers Bromley0800 015 7700www.carersbromley.org.ukCitizens Advice 020 8315 1940 www.bromleycab.org.ukDementia Care Alzheimer’s Society Bromley 020 8460 9245MindCare Dementia Support020 8663 0499,www.mindcare.org.ukGP ServicesYour GP is your first port of call foron-going illness or injury.

If you need your GP out-of-hoursplease dial 111. The out-of-hoursperiod is 6.30pm to 8.00am onweekdays and all day at weekendsand bank holidays.If you need help finding yournearest GP surgery, call NHSEngland on 0300 311 2233 or visitwww.nhs.uk

Urgent Care CentresIf you have an urgent and severebut non-life threatening illness orcondition then attend an UrgentCare Centre. The followingconditions can be treated on site:• Wounds.• Cuts.• Sprains.• Suspected breaks.• Minor illnesses in children or

adults including fever, infectionsand rashes.

Beckenham Beacon379 Croydon Road,Beckenham BR3 3QL.01689 866037Open 8am to 8pm every day.

Princess Royal University HospitalFarnborough Common,Bromley, Kent BR6 8ND.01689 863000 open 24/7.

A&EAccident and Emergency (A&E)departments should only be used in acritical or life-threatening situation.A&E departments provide immediateemergency care for people who showthe symptoms of serious illness orhave injuries that could be lifethreatening. In an emergency dial 999or go to your nearest A&E department:Princess Royal University HospitalFarnborough Common,Bromley, Kent BR6 8ND.01689 863000Lewisham HospitalHigh Street, Lewisham,London SE13 6LH.020 8333 3000Queen Elizabeth HospitalStadium Road, Woolwich,London SE18 4QH.020 8836 6000

Mind - for better mental health0300 123 [email protected]

Menopause Matterswww.menopausematters.co.uk

Citizens Advice www.citizensadvice.org.uk

FirstStop Advicewww.firststopcareadvice.org.uk

National Domestic ViolenceHelpline0808 2000 247www.nationaldomesticviolencehelpline.org.uk

NHS ChoicesNHS Choices is a goodstarting point for informationabout what services areavailable in your area. Visit www.nhs.uk


other useful contact numbers: ...integrated health and care services, including community champions...

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