None of us are immune to the ageing process yet the way society is today means that getting old is placing an ever greater burden on the NHS. But one community - perhaps the most caring in all of Wales - has come together to help more than 50 elderly residents in a Pembrokeshire village.
Solva Care secured National Lottery funding back in 2019 and has used the money to fund initiatives including coffee mornings, lunch clubs, excursions and Friday club. We visit the village on Friday when the organisation holds Friday club in the local village hall. Today, the Ukulele Pirates are performing and there will undoubtedly be dancing and tea and cake.
Not far from the village hall, Sue Woolcott lives in a pretty blue house with her husband Ian. The couple married six years ago and in January 2022 Sue, 58, was diagnosed with early onset Alzheimer's. Ian has taken a sabbatical to care for his wife full time and Solva Care have been there to support them both.
"I didn't know what was wrong with me," Sue said, who worked as a nurse until her illness meant she had to stop. "It was there all the time." Ian gently helped explain that there were things before Sue's memory loss that signalled there was something wrong. She was "shocked" when she was told she had dementia but she seems unswayed as she says: "I'm alright now and I can do things for myself."
Ian is a quiet and supportive presence and said: "I can't imagine other villages in Pembrokeshire having such a strong community. There's a big volunteer population in Solva and everyone seems to help each other. They mother the community."
Solva Care has helped Sue get out independently and accompanied her on coastal walks which also allows Ian time to himself to catch up on other things. "I feel better for it," Sue said. "Sometimes I'm quite sleepy because of the dementia."
"We haven't had to ask," Ian added. "They've taken it upon themselves in the nicest sense to help out. If they think something is wrong they will say what can we do to help."
A couple of hours later, we catch up with Sue in the hall and she shows us her best moves on the makeshift dancefloor as the Ukulele Pirates play tunes from bygone days. Coordinating the not-for-profit organisation is Lena Dixon, aged 63, who worked in insurance but is "good with people and admin". She has witnessed first hand just how people like Sue benefit from Solva Care.
"We do save the health board money," she said. "Hospital admissions among the Solva population have gone down since we started in 2015 and people go home quicker rather than staying in hospital." We saw earlier this year how the equivalent of a full Singleton Hospital in Swansea was being taken up by people who were medically well enough to go home but couldn't.
If there are people admitted to hospital, the Hywel Dda health board will phone Lena to see if they can go home safely. It means hospital beds are released quicker, helping to reduce the strain on the NHS capacity. "If it's only a matter of shopping or walking the dog, then we can help," Lena continued. "As long as it's not hands on care. It's a really cheap way of providing support that could be replicated."
"I think what surprises me is that it's not a one-way system, the support goes both ways," said Lena. "The project keeps people active, they make more friends and get out and about." The job satisfaction is enormous: "You can see the difference you make," Lena added.
Barbara Bale, 66, has a background in the NHS and also worked in government so she knows "how to get things done". She's been a trustee of Solva Care since 2018 and said: "It's what I've done all my life, it's just helping people really, it's my duty." Not that she does it solely out of duty; it's something she enjoys too.
"Society has changed in the expectations," she said. "People expect things instantly and things to be done for them. People expect the NHS to be there. Having seen the other side, I know that expectation is unrealistic. What the NHS set out to do in 1948 is different to what people expect today. The NHS can't afford it."
It might just be "neighbourly things" but that's not to underestimate the impact they can have. The main idea is people stay in their homes and community and can go to places. It's so people can be part of their community and not feel isolated.
"We do have a lot of people who retire down here," Lena continued. The volunteers are central to the service but age is no barrier: there are some volunteers themselves in their 80s. "I always say it's doing neighbourly things in an orderly fashion," Lena added.
Solva Care has been particularly successful at getting a network of volunteers set up and it hopes to join forces with Community Interest Care in Neyland to provide domiciliary care too. A lot of the volunteers - admittedly many of them are women - feel like they are giving back. "It's satisfying and you do get to know people and people become friends," Barbara said.
Both women say isolation and loneliness is the biggest factor in peoples' health and wellbeing: "People living alone have no one to talk to and they become frightened and too scared to ask," Lena said. "Loneliness is the worst thing that causes so many other things. That fear can lead to depression and feeling that no one cares if you live or die."
That particularly rings true for people with dementia: "The ones who join in don't deteriorate in the same way," Lena said. "They can live better lives too. It's very simple what we do but it makes a difference. Lots of things affect other things so something as simple as walking the dog is also a friendly face and a cup of tea afterwards and a chance to make sure they're okay."
Solva Care is evidence that "a community based bottom up approach can work" and that it can be developed to cover all aspects of community well being. It will soon be the first local community based project in Wales and the UK to integrate domiciliary services with a voluntary service.
Other communities have come to them asking for help and advice to set up similar projects and they've been used as an example by the Welsh Government. The approach is about preventative work to promote well being and self help and delay early dependency on services. The group is also starting to develop a network with statutory and non statutory agencies to share service delivery and benefit from the learning to come out of the project so far.
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Lena thinks more locally-run community care groups could help to reduce pressure on services. The last report by Solva Care showed that nearly all those who use the services have slight or moderate difficulties with some aspects of daily health and scored overall health lower than volunteers. Two thirds of clients and nearly half of volunteers used hospital services or visited a GP in the past three months. Clients said they valued Solva Care for providing practical and emotional support which enabled them to remain independent and active in the community.
Right at the front of Friday club is 91-year-old Vera and her dog Lucy. She's all bright eyes and smiles as she tells me: "Lucy comes everywhere where I go." She only lives across the road and walked down herself. She wouldn't miss it for the world: "If you're down in the dumps, you can walk in with the music going and everything is okay again," she said.
Vera has three children and seven grandchildren but lives alone in Solva. Perhaps she's lived so long because she doesn't have a man to look after any more, she joked with a mischievous smile. She's the life and soul of the party and Lucy works the room like a pro too.
Margaret, 89, is sat further along the row and is also quick to get up and dance. Up until two years ago, she was driving her own car but she's stopped now and tells me she "really misses it". She enjoys listening to the "lovely tunes". Sat next to her, 88-year-old Peggy agrees and says she "loves" the band. She gives a Lucy a pat on the head and says: "I'm envious of Vera looking after a dog, I couldn't look after a dog now."
Every so often, volunteer Judy Schunemann, 69, jumps up and coaxes them all to dance. She often runs mindful movement classes for residents, which she says are largely sit down exercises but which help them keep more mobile nevertheless. She said: "The main thing is people feel safe. Old people can be frightened of falling but actually they find they can do more than they think."
Suddenly, the band strikes up a tune she recognises and with a whoop she's back on her feet grabbing Vera for another dance. It's a strikingly beautiful scene showing the power of friendship. Sue gets up to dance too and her face is a picture of joy.
A rendition of Hit the Road Jack gets people swaying and tapping their feet. The enthusiasm is infectious. But there's also something very dignified in the way each and every person in the room is seen as an individual. They are not old and frail people, nor are they burdens. They are friends and the connections are real and run deep.
Solva Care started in 2015 when the project leader, Mollie Roach, came up with the idea, convinced that care could be delivered more effectively. At the time, the pilot was thought to be one of the first of its kind in the UK. But it doesn't run for nothing and it has to secure funding annually to cover its £55,000-a-year running costs. The last lottery funding allowed it to take on Lena, as a development co-ordinator, to provide activities to help older people stay fitter for longer.
But that funding runs out next year and the group is desperately looking for alternatives. For those in the room and who benefit from Solva Care, it's impossible to put a price on independence and the ability to live in their own homes. The demand on the NHS has never been greater and so the work done by the volunteers has never been more important.
As we sneak out the door with the Bear Necessities ringing out behind us, it seems that what's really necessary is a revolution in how health and social care is delivered in Wales. Solva Care are leading the way with Vera and Lucy the dog at the forefront.
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