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Working with Older Men
A Review of Age Concern Services
Sandy Ruxton
Contents
Summary and Key Messages 2
1. Introduction 6
Methodology 6
2. Key issues 9
3. Barriers to older men’s use of services 13
Cultural or social level 13
Individual level 14
Service level 16
4. Enabling factors encouraging older men’s use of services 20
Cultural or social level 20
Individual level 21
Service level 22
5. Practice Examples 28
AC Tameside Gentlemen’s Club 28
AC Gateshead ‘Good Companions’ Men’s Group 29
AC Weoley Castle Men’s Group 30
AC Bromley Hour Bank 32
6. Conclusions and Recommendations 34
Responding to the key issues for older men 34
Recruiting older men 36
Developing service provision 37
Improving men’s health and well-being 40
Creating a suitable atmosphere and ‘feel’ within services 42
Awareness-raising within Age Concern 42
Undertaking further research 43
Extending funding 43
Linking to the policy agenda 44
7. Appendices 49
1) Interviewees 49
2) Publications and Resources 50
3) Organisations 51
4) Reference Group 52
1
About the Author
Sandy Ruxton is an independent consultant, based in Oxford. He is the author of
‘Men, Masculinities and Poverty in the UK’ (Oxfam GB, 2002) and editor of ‘Gender
Equality and Men: Learning from Practice’, (Oxfam GB, 2004). Other published work
is in the areas of children’s rights, asylum and migration, and poverty and social
exclusion. E: sandy.ruxton@ntlworld.com
Summary and Key Messages
Background and context
Despite an increasing focus within public debate on the issues surrounding men and
boys, the specific needs of older men have largely been ignored. The vast majority of
Age Concern services reflect this and remain female-dominated. This review was
prompted by a desire to understand some of the barriers that prevent older men from
using older people’s services and to examine the experience of Age Concerns which
have successfully developed services and activities targeted at ‘socially isolated’
older men.
The final report is based on a brief literature review; three focus group discussions
with older men in Birmingham, Manchester and Gateshead; face-to-face and
telephone interviews with staff working in local Age Concerns; and interviews with
Age Concern England staff and representatives of other organisations working
with men.
The review complements a more detailed long-term investigation into the social and
emotional wellbeing of older men being conducted by Age Concern Surrey with the
Surrey Social and Market Research (SMMR) Ltd, the University of Surrey and the
Centre for Research on Ageing and Gender (CRAG) .
Key issues
There are an increasing number of older men in the population. Whereas in 1951
there were 77 men aged 50+ per 100 women; the ratio had increased to 85:100 by
2003; and is expected to increase to 90:100 by 2031. However, this broad trend
obscures some important characteristics of older men:
2
■Older men are more likely than older women to be married and to live with their
spouses
■Older men – particularly those who are bereaved, divorced or never married – are
more likely than older women to be excluded from wider social relationships
■Grandfathers are less likely to see their grandchildren if they are not married and
living with their wife
■Men’s life expectancy is lower than women’s, although there are significant social
class differences as well
■Older men are major providers of care, with those over 75 providing more intensive
care (50 or more hours per week) than women
■In general, male pensioners have higher incomes than females with the greatest
difference between married pensioners. For single, divorced and widowed older
men the differences are much smaller
■Older men have more access to cars, mobile phones and the internet than do
older women
A picture emerges of considerable differences both between older men and women
and between different groups of older men. Married men retain significant economic
and social advantages over bereaved, divorced or never married men. As the
numbers of older men increase, with associated increases in bereavement and
divorce, this suggests that access to services is likely to become more significant,
and the need to find appropriate responses more pressing.
Why older men don’t use services
In many areas of welfare services, including Age Concern services, men are invisible
or absent. The review suggests a variety of reasons for this:
■Cultural and social reasons. Despite differences of class, race, religious belief,
sexual orientation, etc., traditional notions of gender emphasise the importance
for men of independence and self-reliance. These attitudes and beliefs exert a
strong influence on men’s behaviour at all ages but particularly influence older
generations. Older men’s resistance to participating in Age Concern services –
perceived as primarily geared at those who need ‘support’ or for those who are
‘dependent’ or ‘incapable’ – becomes readily understandable. Where services are
dominated by women, both as staff and clients, the cultural and social barriers
are significant
3
■Individual reasons. Personal barriers to participating were highlighted in the
focus group interviews. These included: emotional problems following the death
of a spouse; differences in outlook – with men over 80 tending to withdraw from
social contact; problems with health and mobility; and the cost of attending
groups. While these hindered involvement, they could be overcome if activities
resonated with older men’s identities and appealed to their interests
■Service reasons. A significant barrier to engaging older men in services is the
nature of referral policies. Several staff commented that where men were referred,
whether by social services, GPs, or PCT staff, they were more likely to attend.
However, existing referral systems did not carry out this function effectively. There
was lack of awareness of Age Concern services, particularly amongst GPs.
Equally important was the lack of male ‘frontline’ staff within Age Concerns and
inappropriate (i.e. ‘feminised’) activities
Messages for service providers
The most significant barriers to older men’s participation in Age Concern services
appeared to be the way services were structured, managed, staffed and organised.
Nonetheless, there were important messages from their experience of addressing
older men’s’ needs. The review sets out a range of ways in which these barriers can
be tackled:
■An important starting point is to identify the needs of older men in the local
community, including personal backgrounds, histories and identities, as well as
significant transitions in their lives (i.e. retirement, bereavement, etc)
■Good referral systems and better understanding of Age Concern services by other
professionals is vital. Self-referred men were generally more affluent and less
socially isolated. Good publicity and awareness-raising activities can help in
getting services better known to a wider range of people
■Another important factor is the existence of positive management and staff
policies and attitudes to engaging with older men. The presence of a male
member of staff, perhaps as a first contact point for men who are joining, may
help to ‘legitimise’ participation for some men. But most important is the attitude
and approach of staff, whether male or female, and the warmth of atmosphere
they create
■Activities that are attractive to older men may help strengthen involvement.
However, there is a danger in reinforcing stereotypically ‘gendered’ activities. Few
men in the focus groups came specifically for educational activities, although
activities aimed at improving men’s health can be a successful way of engaging
older men. For many older men, straightforward social activities and outings are
the most popular activities
4
■The image of the service is significant – the posters on the walls, the kind of
reading material available, décor of the rooms, the availability of a male toilet, will
all encourage or dissuade men’s attendance
■Although men-only groups are not attractive to all men, they have their place in a
menu of options. For some men they provide vital encouragement, support and
friendship in a safe environment. Having the space and autonomy to initiate their
own activities is crucially important for some older men
Ghate et al.’s1 research into fatherhood and family centre services identifies three
types of centre, the
‘gender blind’
(where men and women are treated the same);
the
‘gender-differentiated’
(where men and women are treated differently); and the
‘agnostic’
(which has no identifiable approach to working with men).
They concluded that while the first two approaches were more effective, having a
strategy mattered more than what the strategy was. Rather than be prescriptive,
this Review is intended to help Age Concerns, and other providers of services for
older people, develop a strategic approach to working with older men that is
appropriate to their individual circumstances and the needs of their communities.
5
Peter Brown
‘Peter Brown is 69 and lives on a council estate in Manchester. He has limited
contact with family and has no friends that live in the area and feels that ‘nobody
cares about you anymore’. Ten years ago he left work to become a full-time carer
to his mother. After his mother died, he was unable to find employment and, as a
result, has a limited income. His neighbourhood is a source of stress, with his
daily activities constrained by anxiety about street crime. “It’s not nice travelling
round here at night.” The absence of meaningful social ties and daily challenges
associated with living in his neighbourhood have led Mr Brown to question the
quality of his life: “I’m not interested in anything round here…come to think of it,
I’m not really that interested about living”.’
Case Study cited in ‘A Sure Start to Later Life’: Ending Inequalities for Older People, Social Exclusion
Unit Final Report, Office of the Deputy Prime Minister, 2006
1. Introduction
The last decade has seen increasing public debate about issues surrounding the
status, roles and activities of men and boys (eg. rising suicides, educational
underachievement, detachment from the labour market). The circumstances of
older men have tended, however, to be less discussed, largely because of their
relative invisibility.
Older men are active in a variety of civic and community organisations2, however the
vast majority of Age Concern services for older people remain female-dominated, and
male users are relatively rarely found in such environments. Interest in why this is so
has been increasing in recent years, and has prompted the current review.
Within this context, the aims of the review are:
■To investigate the experience of Age Concerns which have developed services
and activities targeting ‘socially isolated’ older men
■To explore some of the barriers and issues preventing older men from participating
in activities and taking up services designed for older people
■To identify strategies and approaches that have been adopted by Age Concerns
to address existing barriers
The review is intended to build on existing knowledge and activity in this field, and to
complement a more detailed and longer-term investigation into the social and
emotional well-being of older men which is being conducted by Age Concern Surrey
with Surrey Social and Market Research (SMMR) Ltd., the University of Surrey and
the Centre for Research on Ageing and Gender (CRAG).
Methodology
The report has involved a range of methods:
■A brief review of the literature on gender and ageing, and in particular key texts
on older men and relevant statistical compilations and policy documents.
■Discussions with focus groups of older men using Age Concern services.
These were conducted in three locations, Weoley Castle in Birmingham,
Tameside near Manchester, and Gateshead in the North-East (for further
details, see pages 32-37).
6
‘I grow old ... I grow old ...I shall wear the bottoms of my trousers rolled’.
T.S. Eliot, The Love Song of J. Alfred Prufrock
■Face-to-face interviews were carried out with Age Concern staff in Cheshire and
London (Bromley, Southwark) and the locations highlighted in the previous bullet.
Interviews were also undertaken with four Age Concern England staff in Norbury.
■Other interviews were conducted with staff from Age Concern offices in various
parts of the country, and representatives of relevant organisations working with
men but not part of Age Concern (see Appendix one for details).
Finally, two meetings were held with a project reference group (see Appendix one for
membership), one at the start of the project and the other to discuss the interim
findings. Consultation on the final report was undertaken with members of the
reference group and interviewees who had contributed to the study.
Comments on methodology:
The older men interviewed for this study were predominantly from working-class
white backgrounds as it was decided at an early stage to focus on this group.
Members of the reference group felt that, although some work with men from BME or
gay groups had been developed nationally, the reasons why men from groups such
as these come together are closely connected with their particular identities. The
reference group concluded that the experience of attempting to provide services for
BME or gay men was no doubt significantly different from attempting to provide
services for white men. Whilst some links are made in the review to the possible
connections between work with different groups of men, proper consideration of
these issues would require more detailed study.
The individual men who were interviewed were identified by staff as they were
members of existing ‘men’s groups’ run under the auspices of local Age Concerns;
the purpose of the interview was explained to group members, and that participation
was voluntary and any quotes would be anonymised. Access was therefore relatively
straightforward.
This approach could however have led to bias in the findings; for example, staff might
have selected respondents who they would expect to be positive, and/or those who
were more articulate and confident. However, in the event the researcher was
satisfied that this was not the case. In the case of the group from AC Weoley Castle,
for example, staff specifically made the researcher aware before his visit that some of
the men were likely to be hard to engage with.
Given the short-term nature of the review, there were nevertheless limits on the
numbers of interviewees, and the sample was inevitably relatively small. Having said
this, the researcher attempted to ensure representativeness to the degree that was
possible within such a small-scale project. For instance, there was an attempt to
balance visits between the north of England (Tameside and Gateshead), the Midlands
(Weoley Castle) and the South (London) – and to complement these with interviews
with AC services in rural areas and other regions. Among interviewees amongst
workers, 11 were male and 18 female.
7
Whilst there was not a great number of men’s groups to choose to visit, those
selected were quite different in terms of activities, style and membership (see detailed
descriptions, pages 32-37), and are likely to reflect a reasonable cross-section.
Again, however, time and practicality did not allow for visits to, and interviews with,
the most isolated older men who were completely housebound and/or not in touch
with Age Concern services at all. Having said this, the men who were interviewed
were clearly in significant need; many were living on their own on low incomes, and
housebound for much of the time.
Another potential limitation was that there was insufficient time to interview any
groups of older women who were users of Age Concern services about their views on
the potential for, and likely impact of, involving older men in existing services on a
more regular basis. It is suggested that this exercise would provide further insights
into the barriers and enabling factors in engaging with older men.
8
2. Key Issues
Below we provide a picture of the circumstances of older men in the UK, and how this
compares with the position of older women. Some differences between sub-groups
of men are also highlighted. Unless otherwise stated, the evidence is drawn from the
National Statistics report ‘Focus on Older People’ (2005)3.
Increasing numbers of older men in the population
Women continue to outnumber men within the older age ranges in the UK, owing to
their greater life expectancy. However the gap is declining; whereas there were 77
men aged 50 and over per 100 women in 1951, the ratio increased to 85 men per
100 women in 2003 – and there are expected to be 90 men per 100 women by 2031.
More detailed analysis shows the biggest gap is between men and women aged 85+,
probably still due to the higher male mortality in the First World War. However this is
projected to fall sharply; whereas in 2003, there were only 40 men per 100 women
aged 85 and over, this is estimated to increase to 65 men by 20314.
Older men more likely to be married, and to live with spouses
Older men are more likely to be married than older women, especially at very old
ages. In 2001, four out of five men aged 60-74 were married, compared to three out
of five women. Among men aged 85+, 45% are still married compared with 9% of
women, with spouses usually the primary source of care. Overall, married men – a
high proportion of older men overall – are significantly advantaged, compared to
bereaved, divorced or never married men5.
Men are less likely to live on their own than women; 29% of men aged 75 and over do
so, in contrast to 60% of women. However the gap narrows somewhat later on, with
42% of men aged 85 or over living independently compared to 71% of women.
Overall, those from BME groups are much less likely to live alone.
There are also more women than men living in institutions in old age – 5.9% of women
aged 65 and over, compared to 2.7% of men, both because women are more likely to
be widowed and because they report higher levels of disability. Among the older
homeless population, men – particularly white men, and often those from Irish or
Scottish backgrounds – predominate6.
9
‘1.7 million single older men could be living in isolation in the UK. Nearly 400,000
of these are single older men aged 75 and over. Furthermore, it is estimated that
289,000 single older men are living in poverty’. It goes on to suggest that ‘older
men’s lack of social links and contacts makes them even more vulnerable to
isolation in old age than women’.
‘Men most at risk of isolated and lonely old age’, Age Concern press release, 22 December 2005
Women more likely to experience exclusion, but men more likely to be
excluded from social relationships…
Fourteen per cent of men are defined as excluded from social relationships,
compared to 11 per cent of women. But women are marginally more likely to be
excluded across other dimensions, including civic and cultural activities, financial
products, basic services, and material goods7,8. This Social Exclusion Unit study
highlights the vulnerability of men in relation to exclusion from social relationships, and
emphasises ‘the need for targeted efforts if this dimension is to be tackled’. The
groups most likely to lack social contacts with relatives, friends and neighbours are
divorced and never married older men. Their lack of social networks makes them
more vulnerable to social isolation and less likely to receive the practical support that
might help them to remain living in the community should they become disabled9.
Less contact between grandfathers and grandchildren
The overall percentage of people aged 50 and over with no living children is 14% for
men and 12% for women. A consequence of higher divorce rates is that more older
people – around 10% for both men and women – have stepchildren. In practice,
contact between older parents and non-resident children is high, but higher between
mothers and children than between fathers and children. Grandfathers are less likely
to see grandchildren frequently if they are not living with a wife. Being the grandchild
of a son, especially where family break-up has occurred, also decreases the
likelihood of regular contact10.
Falling labour market participation
Participation in the labour market decreases for both men and women from around
age 50, and is part-time for the majority who do work after the state pension age (and
particularly for women). In 2004, 72% of men aged 50-64 were in employment,
compared with 18% of men aged 65-6911, however the employment rate remains
substantially lower than 1979 (when data was first collected). Older men are more
likely than older women to be self-employed.
Overall, older workers are more likely to have educational qualifications, to be in a
higher socio-economic group, and to be part of a couple. Among older men with no
qualifications there were particular increases in economic inactivity between 1993
and 200112.
Health and well-being
Men do not live as long as women, however women are more likely to have more
years in poor health than men. Older men are more likely to smoke and to drink
alcohol than older women. For both sexes, there are differences in life expectancy at
age 65 between social classes; for men, ranging from 17.5 for Social Class I
(professionals) to 13.4 Social Class V (unskilled). Health inequalities by socio-
economic group are less marked among older women than men at ages 50-64.
10
Loneliness resulting from the death of a spouse, poor social support and physical
illness or disability can lead to self-harm and suicide in older age – particularly
amongst older men13. Social isolation also often precedes homelessness, and
homelessness may exacerbate and intensify isolation14.
Social care
As well as being receivers, older people are major providers of care. Among 50-64
year olds, a greater proportion of women than men provide unpaid care, and a higher
proportion provide intensive care (50 or more hours a week). However for those aged
75 and over, the reverse is the case15.
Income and expenditure
In general, male pensioners have higher incomes than females, owing to factors such
as men’s higher employment rates (and women’s greater role in caring), and women’s
lower earnings. The difference is greatest for married pensioners: in 2003/4 married
men had a median income of £212 per week, as opposed to £77 for married women.
But for single pensioners who had never been married, men and women had around
the same median total income. Male divorcees and widowers had higher incomes
than females in the same categories, but the differences were much smaller than for
married pensioners (because many women will have inherited some of their
husband’s pension rights).
Lifestyles and Leisure interests
Older men have more access to cars than older women; in 2003/4 70% of men aged
70+ held a driving licence, in contrast to only 27% of women in this age group. Men
aged 50 upwards also have higher rates of mobile phone and internet usage than
women. Membership of organisations is lower for those who report their health to be
‘fair’ or ‘poor’; 28% of men in excellent or very good health were members of a
charitable organisation, compared with 11% of men in fair or poor health. Women are
more likely to be take part in religious activities than men.
11
Conclusion
The above statistics paint a picture of considerable differences, both between older
men and women, and between different groups of men. Whilst the numbers of older
men in the population are still far smaller than the numbers of older women, this gap
is closing. In general, married men (80% of men aged 60-74) retain significant
economic advantages over their wives in economic terms. They are also far less
socially isolated than other men, whether bereaved, divorced, or never married.
Having said this, changing family patterns in younger generations today suggest that
this pattern is likely to shift in the future. In coming years there will undoubtedly be
considerably more divorced and never married men in the older population. And
given the steadily closing gap in life expectancy between men and women, more men
are likely to be bereaved in later life than are now.
As the numbers of older men in the population increases, and the partnership
status of older men shifts, these figures suggest the issues facing older men in
accessing and using Age Concern services are likely to become more significant,
and the need to find appropriate responses more pressing. The following
chapters therefore explore the barriers and enabling factors affecting men’s use
of Age Concern services.
12
3. Barriers to older men’s use
of services
Men’s relationship to welfare services is contradictory. In some situations, men may
receive preferential treatment over women (eg. at times of family crisis, or when it is
assumed that men cannot cope). Yet in many areas of welfare provision, men often
remain relatively invisible or absent – both practically and conceptually16.
Recent work on parenting and the care of children has increasingly sought to explore
how services can engage more positively with men (especially as fathers), and has
focussed in particular on evidence of ‘barriers’ to male involvement17. In this section,
we have drawn upon the categorisation of three levels of barriers to male involvement
in family centres, developed by Ghate, Shaw and Hazel (2000)18, and apply a similar
framework to services for older people. These are:
■The cultural or social level (for example, in terms of ‘gendered’ attitudes to
family roles)
■The individual or family level (for example, men’s and women’s individual
circumstances or personal attitudes to using Age Concern services)
■The service level (for example, in terms of how the service operates, the range
of activities provided or the overall priority given to working with men).
Below we set out some conclusions in relation to each of these levels.
Cultural or social level
Traditional notions of gender tend to emphasise the importance for men of
independence, self-reliance, and strength. Although there are various differences
in how individual men position themselves in relation to these dominant forms of
masculinity (according to class, race, disability, sexual orientation etc.), these
restrictive conceptions generally exert a powerful influence on the attitudes, beliefs
and behaviour of men as a group at all ages19.
Older men inevitably face an increasing contradiction, however, between their
conscious or unconscious desire to live up to these definitions, and the reality that
they are less able to do so. For example, the interviews for this study confirmed the
importance of men’s relationship with employment and the workplace as central to
their identity; this raised a dilemma for some of the men between their views of
themselves as ‘productive’, contributors to society, and their present experience of
being ‘unproductive’ and ‘dependent’ – for some, as they saw it, ‘on the scrapheap’.
13
This contradiction is also underpinned by widespread social stereotyping20. On the
one hand, older men tend to be depicted as displaying
‘diminished masculinity’
, as
‘sedentary, resting on a park bench, passing time, asexual’
21. On the other, they are
portrayed as ‘Grumpy Old Men’, who are
‘stuck in the past’
, difficult to engage with,
opinionated, and irascible. Of course neither picture is wholly valid, however they
reflect the ambivalent relationship that older men experience in relation to their
masculinity and to the process of ageing.
The interviews for this study suggested that seeking to conform to restrictive
definitions of masculinity often resulted in men avoiding certain behaviours that they
took to be ‘non-masculine’. In particular, older men were widely seen as reluctant to
admit to having problems, to display emotions, or seek assistance from others. In
practice, for example, many older men are less likely to recognise or acknowledge
conditions such as depression, or substance abuse, or stressful life events22. They
also frequently regard visiting the doctor as a sign of weakness, and tend to postpone
appointments until they are very ill – unlike older women, for whom visits to the doctor
have been a more regular feature of their lives (owing to pregnancy, childcare etc)23.
Within this context, older men’s resistance to participating in Age Concern services
which they perceive – rightly or wrongly – as primarily geared at ‘support’ for those
who are ‘dependent’ or ‘incapable’ becomes readily explicable. In circumstances
where, in addition, such services are dominated by women, both as staff and clients,
the cultural/social barriers to getting men through the door are significant.
Individual or family level
Beyond barriers at the broad social and cultural level, personal and family
circumstances may also hinder men’s involvement in Age Concern services.
Within the literature on masculinity, it is widely accepted that there is no universal form
of masculinity (hence the widespread use of the term ‘masculinities’); as indicated
above, differences exist between men according to class, race, religious belief,
disability and sexual orientation, as well as age (as they do for women)24.
Compared to older women, many older men – particularly those who are middle-
class, heterosexual and white – are relatively advantaged. They continue to have
fewer financial liabilities and more assets, and to be supported and cared for by their
spouses into old age. However, women tend to maintain wider kin, friendship and
neighbourhood support networks than men, which continue into retirement and
following widowhood; men’s more work-based networks tend, in contrast, to dwindle
or disappear after retirement.
14
Research by Arber and Davidson25 has also revealed significant differences between
older men, according to their family circumstances; divorced and never married men
are more susceptible to social isolation, poor health, risk behaviours (eg. smoking and
drinking), and material disadvantage than married older men.
This general picture is supported by the current study; almost all the men interviewed
in the three groups (see pages 32-37) were widowers, and several spoke with feeling
about the emotional depths to which they had sunk, and the obstacles they had
faced, following the death of their spouse (or sometimes of a friend or other relative).
Whilst those men who were interviewed were ‘lucky’ in the sense that they had been
able, through a variety of means, to make contact with support services offered by
Age Concern, in reality they were relatively few – and it is likely that the majority of men
in such circumstances remain very isolated and hard to reach.
Related to these issues of individual/family factors are those of men’s age. Several
staff commented that there were clearly differences in the outlooks, interests and
capabilities between men of, say, 60-75 and those over 80. One suggested that for
men at the older end of the age range, there was generally a sense of
‘closing down’
,
a gradual withdrawal from social engagement, communication and participation.
Although they might face the most significant problems of isolation and lack of
finance, they tended to have low expectations and to respond stoically; for better or
worse, they
‘presume this is their lot in life’
. For those aged 60-75, in contrast, there
was a more overt sense of the importance of remaining active and of the potential of
old age; this was particularly the case among the self-organised group in Tameside
(page 32) who were clear that they didn’t want any
‘moaners’
in the group. Whilst the
differences between these age spans are not rigid, they do suggest that if they are to
be effective, services need to think through with care the age and stage of the men
they wish to work with.
Among the members of the three groups, significant – and sometimes severe –
health problems were evident. Of the Weoley Castle group, for instance, whose
members were generally 80+, very few retained independent mobility, and most
had considerable difficulties in looking after themselves. One member was visibly
distressed within the group owing to the worsening speech difficulties he was
experiencing which made it increasingly hard for him to communicate. Within the
generally younger Tameside group, one member had a continuing drink problem; in
Gateshead, several members had health difficulties, particularly related to smoking,
15
‘What I’ve found in the last few years is I’m not in a couple any more, so you don’t
get invited out’.
‘I used to love entertaining all the time. But since my wife passed away, I’m not
particularly interested, to be honest with you’.
Bereaved men quoted in Age Concern (2006) ‘As fit as butcher’s dogs?’: A report on healthy lifestyle
choice and older people
yet a hard core remained adamant they would continue
‘whatever Tony Blair says’
.
But despite the health problems these men faced, which undoubtedly impaired their
ability to access services, if transport was available they still managed – indeed were
very committed to – attending.
From discussions with interviewees, lack of transport reinforced their dependent
status26, and was a major obstacle to them taking part in social activities and making
use of services. Whilst Dial-a-Ride or equivalent schemes were available, they were
frequently oversubscribed and it was often hard to book the exact time ‘slot’ in
advance that was required. Age Concern organisations themselves sometimes had
access to their own transport, but this was by no means universal – and where it was
available, effective operation often depended (as in Gateshead) on the support of
willing and unpaid volunteers (many of whom were also male).
Cost also mattered; a recent weekly increase from £3.50 to £5.50 for attenders at the
Weoley Castle group was largely due to increased transport costs, and there were
fears among some group members that this would force them to make choices about
the activities that they could afford to attend.
Finally, a common perspective among staff was that men were
‘not natural “joiners”
of groups’
, and that this resulted in men not taking up opportunities to attend
Age Concern services. However, claims that men were generally
‘not interested’
or too self-conscious in group settings are undermined by the practical evidence,
which suggests that men are prepared to join groups if they resonate with their
identities and appeal to their interests. At Age Concern Dudley, for instance, there is
a group of white working-class men who meet at the AC centre, purely for informal
social contact; meanwhile, there are individual middle-class men who attend more
educational activities such as digital camera and computer classes. Arber and
Davidson’s research27 takes this analysis further, demonstrating that working-class
older men are less likely to belong to community or religious organisations or sports
clubs, but more likely to belong to social clubs than middle-class men.
On the whole, the above summary suggests that individual level barriers appeared to
be less significant than barriers at other levels, though for a minority of men these
issues did seem to hinder their greater involvement with Age Concern services.
Service level
Barriers to men’s use of Age Concern centres located at the socio-cultural level or at
the individual and family level may be relatively difficult to tackle. However, at the
services level, there may be barriers that are more readily addressed. As in the
research by Ghate, Shaw and Hazel (ibid.), barriers can be identified in relation to:
centre priorities and policies; the service provided, and finally the atmosphere and
‘feel’ of the centre.
16
Centre priorities and policies
One significant barrier to engaging older men in services is the nature of referral
policies. In theory, services that offer activities on a voluntary basis would appear to
be more likely to attract men, but often the reverse seems to be the case; several staff
commented that when men are referred, whether by social services, PCT staff or
GPs, they are more likely to attend. However, existing referral systems do not
necessarily carry out this function as fully as they could. Some GPs in particular were
criticised for stereotyping men as not needing emotional support, for not
acknowledging men’s needs beyond the purely physical, and for lack of awareness of
Age Concern services that were available. In addition, there is the possibility that
doctors perceive most services as female-dominated and assume therefore that men
would either struggle to find their place within, or reject outright, such environments –
and therefore don’t refer them.
In principle, the notion that greater numbers of older men should be encouraged to
attend Age Concern services was widely supported by both male and female staff28.
But although this was regarded as generally desirable, it was also suggested that
some tensions could arise in practice. For example, a male presence might have
an inhibiting effect on some of the female clients; men might even take over, or
dominate, the available space; and they might be difficult to engage and/or
undermine existing groups by not participating. Within couples, female partners
might find it more difficult to assert their independence, or have their social needs
met, if their male partners accompanied them. Whilst these were suggested as
potential negative impacts of greater male participation, it was not however possible
to assess how significant these were in practice. Probably the fact that very few men
currently attend the vast majority of services means that these concerns are rarely
played out in reality; nevertheless, were the numbers of men to rise, they could
become more evident tensions, and could work as barriers.
The service provided
Throughout the services contacted during this research, there was a noticeable lack
of male staff; where male staff were present, it was usually at director or manager
level, reproducing the vertical segregation generally visible within social welfare
organisations as a whole. Horizontal segregation also tended to operate as well; in
practice, face-to-face care work was largely undertaken by women, whereas men
tended to prefer basic grade roles with stronger elements of independence and
control, such as DIY handyperson or driver (often on a voluntary basis)29.
In relation to other aspects of welfare, such as childcare and education, it is often
argued that ‘male role models’ are necessary in order to engage men and boys,
however this assumption is often made too easily, without asking who these models
should be, and what qualities they will impart. In reality, female role models – sisters,
mothers, wives, girlfriends – also play a key role in encouraging men to feel more
comfortable with shifting gender roles and female-dominated environments30. In line
with this analysis, this study found no direct association between the presence of
male staff and higher numbers of male clients. Whilst the low participation of male
17
workers is regrettable, there were, on the contrary, several examples of services
where female workers had been able to foster and maintain the participation of
male clients.
A frequently mentioned barrier to male engagement was the lack of activities that
men would find attractive. Many of the activities, such as cooking, aromatherapy,
dance, sewing, art and crafts, and so on, were widely regarded as ‘women’s
activities’ and therefore rejected by the majority of older men. Nevertheless, there
were other activities (eg. Tai Chi, language learning) that were still dominated by
women, but individual men, or small clusters of men, were prepared to take part in.
Where men did show most interest was in activities with a practical outcome, such as
digital cameras and IT skills.
Overall, most men who attended Age Concern services preferred, however, to ‘do
their own thing’, chat with other (male) friends, playing cards, reading newspapers,
and drinking tea. This represents a challenge to any stereotype that men don’t enjoy
passing time with each other in relaxed, non-competitive ways. It may be that some
older men come to accept the limitations that age places upon their physical ability,
and become less concerned about conforming to dominant notions of appropriate
masculinity. This may allow them to navigate more successfully within settings where
women are in the majority.
An important question here is why this ‘renegotiation’ only occurs among some, or a
few men. Whilst the interviews provided several examples of men who were prepared
to enter female-dominated environments, they tended to be the exception rather than
the rule. In fact, the majority still don’t attend at all, or if they do, they need to find
some way of justifying their presence to themselves and to other men. For example,
some prefer to seek refuge in a ‘men’s group’, often segregated physically and
conceptually from the ‘feminised’ mainstream of the service. Others, as indicated
above, became involved initially as ‘volunteers’ (eg. walk leaders, drivers), as active
contributors rather than passive recipients; this reflects the distinction drawn by Arber
and Davidson between men’s preference for social activities and organisations
involving
‘doing for others’
rather than being
‘done to by others’
31.
The atmosphere and ‘feel’ of the service
Probably the most significant barrier to older men’s participation in Age Concern
services is how the atmosphere and ‘feel’ of the service is perceived by them. This
was acknowledged even by men who were already using the service.
The different life courses of men and women have invariably resulted in services for
older people focussing primarily on the needs of women, and predominantly lone
older widows. Correspondingly, male interviewees highlighted the lack of other male
clients, and a sense that their presence ‘went against the grain’.
18
In practice, the fact that there were far more women than men attending a service
appeared to result in men assuming that the service was primarily ‘for women’ – and
even that this was justifiable, and that men’s needs were fewer or less significant. This
common perception clearly acted as a major barrier to male recruitment.
Allied with this, some men – even those who were now regular attenders – entered
services or centres with some trepidation, feeling that they were not only out of place,
but also that they were likely to be tolerated rather than welcomed. They were also
sensitive to how they should behave to be acceptable to the women, and
occasionally worried that they would overstep the mark in some way
(‘You have to
mind your P’s and Q’s when there are women around’)
. Several described
circumstances where they had gingerly come into a centre for the first time, and felt
hugely relieved to be hailed by one or two other men (usually unknown to them),
sitting at one of the tables. Without this kind of informal support, many do not venture
to come back in again.
Even where a small nucleus of older men have established a ‘bridgehead’ within a
centre, this is no guarantee that other men will naturally be accommodated. Often
men who do attend are regarded with a degree of scepticism by other men; they are
somehow ‘different’, maybe perceived as emasculated because of their regular
presence in a feminised atmosphere. This is probably why those men who do
establish groups, either consciously or unconsciously, appear to take particular steps
to differentiate their role and presence from that of female clients. The group at AC
Tameside, for example, were very clear which their table was, and how the
atmosphere and tone of their conversations was unlike that of the women who
surrounded them.
Finally, certain services clearly had another image problem for men, namely that they
were seen as synonymous with ‘the last stop’ on the way to the grave. As Arber and
Davidson comment: ‘Efforts need to be made to make the clubs specifically aimed at
older people more congenial for older men so that they do not feel they are “yielding
up” their individuality, or admitting some sort of “defeat” by attending’.
19
4. Enabling factors encouraging older
men’s use of services
Whilst it is invariably the case that women outnumber men as clients of Age Concern
services, there are nevertheless a small number of men who do attend (some of them
on a regular, or even daily, basis) and men are engaging in a range of ways with what
is on offer.
The main focus of this study has been on service settings with established men’s
groups, however it is important to acknowledge that these are not the only routes
into, or fora for, male participation. Some individual men come for particular activities,
others to get information or practical support, and others receive home visits – or they
may benefit from a combination of all of these.
This section seeks to identify some of the ‘enabling factors’ that encourage and/or
nurture male participation. These are perhaps harder to isolate than barriers, as it is
often easier for individuals to articulate why they don’t do something, rather than why
they do. The enabling factors are also not just the mirror image of the barriers. As
Ghate, Shaw and Hazel suggested in relation to their research on family centres32:
‘
…enabling factors appeared to operate in a subtle and cumulative way, acting
independently of, or in parallel to, barriers. Thus for example in trying to understand
why one man had been ‘enabled’ whilst another had not, it often appeared that two
or three enabling factors had interacted to outweigh the effect of one particularly
significant barrier’
.
As earlier in this report, the following section is structured around the cultural or social
level; the individual or family level; and the service level.
Cultural or social level
Men in general tend to exhibit traditional attitudes towards gender roles, yet in recent
years shifts have become increasingly visible in the attitudes and practices of some
men, who are spending more time with their children than their fathers did (albeit still at
a lower level than mothers)33. This is widely regarded as an enabling factor for daycare,
nurseries, and family and community centres in involving men in their activities.
Older men are often regarded as more resistant to change than younger men, and as
especially keen to maintain conformity with masculine ‘norms’, yet there is some
evidence of the blurring of gender roles and identities as men age. Davidson et al.34
have shown, for instance, how older men without partners often take on domestic
tasks traditionally performed by women (although they may do them differently, and
not necessarily to ‘her’ standards). Similarly, although older women still take
responsibility for the majority of ‘care’ – particularly for their spouses – the numbers of
male carers are increasing; here again, men may undertake the role differently from
20
women35. Little is known about the very specific experience of older gay men caring
for other gay men (particularly those with HIV or Aids), but this is another clear
example of the shifting boundaries of contemporary masculinities.
In the interviews for this review, there were some (limited) indications of men
reassessing traditional attitudes and behaviour. Several men, in addition to being
members of all-male groups, were relatively comfortable in female-dominated
environments – indeed they emphasised that they ‘enjoyed female company’;
although they sometimes felt ‘under scrutiny’ from the women, they also welcomed
the attention (and often, the opportunity to engage in mutual flirtation). Within the all-
male groups, there was sometimes considerable support and co-operation between
the men, who would look out for each other at and between sessions. In relation to
domestic tasks, a 96-year-old in one of the groups proudly announced that
‘on
Fridays, I do my vacuuming’
, a task that his wife would probably have performed
before her death.
These shifts, albeit tentative, suggest that over time, it is likely to be perceived by
older men as more ‘normal’ for them to participate in services that are dominated by
women. This in itself is likely to swell the numbers who do so.
Individual or family level
For some older men, the primary reason for attending an Age Concern service was
that it helped to combat their isolation, by getting them out of the house. Without
somewhere to go that was welcoming, friendly, warm and didn’t cost too much, they
would in many cases have been sat staring at the same four walls, day in, day out.
Although this may not represent a whole-hearted positive endorsement of what is on
offer, it does suggest that where services respond to men’s very basic need for
contact and companionship, they are likely to perform a worthwhile function. Whilst
this is probably also true for many older women, the reduced social networks that
older men experience, particularly post-bereavement, suggest this factor is especially
relevant to the latter group.
As indicated above, being a certain type of man, someone who could empathise with
women and who, in the eyes of female clients, might have qualities they defined as
‘feminine’ – eg. sensitive, a good listener, not too traditional – tended to fit in relatively
straightforwardly. It seems likely, however, that the men themselves wouldn’t
necessarily identify with this image; even though, or perhaps because, they were
present in female environments, they were careful to avoid being seen, if only by their
male peers, as ‘non masculine’.
Nevertheless, however they defined themselves, or were defined, some men did feel
at home within a feminised service. Further exploration should be undertaken into the
reasons why this is so; it may be to do with their experiences of caring, or being cared
for, it may be linked to core issues of identity (eg. family circumstances, race, sexual
orientation).
21
As set out above, some of the male clients interviewed suggested that some female
clients did not appear to welcome men’s presence in ‘their’ space. Staff thought that
on occasion, women wanted a break from their partners, and the service provided
this. Counter-examples also existed, however, of circumstances where older men
had been deliberately introduced into female groups by women themselves (some
were couples, but by no means all). It appears this approach is more likely to be
successful when other men are also attending with whom they can ‘bond’.
Male participation in service provision may be related to a process of individual
change following traumatic life events, such as retirement and/or bereavement.
Several men interviewed stated that it was only when they ‘hit rock bottom’ that they
forced themselves to seek help and support. Whereas the experience of fatherhood
is often seen as an ‘opportunity moment’ for welfare services to make contact with
younger men, bereavement and retirement may provide similar opportunities
(admittedly for quite different reasons).
Research has identified, for example, that both men and women believe in the
importance of ‘keeping busy’ after bereavement, and this provides structure,
meaning, and an active means of coping36. Some of the male interviewees (eg. at AC
Tameside) first came to Age Concern activities at this vulnerable time in their lives;
whilst they came to ‘keep busy’ by attending classes, it seems they stayed because
of the access to emotional and support they received, both from staff and from other
(male) clients with similar backgrounds.
Service level
Centre priorities and policies
As indicated above, a common barrier to working with older men is lack of referrals,
particularly by GPs who are either seen as not knowing about or understanding what
services could provide, or not looking beyond the physical health of their patients, or
simply being too overworked. Having said this, several Age Concerns reported good
relationships with social services and PCT staff, and they were often a positive source
of referrals. Although it was not possible to explore this area in much depth, it
appeared that proactive outreach work to inform staff about what was on offer,
together with greater contact developed over time around individual referrals, did
make a difference. Given the reticence of potential male clients to attend, and the
widespread perception – not just among the men themselves, but probably also
among referrers – of Age Concern services as predominantly or exclusively ‘for
women’, there is a clear need for specific awareness raising targeting particular
groups of professionals (and especially GPs).
Beyond statutory referral, publicising a service properly is crucial; in practice, men
either do not know what is on offer, or believe it is ‘for women’. Any advertising to
attract men must therefore not only be informative, but also must seek to undermine
men’s perception that the service is not for them. Language is also important – for
instance, ‘the opportunity to talk to other men with similar experiences’ is more likely
to be encouraging than ‘a men’s group’.
22
Services had employed a range of recruitment methods, with mixed results.
Recruitment through flyers posted on community noticeboards, in libraries, GP
surgeries etc, and newspaper ads, appeared to be successful where specific
activities were highlighted that men were generally keen to do. For example, a
new digital camera course for men initiated by AC Blackburn with Darwen was
immediately oversubscribed, with 34 men queuing for 10 places.
Impressive though this is, the self-selecting nature of such involvement is likely to
mean that the men who attend are generally more affluent, and less socially isolated.
With the latter, personal approaches from staff or other male users are more likely to
be effective than advertising that may never be seen by a generally housebound
target group.
Another important enabling factor is the existence of positive management and staff
policies and attitudes to engaging with men. Those interviewed for this study (both
men and women) overwhelmingly endorsed the value and worth of seeking to work
with older men. They highlighted in particular the social benefits for the men
themselves, and of giving a break to (female) wives/partners caring for the men.
However this support for working with men is relatively unsurprising as the majority of
interviewees were identified precisely because they were already working proactively
in this area (or had done so).
Management support was certainly relevant too. In AC Weoley Castle, AC Gateshead,
and AC Tameside (see pages 32-37 below), the survival and flourishing of the men’s
groups appeared to be linked to supportive management. At AC Dudley, staff were
approached by an existing group of older men who used to meet in the canteen of
their former workplace; when the factory (and canteen) closed, space was found for
them on Age Concern premises. Over a two year period, the existence of this group
was felt by the Director to have had a knock-on impact on the numbers of men
attending other aspects of the service.
Positive attitudes are not, in themselves, sufficient and there were some services
where these aspirations either did not appear to have translated into practice, or
could not be sustained. In several cases, despite staff commitment, factors such
as lack of funding or referrals had undermined planned activities – and once
undermined, it required particular commitment to kick-start them again. Where
activities had been maintained, and the numbers of men attending the service
were stable or increasing, there was very often evidence of focussed action on the
part of the service (egs. visiting men at home, marketing targeted at men, ensuring
protected space for male activities in a centre, personal introductions).
Nevertheless, some Age Concerns that were contacted by the researcher,
particularly those intended as comparators with no obvious ‘track record’ on
encouraging male involvement, did not however respond. Although this might
be because some services accord less priority to work with older men, it could
simply be that relevant staff were not available or that messages went astray.
23
The service provided
Earlier (page 20), we indicated that the absence of male staff did not appear to act
as a barrier to male participation in a service. It may be, on the other hand, that for
some older men, the presence of male staff helps to ‘legitimise’ their participation.
A male staff member may also act as a first contact point for men who are joining,
and someone who they can talk to about ‘male’ interests. But overall, the attitude
and approach of staff, whether male or female, seems to be of more importance
in engaging men than the sex of staff. At AC Gateshead, for instance, the men’s
group members responded very positively to the lively personalities of the (female)
group leaders.
An interesting associated issue is the importance of warmth, and in particular touch.
The literature of nursing endorses the view that spontaneous touch of patients by
nurses is an aid to healing; similarly, it is likely to have benefits for older men (and
women) who no longer experience any physical contact in their lives. Whilst warmth
and touch may act as enabling factors, it is important for workers to be aware of
some of the dilemmas which they may face in using touch: how to know what sort of
touch to use and when, and how to know when it is not appropriate; how to use
touch in a planned way without losing spontaneity; and how to lessen the risk of
touch being misinterpreted.
Another enabling factor is the nature of the activities provided by the service, and
whether they are attractive to older men. Some men will be engaged by specific
activities. This was indicated in the digital cameras example from AC Blackburn with
Darwen above. Computer classes are generally successful too. Men from the AC
Tameside club (see page 32 below) expressed interest in having computers available,
with access to email and the internet; one man talked there about how he greatly
valued the contact he was able to maintain with family in Australia. At AC Gateshead,
another man mentioned how, following a visit to the Google Earth website, he had
been able to tell his mate that
‘he’d got six tiles missing on his roof!’
Clearly, activities
involving new technology are of interest to at least some older men.
Some men, but relatively few, came for educational activities such as language
classes. Those interviewed tended to support the view that men who came to learn
about new technology or other educational interests such as languages were more
affluent/middle-class, whereas the less affluent/working-class came for more social
reasons (few of the latter group owned digital cameras or computers in any case).
Although this appears to hold generally true, there were examples (eg. from AC
Tameside) of men on lower incomes joining education classes.
Some men came in order to take part in exercise or tai chi classes; generally, there
tended to be few men in these female-dominated groups37. For similar reasons, they
joined walking groups, although they preferred to be in charge as a leader rather than
just a participant.
24
Opinions varied on the feasibility of attracting men to health-related activities. In
Preston, for instance, where a three-year SRB-funded project has been seeking to
improve boy’s and men’s health in deprived areas38, Age Concern received funding to
provide IT courses, a series of one day health seminars, and two-hour workshops on
health, leisure and education topics over a period of six weeks. Whereas the IT
classes were constantly well-subscribed, targeted advertising in relation to health
activities was initially very unsuccessful; only when the project said that women would
also be welcome did couples come. Whilst this was more effective in terms of
numbers, it did mean that the service did not manage to get socially isolated men
involved – the very group identified as ‘vulnerable’ in a recent Age Concern/National
Consumer Council report on health39.
In contrast, the male worker at the Well and Wise project in Camden (formerly part of
AC Camden) has made direct contact with around 320 men aged 55+ around men’s
health issues over a relatively short period. The men were mainly recruiting through
resource centres, using well-produced leaflets and posters, adverts in free papers,
the council website, and men’s health events; the majority are from the wide range of
BME communities in the borough (including Irish, Bengalis, Somalis and Iraqis).
Running six week sessions, each on a different health topic, the worker found an
extremely positive response and suggested that the men talked quite intimately about
the health problems – including risk-behaviours such as heavy drinking - they faced.
The project went on to set up a men’s stakeholder group, including PCT and
voluntary sector staff, and individual men, to raise the profile of men’s health in the
borough. Unfortunately, however, funding has ceased for the Well and Wise project,
which is due to close shortly; nevertheless, this example suggests that, with a
concerted approach and sensitive environment, it is possible to reach older men via
a health route.
25
Why did you go?
* ‘My ladyfriend thought we weren’t getting out and about enough, getting
enough exercise’.
* ‘Looking for something to do, it was free, wanted to see if I could cope before
buying a computer’.
* ‘Granddaughter has a computer, I was afraid of going to other classes because
I thought it might be above my capacity – these classes stressed their elementary
nature’.
* ‘They had some sessions at the health centre but I wasn’t able to attend’.
Interviews with four participants in the Older Men’s Project, quoted in Hobbs A. (2003) Men’s Health
Project Preston, Interim evaluation report
Similar dilemmas arise in relation to cookery classes. Staff at AC East Sussex
struggled to find men to attend a cookery course they wanted to establish. In
practice, the men approached often just didn’t want to go, and preferred to get their
meals in local pubs or cafes (although they did tend to take specially prepared
cookery manuals when offered). Visits to sheltered housing to provide cookery
classes proved more successful, and staff opined that ‘you will mop up men quite
quickly’ in such locations. They concluded that it was not sensible to make cookery
the main thrust of work with older men, and that for many men the social aspect of
cookery and food was a better way into engaging with them than direct skills training.
This chimes with the experience of another Age Concern40, which started off a group
for older men who had been widowed; originally the group met in a pub, but
gradually, as relations solidified, each man took a turn in inviting the others to a meal
in his own home. In this case, the focus on social interaction preceded assistance
with cookery.
A related activity which seems to be widely popular with older men is the pub/lunch
club (see for example, AC Gateshead, page 33). If transport is available, this provides
a relatively straightforward way to encourage social interaction between older men,
and helps them to maintain their sense of their own identities and take part in an
activity which most will have done regularly during their adult lives. It also provides the
opportunity for men, some of whom are not very able to look after themselves, to get
a hot meal. A variation on this theme is the suggestion of Arber and Davidson41 that
services are too often set up according to a female yardstick; they should be made
more welcoming for older men, and one way of doing this would be to provide wine
and beer at lunch.
Along similar lines, some services seek to exploit the potential of traditional leisure
pursuits, such as snooker and board games, to get men through the door. These are
undoubtedly a ‘draw’ for some; we encountered, for instance, more than one man
who was keen to continue playing chess, but had no available opponents. Although
there is a dilemma in relying upon – and potentially reinforcing – stereotypically
‘gendered’ activities, in practice there is some cross-over in terms of what men and
women are prepared to do. Whilst some men stated, for example, that they hated
bingo, others, particularly in the AC Weoley Castle group, clearly enjoyed it.
Another enabling factor in attracting men is, as has been mentioned, the availability of
‘masculine’ roles within the service, with men volunteering to do DIY, lead walks, and
so on. If these do not exist, some men will create suitably masculine roles for
themselves. At AC Dudley, for example, a pilot project saw two men trained to sell
reconditioned PCs; another man attended computer and digital camera classes and
ended up as one of the tutors; the men’s group organises itself, and collects money
for outings and trips for the mainly female clientele. The men’s group at AC
Gateshead relies heavily on a pool of male volunteer drivers. Often, if men can ‘find
their place’ within a service in this way, then their engagement may deepen over time.
Finally, although men’s groups are not attractive to all men, as we have noted, they
have their place in the menu of options – and for some, they provide vital
26
encouragement, support and friendship, and can be a significant enabling factor. For
those with particular needs, for example widowers, they can also provide a crucial
opportunity to share experiences with others in similar situations. As we identify in
section 5 below, there are however significant differences between groups. Some, for
instance, are by voluntary attendance, others are by referral. Some are based around
members who have known each other for some time and are not especially
welcoming to newcomers, others are more flexible and accessible. Whilst they bring
important benefits to services, and to some individual men, men’s groups are not
however a panacea to the problem of how to involve men; they should be seen as a
complement to, rather than a replacement for, the range of other approaches
identified in this review.
The atmosphere and ‘feel’ of the service
One of the most significant barriers to male engagement highlighted earlier was the
‘feminised’ atmosphere of services. Yet a warm welcome, and a comfortable and
positive atmosphere did much to counter this perception. Humour was especially
valuable in diffusing tension and undermining uncertainty. Where there were also
opportunities for men to mix informally with other men and organise their own time,
and appropriate and sufficient space for them to do so, again this helped to
undermine resistance to female-dominated environments. In particular, the men
appeared to need to feel secure, and this feeling was reinforced by having like-
minded men around to whom they could relate.
Another relevant issue is the image of services. It is important to consider whether the
environment itself – the posters and photos on the walls, the kind of reading material
available, the decoration of rooms, the allocation of designated space, the availability
of a male toilet – is likely to encourage or dissuade men’s attendance. It may require
subtle presentational shifts to develop settings where men and women are likely to
feel comfortable.
27
‘Eddie said he’s not asking for all-male company. But he doesn’t want all-female
company either. “There is a day centre but they’re more or less telling me that it’s
all women over there now,” he said. “Nobody wants to make it sexless in that
sense of the word – but I think if it’s all men, fine. I think I’d feel uncomfortable
among all women but, having said that, I don’t see why you can’t go to a place
where there’s a mixed group, if there is such a thing.”’
Welsh Consumer Council/Equal Opportunities Commission in Wales (2006) Gender Equality in Public
Services: Care for Older People
5. Practice Examples
In this section we present examples of different types of group within Age Concern
that attract numbers of men. It is not suggested that they are necessarily ‘best
practice’ models, and there are certainly other ways of providing support to isolated
older men (including through home visits, telephone or email contact, drop-in
provision, and so on). However they proved interesting fora for exploring some of the
core issues facing older men, and for many of the men, they provided essential
opportunities for friendship and mutual support.
AC Tameside Gentlemen’s Club
The ‘Gentlemen’s Club’ meets daily on AC Tameside premises in the community café
in Ashton-under-Lyne, near Manchester. A stable group of around 7- 8 men come in
the morning, and stay until around lunchtime. Several come with ‘Ring and Ride’, but
are dependent on the times they arrive; one man comes on two buses from Bramhall
in Stockport, a considerable daily journey. The oldest man in the ground is 88 years
old, but most are around 70. Several have backgrounds in the army, the police, or the
law, which gives them a common point of contact.
Before AC Tameside had the current building, which is new, they had no real access
to this group. Most of the men came in the aftermath of bereavement (‘I was just
sitting in my chair’); in these circumstances, as one put it, ‘It was a godsend’ and all
agreed they would have struggled without the group. Some originally came to do
activities, and then met other men in the café, and stayed. Others just came into the
café off the street with male friends or acquaintances; they wouldn’t have known the
cafe was there if they hadn’t been encouraged to come along.
Some of the men have taken part in activities run at the centre (eg. French/German,
Tai Chi, Art, Keep Fit). Some would welcome more access to computers (one keeps
in touch with family in Australia via email), but not TV (‘we can watch that at home’).
They would probably do more of the activities if there were more male participants.
Most are happy, however, with informal conversation and friendship as the basis for
their participation. The only condition for being accepted appears to be that the men
don’t want ‘people who complain’ – they maintain a generally upbeat atmosphere,
chat and flirt with the older women at neighbouring tables, and their conversation is
laced with humour and banter. They don’t tend to see each other outside the group,
and don’t like weekends as they are more boring as the centre is closed.
Most of the men are not well-off, and are careful about money; for example, the rising
cost of classes (from £1 to £2-£3) was an issue for some. As the AC café does not do
lunches, several go afterwards to a soup kitchen in the town centre for soup and a roll
at £1.50. A couple of the members said they were better off; they are able to go for a
restaurant meal together every week. One or two also go on outings arranged by the
centre, but these are more expensive.
28
The group is a very committed one, and the men’s well-being and contentment
appears directly related to the group’s existence – if the centre needs to be closed
for a day (eg. for carpet cleaning), the men negotiate to keep a part of the space
open so they can still come! As a male member of staff said: ‘There is nowhere else
for them to go’.
Other men do drop into the centre occasionally, but they usually come for specific
help (eg. with insurance), or with their wives/partners, and don’t tend to stay. The
staff are aware of the importance of reaching more men, and keen to stimulate
more informal networks in the community, knowing there are limitations to what
Age Concern can directly deliver:
‘for every man we engage, there are another ten
to a hundred in the community who we don’t’
.
AC Gateshead ‘Good Companions’ Men’s Group
The Gateshead Men’s Group has been running since 2002. It was set up primarily
for older men who are not taking up other Age Concern services; some of the
attenders also go to day centres, but most don’t. The majority live in sheltered units,
and are generally housebound. On the whole, the men do not have experience of
practical tasks, such as cooking or cleaning. They tend to be isolated, with family
support networks frequently having broken down; those who have been bereaved
are regarded as more vulnerable, and often suffer heavily from their loss.
The men are usually referred by health or social services, and sometimes come by
word of mouth; doctors tend to be very poor at referring. Home visits are undertaken
before men join the group to assess their needs and circumstances.
Of the 26 currently on the list for the Men’s Group, around 18-20 attend each time.
The group involves fortnightly trips (egs. to pubs, museums, bowling alleys, or the
coast); the men themselves come up with the ideas, and the co-ordinators carry out
risk assessment visits to check that the outings are feasible and safe. Members are
transported to locations in three minibuses by volunteer drivers, at a cost of £3 a
head (a sizeable sum for the men); they also pay for lunches, and most have to save
up in advance in order to come.
The committed group of volunteers, most of whom are also male, are unpaid, but
have lunch provided for them.
Most of the men are from the Tyneside area, and have spent much of their lives
working locally, often in heavy industry; they bemoan the loss of such employment
today, and the lack of opportunities for young people. According to the Co-ordinator,
the group is attractive because it
‘gives the men a taste of what they used to do’
,
such as going to the pub and the Hexham races; the men like the sheer normality of
the things the group does, but don’t like being organised too much. Most specifically
like the fact that it’s a men’s group; this enables them to talk about ‘men’s issues’ –
one raucous recent discussion amongst a group of 85/90 year olds was on the topic
of erections!
29
On joining the group, some men are very quiet, but they quickly become more
confident and open up. The atmosphere within the group is friendly, and caring; the
staff set the tone by ensuring they hug each group member on arrival and departure –
for some, the only time that they experience physical contact.
Most of the men laugh quite a lot, and some are flirtatious. They look out for each
other and care about each other – it’s common to hear them say
‘Where was so and
so today?’
– and some ring each other between sessions. The morale of the group
can however be dented by deaths within the group, with up to three or four men lost
each winter.
The staff have tried to use the group to educate the men about their health, but a ‘so
what’ attitude is common. In practice the opportunities to communicate presented by
the group have significant health benefits for the men. They also get a hot meal, which
is very important for all of them, and especially those who don’t cook for themselves.
Overall, staff suggested the key lessons from the group were that
‘the simpler the
activity is, the better it works’,
and that the main reasons the group worked well was
because the staff listen to the men, and find out what they want.
AC Weoley Castle Men’s Group
The men’s group in Weoley Castle, a large working-class former council estate in
Birmingham, has been running for 14 years, and was originally set up because of
concerns about the absence of men within female-dominated day centres. Some of
the members have come for the whole time; the oldest is now 96, and the average
age is 81-82. Although membership is relatively stable, over the years there have
been several deaths; other members have gone on to residential care.
The group takes place on Tuesdays from 10am-2pm and is based on a very
straightforward formula; in the morning, the men arrive for a cup of tea, then some
read the papers, others play games or do word puzzles, they chat, then have lunch
(with other female groups); the afternoon session is invariably devoted to bingo. Every
4-5 weeks, the group goes for a pub lunch.
The men pay £5.50 every week: 50p for refreshments; £2.50 for transport (which is
provided) and £2.50 for lunch which is not provided by Age Concern. All of them live
fairly close to the centre, but all except one need transport. The church where the
group takes place employs a chef – this is a great money saver and resource for AC.
Within the group of around 10 men, two have partners, and the rest are widowers.
Most have some health problems (eg. arthritis, strokes, cancer), and they are not very
physically able. One knock-on benefit from the group is that partners and other carers
get a break. Members are able to talk on an individual level (although one man has
speech difficulties), but generally the atmosphere is fairly quiet and ‘low key’.
30
The group provides a safe and friendly environment, but the staff don’t claim to offer
particular activities. The manager appeared somewhat concerned that it was hard to
keep finding activities for the group, and that there was not much interaction between
members (either within, or outside of, the group). He said they had set up the group in
the belief that members
‘would have blokes’ things to talk about’
, yet topics that
might have been expected to generate some discussion between men, such as
sport, did not tend to do so. One of the only issues that prompts a lively conversation
is wartime reminiscence; several group members were in the forces (as was,
interestingly, the only [female] volunteer).
He suggested this might be connected both to the men’s relatively advanced ages,
and to the fact that most had worked in factories (particularly the Longbridge car
plant); he thought that because their working environment had been very noisy
(turning lathes, and so on), the men had lost the art and inclination to chat with each
other – and that this relative isolation affected their behaviour in old age. As he put it,
‘they presume this is their lot’
.
Having said this, the environment within which the group takes place is not conducive
to social interaction. The group has use of a small rented room, with no windows;
group members sit round the walls in armchairs. Some have hearing difficulties. A
different layout could possibly produce more engagement, but it is hard to change the
seating arrangements as the men are all rather wedded to their individual places. One
advantage of being on church premises is, however, that three or four of the men can
go to Communion if they want to.
New members find it quite hard to integrate and some have not stayed as they felt
there was not enough going on. Apparently, the welcome they receive is not effusive;
if they worked at Longbridge, one of the current members may say
‘you used to work
southside’
, but interest in the background of a newcomer doesn’t go very much
further.
But despite the low level of activity in the group, the members say they feel valued
there – and are positive about the group. They say there is a nice collective
atmosphere and everyone is friendly. They like chatting, playing the quizzes and doing
the tombola…
31
Weoley Castle Group – some pen portraits42
Bert: used to run a shoe-shop, among other occupations. He's been attending
for many years, but couldn't remember how long. It’s his only outing during the
week, although his daughter visits him at home and he has a ‘lady companion’.
He has had several lady companions since his wife died, all of whom had died.
He has another companion now but she is in hospital, and he is looking forward
to seeing her when she comes out. He originally came to the group as he wanted
to play chess, but his regular opponent moved away; he has however managed
to set up a small chess club outside the group.
AC Bromley HOur Bank
HOur Bank was set up to tackle social isolation, promotes a spirit of equality and
helps build self esteem amongst members (the oldest is 95) – it is a reciprocal skill
swapping scheme where everyone both gives and receives skill swaps. Since its
launch in 2003, HOur Bank has helped rebuild a sense of community across the
Borough and has had the effect of encouraging social networks. There are currently
over 150 individual members (including 37 men), a figure that has increased
significantly since 2004. There are also ten organisational members, including Harris
HospisCare, two secondary schools, three Residential homes, the Bromley Asian
Cultural Association and the Metropolitan Police cadets in Bromley.
32
He enjoys reading the paper at the club - particularly page 3 of The Sun.
Everyone chats together well, and they all enjoy the bingo. He doesn't really like
speakers coming –
‘It's the company that matters’
.
Derek: has been in hospital recently. He goes to other groups with women, but
‘you have to watch what you say’.
Ken: aged 96, has a daughter aged 62 who has Parkinson’s. He still goes
shopping by himself. He feels the estate ‘has changed for the worse’, a negative
comment on the increasingly multi-racial character of the area.
Frank: has trouble communicating (
‘it’s awful’
), and is depressed. His wife died,
and now he has nothing to look forward to, and his health is getting worse. He is
proud of his son.
Fred: has difficulty swallowing. He says there are smaller friendship circles within
the group; he is particularly friendly with Derek. His attendance helps to give his
wife a break. He answers questions willingly, but seldom goes much further than
a nod and a ‘yes’.
Eric: doesn’t go out and the only people visiting him at home (generally) were the
district nurse and the 'helpers' –
‘there's not a lot a fella can do’
when stuck at
home by himself. In day centres, he said that the women just leave the men
standing in mixed groups, and that he has found that the men and women don't
mix. This group provides him with an improved sense of well-being. He and XXX
had common backgrounds and that helps them talk - both were in the forces
(spending time abroad) and then at the car plant.
Bessie (volunteer): She was unemployed when she began to run the men’s
group, and has been there ever since! She finds it easy to relate to them as she
used to be in the forces. They enjoy the company and, particularly, the bingo
which they do every day after lunch. She has recently developed diabetes.
During the year, the HOur Bank team brokers over 3000 thousand skills swaps
between members. In addition to individual and organisational swaps, a range of
interest groups have been created, including: poetry, art, knitting, music participation,
craft, storytelling and cookery. Outreach venues provide regular drop-in facilities to
existing and new members and host special events of interest to the members.
Men are very active within HOur Bank, for example providing companionship through
1-1 visiting, and playing scrabble and chess. There is also one man in the cookery
group, and three men in the poetry group. Men also engage in gardening and DIY
activities. Two men are housebound; it’s harder to get them involved in skill swaps,
but they will accept social visits. According to the co-ordinator, it is important to
encourage all members, but particularly older men (and especially those have been
bereaved), to understand that they
‘can receive as well as give’
.
33
One member’s experience:
‘Mr P is 84 years old and lives alone. He has been a member of HOur Bank since
March 2004. He suffers from tinnitus, a debilitating hearing condition for which
Mr P has developed his own strategies to manage. He is an ardent letter writer to
HOur Bank and in the past has always attended members’ meetings, summer
and Christmas gatherings, as well as being an advocate for HOur Bank.
Mr P joined the poetry group and interacted well with his fellow members. He
was open about his hearing difficulties and very good at talking about how he
interfaced with the world – how he has to ‘translate’ people’s words. Tinnitus has
left him unable to always fully comprehend the exact words that people are
saying to him when he has a conversation…
…The poetry group gave Mr P the platform from which to express himself
creatively and revealed his interest in theatrical anecdotes and lyrical words in
general. It also offered the chance to perform with the group. Other members
now see him differently and he has gained in confidence through the opportunity
to work within a small, intimate and creative group setting’.
AC Bromley Annual Report 2004-05
6. Conclusions and
Recommendations
Overview
This review found a complex web of barriers and enabling factors affecting men’s
engagement with Age Concern services. Some of these operated at the cultural/
social level; others at the level of the individual and their family circumstances;
but the most significant appeared to be those arising from the way services are
structured, managed, staffed, and organised.
There are considerable obstacles and challenges for services in seeking to engage
and work with older men. However, this small-scale study identified several services
that are wrestling with some of the difficulties, and developing innovative ways
of responding.
Despite the endurance of strong cultural/social barriers (eg men’s traditional
attitudes/behaviour), there is evidence that some men are, or are becoming,
comfortable within the usually female-dominated environments of existing services.
The numbers of men are nevertheless very small at this point, and making further
progress will require concerted strategies to be developed by organisations at the
local level.
Although it was not heard from interviewees in this study, it is sometimes argued
that the dominant cultural/social factors are so strong that there is not much that
can be done to attract men to services. But this defeatist approach ignores the
range of steps that services can – and some do – take that can not only enable
them to engage with older men, but also contribute to shifting the culture.
Below we set out a range of conclusions and recommendations for advancing this
area of work:
Responding to the key issues for older men
An important starting-point for services in developing work with older men is to be
clear about what the needs of older men in the local community are, and who they
are. In practical terms, this may involve developing sensitive information systems to
monitor male and female attendance, surveying older men locally about what they
would like from the service; making connections with other relevant local agencies;
and identifying community leaders.
34
On a deeper level, it should involve investigation of the nature of their backgrounds,
their histories, identities, and so on. An essential part of this challenge is to
understand, and respond to, older men’s perspectives. Here we set out some key
issues for older men:
■
Key transitions in men’s lives:
Responding to the different transition points in men’s
lives provides opportunities for services to engage with them. In the same way that
becoming a father is a time when men are relatively open to renegotiating roles
and responsibilities, and to seeking advice and support from welfare services, this
is also true for older men when they retire, are bereaved, or develop significant
health problems. Many of the men who were interviewed for the review came to
Age Concern on a regular basis shortly after bereavement. Services should seek
to develop sensitive ‘early warning’ systems so that they can identify older men in
their community who are going through a significant transition; whilst the men
themselves might reject direct offers of ‘help’ they may respond more positively to
the offer of a service they may find useful.
■
Sensitivity to different masculinities:
The main focus of the review has been on the
issues facing older white working-class men. It was felt that the issues for men
from BME or gay communities were significantly different, and that the reasons
why men from these communities would come together would be more closely
related to identity, solidarity and support. Although the review did not set out to
explore this broader canvas, there are a number of BME and gay men’s groups
in various parts of the country that are already established. In the longer-term it
would be useful to explore whether there is the potential for greater connections
to be made between these very different groups, and whether there is potential
for learning in terms of approaches and methods.
■
The importance of ‘collective masculinities’:
According to Connell43, ‘masculinities’
are collectively constructed within cultures, groups and institutions beyond the
individual. In this study it was very evident that those who attended the men’s
groups that were identified frequently drew upon elements of a collective white
working-class identity, based on the factory (as in AC Weoley Castle) or the
police/army (AC Tameside). At AC Dudley, the link was very direct, with a group of
retired men from the same factory approaching Age Concern to see if they could
meet on AC premises when the factory closed down (removing their habitual
venue in the canteen). To encourage men to attend, services should establish links
with key institutions locally where they are likely to have worked, perhaps through
trade unions or retired associations.
■
The centrality of work and war in older men’s lives:
Masculine identity and work are
closely linked, and men often judge their status, ability and worth according to
their work; on leaving work, men feel
‘anxious about leaving the traditionally
masculine turf of the workplace for the traditionally feminine realm of the
household’
44. In the same way that older men often regret the loss of role upon
retirement and of the self-esteem work provided for them, they also often look
back at wartime as a defining period in their lives when they were young, physically
35
active, part of a collective endeavour. It is suggested that services could usefully
explore further the potential benefits of reminiscence projects for men around
these two themes, with other local institutions such as schools, community
projects and museums. The process of doing this would help the men involved to
validate their past experiences, and provide a focus for interaction with others,
particularly those who they might not naturally come into contact with, such as
children and young people.
Recruiting older men
In order to develop effective work with older men, the first barriers to overcome are
the lack of visibility of older men within services, and the problem of recruitment. The
following are suggested:
■
Finding older men:
It is possible to find older men in or at certain key locations,
such as pubs, cafes, allotments, churches, surgeries, bowling greens, and so on.
However, approaching older men ‘cold’ can be difficult, and may not be readily
welcomed. A less direct, but probably more effective strategy, is to encourage
current male (or female) clients and staff (including volunteer drivers, handypeople
etc) to invite other older men along that they know – particularly following key
transition points in their lives. Where appropriate, home visits by staff can be used
to raise the possibility of attending a particular service. These approaches provide
more personal, less threatening introductions, and are also likely to reach more
socially isolated men.
■
Strengthening referred access routes:
In many cases, social services and PCT
staff are already in regular contact with Age Concern services locally, and are
aware of what they have to offer. In general, however, GPs do not refer often; either
they tend to deal with the specific health problem that a man presents with and are
less sensitive to social needs, or they only refer men when they
‘think they can
cope’
in a female-dominated setting. There is considerable potential to formalise
pathways for GPs to refer; whereas some do already (eg. for exercise classes),
their awareness of the value of ‘social prescribing’, particularly for socially isolated
older men, should be raised.
■
Addressing men’s lack of awareness of services on offer:
Printed publicity and
information materials for older men about the practical benefits of services are
important, and should be made available in locations such as those identified
above. They should be reinforced by inserts in local newspapers and on radio and
TV. But such methods are probably more important as a complement to face-to-
face recruitment, which remains the most effective approach.
■
The particular difficulties of rural areas:
Rural areas present difficulties for many
local Age Concerns attempting to run services (such as AC Cheshire). Some older
men can come by car (and generally have more access to a car than older
women); married men are most likely to own a car, but divorced and never married
men are less likely to. For the socially isolated, lack of transport places severe
36
restrictions on mobility and the ability to attend services. Where minibuses or
Dial-A-Ride schemes are available, these can make a big difference. For some
men, arranging their own shared transport can, however, maintain their sense of
being in control of their lives. Whilst geographical barriers to attending services
can be insuperable, home visiting schemes provide an alternative way of reaching
men who are isolated, and Age Concerns should seek to recruit pools of male
volunteers to visit other older men. Another possibility, where access to
information is difficult, is the establishment of a ‘mobile office’ (as on the Dingle
Peninsula in Ireland45); using a laptop computer and mobile internet connection,
it is possible to visit a person at home, discuss their needs, connect to the
internet, download necessary forms, fill them in on the spot and return them via
the Internet.
Developing service provision
The research provided a range of pointers to the development of effective service
provision for older men:
■
Consulting with older men:
A basic message from this research is that older men
often react best to service provision that is simple and straightforward, and
protects as far as possible their right to organise and control their own lives. Some
men will want, for instance, to have an ‘exit strategy’ and to preserve own
independence and this should be taken into account in planning. The example of
the men in the AC Gateshead group showed the value of consulting with men
themselves, responding to their wishes, and tailoring the activity and its frequency
to the men’s interests and abilities. Conversely, service provision that was
designed ‘for men’, but without their input, was generally less successful at
attracting them.
■
Supportive management and coherent strategy:
Supportive management that
recognises the benefits of engaging with older men, not just for the men
themselves, but also for their services as a whole, is essential. A concerted
strategy can then be established that is explicit about commitment to engaging
with older men, develops clear aims and objectives for the service, and allocates
sufficient resources to make it happen. Age Concern England should seek to
initiate more discussion and awareness among local Age Concerns of the issues
involved, and appropriate ways of tackling them (see also ‘Awareness raising
within Age Concern’, below).
■
Designing appropriate service models:
In line with the thrust of the ‘Day
Opportunities’ work being developed within Age Concern, services are
increasingly seeking to ensure older people have access to mainstream and
universal services, rather than just segregated provision. Given older men’s
general reluctance to attend female-dominated environments such as day centres
and social clubs, it may be that this trend could provide creative opportunities for
engaging older men.
37
Alongside existing activities such as pub clubs that involve going out into the
community, there are significant opportunities to link up older men on a more
systematic basis around their interests, be they chess, snooker, or watching sport,
perhaps using volunteers to accompany them. The key is probably finding a
reason to bring the older men together; this involves exploring what individuals
would like to do (including activities they used to enjoy doing, or always wanted
to do but didn't get a chance to, or that only exist now that they'd like to try) and
then supporting them to connect with each other, and organising activities around
their interests46.
■
Developing attractive activities:
As described earlier in this report (pages 25-30),
Age Concern services offer a wide range of activities in day centres and social
clubs, some specifically designed to encourage male participation, and others that
are not gender-specific but may bring in male attenders. These include
educational classes (eg. computers, digital cameras), healthy living activities (eg.
exercise classes, Tai Chi, line dancing, bowls), recreational pursuits (eg. board
games, snooker), and groups based on social interaction (eg. pub clubs, men’s
groups). In general, it appears that middle-class men may attend for educational
reasons, whereas working-class men are more attracted by social contact.
Overall, it is hard to draw clear conclusions about the activities that ‘work’, and
those that don’t; in practice, the success of a particular activity may depend as
much on how it is presented to men, how it is run, whether other men also attend,
and crucially, on whether it is regarded by men as an appropriate ‘masculine’
activity – rather than on the activity itself. Having said this, among men who are
isolated and/or vulnerable (eg. through bereavement), there was a preference
for social over skills-based or educational activities. Pub clubs were particularly
well-liked and attended; these enabled men to reconnect with important
aspects of their former lifestyle, and avoided the necessity of attending a female-
dominated centre.
For the more enterprising, men’s groups, once their individual place had been
‘secured’, provided a focus for more regular and less structured interaction with
other men; for some, they provided a place of safety from which they could make
forays into female-dominated activities. Men’s groups are not however a universal
panacea to the problem of how to engage men; what is perhaps more important is
the issue of whether the men’s group can have a ‘ripple effect’ throughout a
service. This has been the case for, say, AC Tameside and AC Dudley, and these
approaches may be applicable elsewhere.
■
Developing male roles in services:
In this study, male staff were largely absent
from basic grade face-to-face work within services, however they were more often
present at director or manager level. It is argued above that the presence of male
workers is not essential in order to attract older men to a service, nevertheless it
may help some men to feel more welcome and comfortable in a female-dominated
environment. Whilst attempting to employ more male workers is a common
aspiration among services, research in the field of childcare suggests that
38
employing individual men is unlikely to have much impact on the numbers of
men attending a service
‘without a more structural and wide-ranging approach
to gender issues within the centre’s practice’
47. A significant difficulty is that the
relatively low pay levels and the related perception that caring is ‘women’s work’
discourages men from applying for basic grade work. If they are taken on,
they tend to move away from direct work (and frequently into management)
relatively swiftly.
■
Increasing volunteering opportunities:
Another way of creating a male presence or
nucleus within a service is to create more volunteering opportunities. This could
encompass, as it already does in many services, male volunteers acting as drivers,
handypersons, or gardeners, carving out suitably ‘masculine’ roles. Other sources
could be male students, and male workers from other agencies.
Similarly, increasing volunteering opportunities for men beyond an individual service
would also be beneficial. This could include not only the kinds of roles set out in the
previous paragraph, but also intergenerational projects (eg. helping children and
young people in schools, sports clubs and the community).
■
Stimulating informal support networks:
Ultimately, there are limits to what
Age Concern services can do on their own in terms of engaging with older men.
Whilst more men can and should be encouraged to make use of Age Concern
services, they are likely for the foreseeable future to remain in a minority. This begs
the question of what mainstream or informal support exists, or can be developed,
within the community, for older men. Research by Davidson, Daly, and Arber48
highlights clear gender differences in social networks; whereas women tend to
develop friendships around the home and social groups, men’s tend to be
employment-based, and are more likely to be reduced or to disappear on
retirement. Widowed men also rely heavily on family, and for a longer period, after
bereavement. These differences underline the importance of developing new
social networks for men. One positive example arising from the current research
was that of the ‘HOur Bank’ set up by AC Bromley (see description, page 36),
which has provided a framework for encouraging social interaction between older
men and others, based around the exchange of skills and interests. In so doing,
it has responded to men’s common desire to be active contributors, rather than
passive recipients. Another interesting initiative, by Dulwich Picture Gallery in
South London, seeks to encourage ‘Friends’ of the Gallery to make contact with
isolated older men (and women) in their street, and to bring them along to visit
the gallery49.
■
Reaching the ‘hardest to reach’:
This study identifies that some local Age Concerns
are having some success in reaching a limited number of men through their
activities, however in many cases it appears that the most isolated and frail men
(who may hardly ever, or never, leave their homes) are often not touched by these.
Within the limits of this research, it was not possible to talk to any of these men.
Whilst some receive home visits through befriending schemes, it appears many
rarely receive visitors apart from the occasional nurse or home help. Although
39
some may not wish to be ‘reached’, others, as in the AC Bromley HOur Bank
example, find it hard to receive rather than give – and this may hinder their ability
to accept help or welcome support. In practice, solutions are likely to need to be
creative, and individually tailored.
■
Issues around fatherhood and grandfatherhood:
Fatherhood and
grandfatherhood were rarely mentioned by any of the men interviewed for this
study; whilst this may partly reflect the fact that the interviews tended to be
conducted in collective settings, it is also symptomatic of the social isolation of
many of these men. Of course some had not had children, but of those who had, a
number had little contact, either because family did not live close, or because of
relationship tensions. A small number were cared for by the families. Whereas
many older men nowadays are actively involved as grandfathers (probably more
than they were as fathers), this was not generally the case for the men in this study.
It is suggested that services should consider establishing courses/activity
sessions for older men to enable them to meet each other and explore issues
around fatherhood/grandfatherhood50; this could lead to the setting up of
‘grandfathers groups’ – for some, probably a more attractive focus than a pure
‘men’s group’. Links should also be developed with other community groups
working with fathers (eg. the fathers groups often established by family/Sure Start
centres), and with national organisations supporting fathers (eg. Fathers Direct).
Improving men’s health and well-being
Several interviewees argued that it was difficult to engage older men around health
issues. In line with dominant notions of masculinity older men tended to ‘tough out’
illnesses, avoid any displays of ‘weakness’, and only presented at GPs when they
were at a crisis – or too late. Evidence from the review, and from the Ageing Well
network of projects, suggests that where men do engage, it is usually around physical
activity (eg. exercise or walks); they are less keen to participate around diet/nutrition,
mental health, or alternative therapies. Nevertheless, some key messages can
be identified:
40
‘The answer for one of these men was to help him arrange to go back to the pub
he used to drink in, where the landlady and a barmaid remembered him (he has
been a care home resident for over 4 years, and had not been back to the pub in
that time); he can only afford to go once a month but is at least going, and is
gradually getting to know the other regulars’.
Cited in email from Lorna Easterbrook, 16/10/2005
■
Going to where men are:
Generally, it was regarded as initially easier to approach
older men in places where they felt comfortable, such as pubs, allotments,
bowling clubs, snooker clubs, residents associations, working men’s clubs, and
so on. However this sometimes could create tension; for example, attempts at
recruitment in pubs had occasionally fallen foul of landlords who were not so keen
on their regulars reducing their alcohol intake!
■
Respecting men’s choices:
In some cases, attempts at intervention were not
particularly welcomed by the men themselves, who felt that, at this stage of life,
their choices (eg. to smoke or drink) should be respected – even if they knew that
the impact on their health would be detrimental. In spite of this, it appears that
some men will change their risk-taking behaviour patterns if told to (eg. by a GP).
Ideally, however, decisions should be reached by agreement between
professionals and individual older men.
■
Communicating with older men:
Anecdotal evidence indicates that some
professionals – particularly those dealing with health issues – are insufficiently
sensitive to how men will receive information. For example, a study for the
Prostate Cancer Charity51 uncovered instances of men being informed of a cancer
diagnosis by phone, or even by letter – a possibility that the researchers had not
considered in their research design. Appropriate information must also be backed
by the knowledge that men are individuals
‘with different priorities, responsibilities,
family background, medical history, ages, and attitudes to risk’
52. If health
messages are to be understood and acted upon by men, it is therefore essential to
respond to their individual circumstances and to find the ‘triggers’ that will foster
positive responses. This requires significant communication skills, and training
should be available for health and social care professionals on how to engage men
around their health.
■
Psychological/mental health/substance abuse issues:
Whilst there was little
evidence of this among the men interviewed for this study, a recent Age Concern
report53 highlights that:
‘There is clear evidence that some older people, especially
men, can fall into depression and negative health behaviours after losing their
partners’
. Other research also confirms that isolation and loneliness are linked to
poor physical and mental health, alcohol misuse and mobility problems54, and
that older men are less likely than women to seek help for problems such as
depression and substance abuse. The Age Concern report suggests that extra
support and company is vital for those who are socially isolated, and that more
active and engaged older people may be able to provide this to those who are
less able or motivated (ie. a system of health mentors/peer support people). It
recommends that the Ageing Well UK Network should work with the Men’s Health
Forum to pilot further ways of working with older men to raise awareness of health
issues and to promote appealing approaches to increasing healthy lifestyles.
In particular, the emphasis of ‘Men’s Health Week’ 200655 on men’s mental well-
being provides a focus for exploring these issues in relation to older men.
41
Creating a suitable atmosphere and ‘feel’
within services
The ‘feminised’ atmosphere within Age Concern services operates as a significant
barrier to male involvement, which should be addressed:
■
A positive welcome:
The nature of the welcome older men receive on first visit is
likely to affect their desire to come through the door again. Whilst male staff can be
helpful, they are not essential. It seems one of the most effective ‘routes in’ is if
contact is swiftly established with a man who is already attending; this suggests
that encouraging selected male attenders to welcome newcomers personally is
likely to be effective. It is also important to recognise that engagement with a
service is a process and may take time; it become easier for some of the men at
AC Tameside to undertake education classes once they felt ‘at home’ in the
centre.
■
Developing ‘male-friendly’ imagery:
Posters and photos on walls, available reading
matter, and information leaflets about Age Concern services should convey the
message to older men that their presence and participation is valued. Men should
appear in a variety of roles, including not just undertaking activities, but also
participating in conversation and social interaction.
■
Attention to the physical environment:
The decoration within services should be
neutral and not overly ‘feminine’, a male toilet should be available (and marked as
such), and specific physical spaces (and where necessary, time slots) should be
identified where older men can meet and chat without feeling overwhelmed.
Awareness-raising within Age Concern
Whilst this review has revealed some elements of good practice, there is clearly much
more that could and should be done by Age Concern services at local level to engage
with older men, especially those who are socially isolated:
■
Sharing learning:
Age Concern England should convene a seminar/workshop to
explore the issues arising from this review with local Age Concerns. AC Tameside
offered to host such an event, and would be keen to involve their men’s group
members in this. Ultimately, there would be value in establishing a network to
share learning and good practice in this field.
■
Team awareness of gender:
In order to encourage more men to engage with
Age Concerns, it is essential to establish work cultures where gender issues are
recognised and discussed openly within day-to-day interaction and training,
and responses formulated jointly by male and female members of staff teams.
Within its work on equalities and diversity, Age Concern England should seek
to develop a training module on gender awareness, particularly as it relates to
service provision.
42
■
Developing links with other organisation working with men:
Links should be
developed and deepened between Age Concern England and other organisations
working with men (eg. Father’s Direct, Working with Men, Men’s Health Forum, UK
Coalition on Older Homelessness) for the purpose of mutual learning and support.
Undertaking further research
With the notable exception of the work undertaken at Surrey University by Arber and
Davidson, there is a dearth of research in this area. It is suggested that more detailed
work would be useful into:
■
The ‘gender-orientation’ of services:
The research by Ghate, Shaw and Hazel into
fatherhood and family centres identified three types of centre, the
‘gender-blind’
(where men and women were treated the same), the
‘gender-differentiated’
(where men and women were treated differently), and the
‘agnostic’
(which did not
have any identifiable approach to working with men). They concluded that the first
two approaches were more effective than the last, and that having a strategy
mattered more than what the strategy was. Within the current review it was not
possible to undertake sufficiently detailed analysis to categorise services in this
way. However it would be useful to explore more deeply the ‘orientation’ of
services, and how this affects their ability to engage men. In particular, this should
involve further investigation of the attitudes of male and female staff at different
grades, and of female users of services.
■
Caring roles and older men:
Whilst the majority of ‘care’ (eg. for spouses and
friends) by older people is undertaken by women, older men’s participation in
caring is under-explored. Further research should be undertaken into the care
provided by older men, particularly those in the 75+ age bracket, who outnumber
women; there are some indications, for example, that men may be unwilling to
admit to the pressures carers face. Older men’s roles as grandfathers are also
poorly understood, and Age Concern could usefully contribute to, and learn from,
the forthcoming Leverhulme-funded research by the Oxford University Institute of
Ageing on ‘Understanding the dynamics of Contemporary Grandfatherhood’.
Extending funding
One noticeable feature of the research was how often specific activities designed to
engage men had been initiated, but had been terminated through lack of funding. In
some cases, this was because the activity had not attracted sufficient numbers of
men to justify continuing. In others, termination of short-term funding had occurred
even when an activity was successful. This suggests several issues:
■
An Innovation Fund for work with older men:
Age Concern England should establish
an Innovation Fund for work with older men to assist local Age Concerns in piloting
new initiatives and ways of working. Projects supported by the Fund should be
monitored and evaluated, and learning shared across Age Concern organisations.
43
■
Raising awareness amongst funders:
Funders should be made more aware of the
specific circumstances of isolated older men, and their need for social interaction.
Rather than emphasising specific skills and particular learning outcomes, the value
of informal contact should be recognised, and supported appropriately.
■
Longer-term funding commitments:
When allocating resources to new initiatives
to engage older men managers and funders should take account of the length of
time it takes to attract older men to participate in services, and the difficulties of
sustaining ‘men’s’ activities/groups.
Linking to the policy agenda
The analysis in this report suggests that, if it is to respond to the range of challenges
presented in working with socially isolated older men, Age Concern England should
develop a more integrated gender analysis within its policy and practice; this would
encourage a sharper focus on the specific needs of older men and women (and on
particular men and women within these overall categories). ACE should also consider
whether there are external policy areas that should be taken up in relation to older
men. A range of activities and issues could be considered, for example:
■
Developing an Age Concern England policy position on older men:
Drawing on
the findings of this review, ACE should develop a policy position paper on older
men, setting out the context for this work, the aims and objectives of ACE
intervention in this area, learning from practical experience, and identify specific
policy positions (eg in relation to carers services, health and healthy lifestyles,
access to healthcare, assessment for social care, and so on.
■
A gendered approach to the ‘Sure Start for Later Life’:
The Government’s
commitment to the ‘Sure Start for Later Life’ Programme, and its recently
published analysis of the inequalities facing older people56, are welcome. However
the report fails to integrate a gender analysis, and to separate the position and
perspectives of, and issues facing, older men and women. As the programme is
developed it will be important to sharpen this analysis, and explore the differing
needs of older men and women.
■
Exploiting the potential of ‘gender as a public duty’?:
The new duty, to be
introduced in 2007, will require public bodies to take the needs of women and
men into account equally when they provide services – not just to react to
complaints when things go wrong. A recent discussion paper from the Welsh
Consumer Council and the Equal Opportunities Commission in Wales57 explores
how care services for older people need to be sensitively planned in order to take
gender into account. The paper suggests, for instance, that the gender duty
‘may
lead to the discovery that local day centre activities are not men-friendly enough,
sparking a rethink and a new wave of activity aimed at getting more men into day
centres’
. Age Concern England should explore further the potential of the gender
duty to help public bodies identify and respond to the differing needs of older men
and women.
44
■LinkAge and transitions for older men: Research carried out for the Department
for Work and Pensions in relation to the LinkAge programme58 has confirmed
the importance of transitions (egs. the ageing process, retirement, health
deterioration, bereavement, divorce, and moving house) in the lives of older
people, and the impact they have on their sense of self and independence.
The research argues there is
‘evidence of the value of specialised services in
supporting older people through periods of acute adjustment’
. It concludes that
services should be targeted to meet needs at key anticipated crisis points, and
that these should be accessible, easy to navigate, and
‘should offer multiple points
of contact where any one agency could jumpstart the facilitation of access to a
wider host of relevant services’
. Given the emphasis within the present report on
the importance of transitions to older men in particular, further exploration would
be worthwhile of how services can identify trigger points for older men where
intervention may be effective, and design appropriate responses. Age Concern
England should seek to ensure that this issue remains high on the government’s
policy agenda.
45
References
1Ghate, D. et al. (2000) Fathers and Family Centres: family centres, fathers and working with men. London: Policy
Research Bureau
2Davidson K, Daly T, Arber S (2003) ‘Older Men, Social Integration and Organisational Activities’, Social Policy
and Society 2, (2), 81-89.
3Soule A, Babb P, Evandrou M, Balchin S, Zealey L (2005) Focus on Older People, Office for National
Statistics/Department for Work and Pensions, Palgrave Macmillan
4Although a very small proportion of older people in Britain are from BME groups (3.5% aged 50+), patterns of
previous migration lie behind the higher numbers of older men than women who describe themselves as Muslim
(1.2-0.9% ), Hindu (0.7-0.6%) or Sikh (0.4-0.3%).
5Arber S, Davidson K (2003) Older Men: Their Social Worlds and Healthy Lifestyles, University of Surrey, ESRC
Growing Older Programme
6Crane M, Warnes A (2001) Single Homeless People in London: Profiles of Service Users and Perceptions of Needs.
Sheffield Institute for Studies on Ageing, University of Sheffield; Willcock K. (2004) Journeys out of loneliness: the
views of older homeless people, Help the Aged
7Barnes M, Blom A, Cox K, Lessof C, Walker A (2006) The Social Exclusion of Older People: Evidence from the first
wave of the English Longitudinal Study of Ageing (ELSA), Social Exclusion Unit, Office of the Deputy Prime Minister
8In this study, seven dimensions of ‘exclusion’ were studied: social relationships (contact with family and friends);
cultural and leisure activities (for example going to cinema or theatre); civic activities (for example membership of a
local interest group, voluntary work, voting); basic services (for example health services, shops); neighbourhood (for
example safety and friendliness of local people); financial products (for example bank account, pension); material
goods (for example consumer durables, central heating).
9Arber S, Price D, Davidson K Perren K, ‘Re-examining Gender and Material Status: Material Well-Being and Social
Involvement’, in Arber S, Davidson K, Ginn J (eds) (2003), ‘Gender and Ageing: Changing Roles and Relationships’,
Open University Press
10 Clarke L, Roberts C (2003) Grandparenthood: Its Meaning and Its Contribution to Older People’s Lives, Research
Findings 22, ESRC Growing Older Programme
11 The figures for women were 68% and 30% respectively.
12 Bartham C (2002) Patterns of economic inactivity among older men, Labour Market Trends June 2002
13 Dennis M, Lindesay J (1995) Suicide in the elderly: The United Kingdom perspective, International
Psychogeriatrics, 7, cited in ‘A Sure Start to Later Life: Ending Inequalities for Older People’ (2006) Social Exclusion
Unit, Office of Deputy Prime Minister
14 Willcock K. (2004) Journeys out of loneliness: the views of older homeless people, Help the Aged
15 Four per cent of men aged 85 and over report providing 50 or more hours a week of unpaid care, compared with
one per cent of women of the same age.
16 See Popay J, Hearn J, Edwards J (1998) Men, Gender Divisions and Welfare, Routledge
17 See, for example, Burgess A, Bartlett D (2004) Working With Fathers, Fathers Direct
18 Ghate D, Shaw C, Hazel N (2000) Fathers at the Centre: family centres, fathers and working with men, Policy
Research Bureau
19 For futher discussion see, for instance, Connell R (1995) Masculinities, Cambridge: Polity Press and Kimmel M
(2000) The Gendered Society, New York and Oxford: OUP
20 See Age Concern (2005) How Ageist is Britain?
21 Thompson E, ‘Older Men as Invisible Men in Contemporary Society’, in Thompson E (ed.) (1994) Older Men’s Lives,
Sage
22 Kosberg J (2005) ‘Meeting the needs of older men: challenges for those in the helping professions’, Journal of
Sociology and Social Welfare, March 2005
46
23 Arber S, Davidson K (2003) Older Men: Their Social Worlds and Healthy Lifestyles, University of Surrey, ESRC
Growing Older Programme
24 Connell R (ibid), Kimmel M (ibid)
25 Arber S, Davidson K (ibid)
26 Research by Gilhooly et al (2003) Transport and Ageing: Extending Quality of Life via Public and Private Transport,
University of Paisley, ESRC Growing Older Programme, has suggested that, for working class men, owning a car
may be an important status symbol – and that giving up a car may be associated with downward social mobility.
27 Arber and Davidson (ibid.)
28 There was insufficient time within this small-scale study to conduct interviews or focus groups with female users of
services to ascertain their views on male participation, however this would be a useful additional exercise to
undertake.
29 See Pringle K (1995) Men, Masculinities and Social Welfare, UCL Press, for further exploration of gender roles in
social welfare organisations.
30 Ruxton S (2004) Gender Equality and Men: Learning from Practice, Oxfam GB
31 Davidson K, Daly T, Arber S (2003) ‘Older Men, Social Integration and Organisational Activities’, Social Policy and
Society 2, (2), 81-89.
32 Ghate D, Shaw C, Hazel N (ibid)
33 O’Brien M (2005) Shared caring: bringing fathers into the frame, Equal Opportunities Commission
34 Davidson K, Daly T, Arber S, ‘Exploring the Social Worlds of Older Men’, in Arber S, Davidson K, Ginn J (2003)
Gender and Ageing: Changing Roles and Relationships, OUP
35 Calasanti T, ‘Masculinities and Care Work in Old Age’ in Arber S, Davidson K, Ginn J (2003) Gender and Ageing:
Changing Roles and Relationships, OUP
36 Bennett K, Smith P, Hughes G (2002) Older Widow(er)s: Bereavement and Gender Effects on Lifestyle and
Participation, Research Findings 6, University of Liverpool, ESRC Growing Older Programme
37 For example, the North Tyneside Active Age Programme runs two Tai Chi classes; of the c50 people attending each
group, 5 or under are men.
38 Hobbs A (2003) Men’s Health Project Preston, Interim Evaluation Report and Turnbull G (2004) Preston Men’s
Health Project, Evaluation Report
39 Age Concern/National Consumer Council (2006) ‘As fit as butchers’ dogs?’: A report on healthy lifestyle choice and
older people
40 Unnamed here as this information came second-hand from another Age Concern, rather than the service directly
concerned.
41 Arber S, Davidson K (2003) Older Men: Their Social Worlds and Healthy Lifestyles, University of Surrey, ESRC
Growing Older Programme
42 Anonymised to protect confidentiality
43 Connell R (1995) Masculinities, Cambridge: Polity Press
44 Gradman T, ‘Masculine Identity from Work to Retirement’, in Thompson E (ed.) (1994) Older Men’s Lives, Sage
45 O’Shea M, presentation on Dingle Peninsula Men’s Action Group, in National Council on Ageing and Older People
(2004) The Role and Future Development of Day Services for Older People in Ireland
46 Email from Lorna Easterbrook, 16/10/05
47 Cameron C, Moss P, Owen C (1999) Men in the Nursery, London: Paul Chapman Publishing
48 Davidson K, Daly T, Arber S (2003) ‘Older men, social integration and organisational activities’, Social Policy and
Society 2(2)
49 The AC Bromley HOur Bank Art Group is also working with the Dulwich Picture Gallery.
50 Bullock K (2005) ‘Grandfathers and the impact of raising grandchildren’, Journal of Sociology and Social Welfare
47
51 The Prostate Cancer Charity (2005) The Real Man’s Prostate Cancer Journey, First National Survey
52 The Prostate Cancer Charity (ibid.)
53 Age Concern/National Consumer Council (2006) ‘As fit as butchers’ dogs?’: A report on healthy lifestyle choice and
older people
54 Willcock K (2004) Journeys out of loneliness: the views of older homeless people, Help the Aged
55 12-18 June 2006
56 ‘A Sure Start to Later Life’: Ending Inequalities for Older People, Social Exclusion Unit Final Report, Office of the
Deputy Prime Minister, 2006
57 Welsh Consumer Council/Equal Opportunities Commission in Wales (2006) Gender Equality in Public Services:
Care for Older People
58 Parry J, Vegeris S, Hudson M, Barnes H, Taylor R (2004) Independent living in later life, Department for Work and
Pensions, Research Report 216
48
Appendix 1
Interviewees
Age Concerns
AC Blackburn –
Alison Hamer
AC Bromley –
Liz Kent
AC Camden –
Fraser Connell
AC Cheshire –
Ken Clemens, Jill Clough
AC Dudley –
Sally Huband
AC East Sussex –
Lesley Williams
AC Gateshead –
Val Jewitt, Betty Shepherdson
AC Tameside –
John Sheridan, Ian Williamson, Denise Bates
AC North Tyneside –
Nick Powell
AC Preston and South Ribble –
Lesley Farnworth
AC Southwark Black Elders –
Moji Coker
AC Surrey –
Gill Walker
AC Weoley Castle –
Andrew Vaughan
Age Concern England
Carolyn Robertson
Katharine Orellana
Su Ray
Stephen Lowe
Others
Dulwich Picture Gallery –
Susan Ghosh, Johanna Kociejowski
Father’s Direct –
David Bartlett
Men’s Health Forum –
Peter Baker
Surrey University –
Kate Davidson
UK Coalition on Older Homelessness –
Sarah Gorton
Well and Wise Camden –
Ian Bainbridge
Working With Men –
Trefor Lloyd
49
Appendix 2
Publications and Resources
Age Concern/National Consumer Council (2006) ‘As fit as butchers’ dogs?’: a Report
on Health Lifestyle Choice and Older People
Arber, S., Davidson,K. (2003) ‘Older Men: Their Social Worlds and Healthy Lifestyles’,
University of Surrey, ESRC Growing Older Programme
Bennett, K., Smith, P., Hughes, G. (2002) ‘Older Widow(er)s: Bereavement and
Gender Effects on Lifestyle and Participation’, Research Findings 6, University of
Liverpool, ESRC Growing Older Programme
Clarke, L., Roberts, C. (2003) ‘Grandparenthood: Its Meaning and Contribution to
Older People’s Lives’, Research Findings 22, ESRC Growing Older Programme
Davidson, K., Daly, T., Arber, S. (2003) ‘Older Men, Social Integration and
Organisational Activities’, Social Policy and Society 2, (2), 81-89
Davidson, K., Daly, T., Arber, S. ‘Exploring the Social worlds of Older Men’, in Arber,
S., Davidson, K., Ginn, J. (2003) ‘Gender and Ageing: Changing Roles and
Relationships’ , Open University Press
Thompson, E. (ed.) (1994) ‘Older Men’s Lives’, Sage
Welsh Consumer Council/Equal Opportunities Commission in Wales (2006) ‘Gender
Equality in Public Services: Care for Older People’
Willcock, K., (2004) ‘Journeys out of loneliness: the views of older homeless people’,
Help the Aged
50
Appendix 3
Organisations
Men’s Health Forum
The Men’s Health Forum’s mission is to provide an independent and authoritative
voice for male health and to tackle the issues affecting the health and well-being of
boys and men in England and Wales.
The Men’s Health Forum, founded in 1994, is an independent body that works with a
wide range of organisations and individuals to tackle this problem. Now well-
established with an active membership, the MHF works for the development of health
services that meet men’s needs and to enable men to change their risk-taking
behaviours.
The Men’s Health Forum, Tavistock House, Tavistock Square, London, WC1H 9HR
T: 020 7388 4449 www.menshealthforum.org.uk
Malehealth is an information service run by the Men’s Health Forum. Offering fast,
free independent information for the ‘man in the street’, it’s a good starting point for
men whatever the health query, and includes up-to-date sections on weight
problems, diet and related issues.
www.malehealth.co.uk
Father’s Direct
The Fathers Direct Network is a free UK network of people working with, and
interested in working with, fathers. The Network provides members with an online
database of other members and the services they offer, as well as a monthly email
newsletter and other listings of resources. Other Fathers Direct initiatives include
seminars and conferences, briefings and other publications, training and consultancy,
a monthly email newsletter and a quarterly magazine ‘FatherWork’.
Herald House, Lambs Passage, Bunhill Row, London, EC1Y 8TQ
General enquiries – T: 020 7920 9491 Training – T: 01873 858010
training@fathersdirect.com www.fathersdirect.com
51
Working with Men
WWM is a not-for-profit organisation that supports the development of work with men
through projects, resources, publications, training and consultancy. WWM have a
network of practitioners, trainers and consultants with substantial experience of
working with men (particularly young men), and publish a free monthly email
newsletter.
320 Commercial Way, London, SE15 1QN
Consultancy – T: 020 7732 9409 Resources – T: 020 8308 0709
tlloyd@workingwithmen.org www.workingwithmen.org.
Appendix 4
Age Concern England Reference Group
Graham Arnold –
London Regional Fieldwork Team
Claire Ball –
Research & Development Unit
Clive Newton –
Research & Development Unit
Simon Northmore –
Research & Development Unit
Katharine Orellana –
Research & Development Unit
Su Ray –
Policy Department
Carolyn Robertson –
Active Age Unit
52
www.ageconcern.org.uk
Research & Development Unit, Age Concern England, Astral House,
1286 London Road, London SW16 4ER.
Tel: 020 8765 7467 Email: lullyn.tavares@ace.org.uk
The Research & Development Unit is part of the Fieldwork Division of Age
Concern England. The Unit aims to influence the provision, quality, development
and range
of services/activities for older people who experience relative disadvantage.
Published by Age Concern Reports
Price £10 ISBN: 1-903629-45-4
Registered Charity No. 261794 168_0706 AC Services for Older Men / 1000
