Background to the Research

• User involvement and consumer choice have become key concepts in the planning and delivery of health and social services. In the changing culture of social care, advocacy has become an increasingly important mechanism through which people can influence policy and practice.
• Currently17% of the NI population is over 60 years of age and this group are major consumers of social care services. In 1999, the CCETSW commissioned Age Concern (NI) and VSB to compile a report of their experiences of working in the field of advocacy with older people.
  

Research Approach

• The report presents an overview of the concept and role of advocacy with older people in NI society. It goes on to profile the two organisations working in this area and outlines various projects undertaken by them. A number of older people involved in advocacy projects took part in a workshop and their views informed the structure of the report.
  

Main Findings

• Advocacy has many forms, professional advocacy includes legal and public advocacy; lay advocacy includes citizen advocacy and peer advocacy and self-advocacy which involves either an individual or a group of people.
• Various key players in the advocacy process include older people themselves, the advocate, the relatives and family carers, the service providers and advocacy providers.

Age Concern: North Down & Ards Community Care Consultation Project

• Age Concern used a self-advocacy model in which they worked with UCHT and the older people of North Down & Ards in order to raise awareness of, and access to, services available within the Trust.
• The project also sought to keep older people and their carers informed of their rights in relation to services and to act as representatives of older people in the design and delivery of services provided by the Trust.

Help the Aged: Regional Independent Advocacy Project

• Help the Aged used a citizen and crisis advocacy (paid) and self-advocacy model in partnership with 4 HSSBs, DHSS, CrestaCare, CAB,VSB and the Law Centre. The project sought to identify older people/carers who had problems contributing to the care decisions made on their behalf and to advise and inform older people/carers of the existing services.
• The project also sought to provide an independent advocate to act with or on the person's behalf.

VSB: Independent Representation Service Advocacy Project

• VSB used a 'composite model' combining professional, citizen, crisis and self-advocacy. The project sought to ensure the needs of service users were represented in relation to the closure or change of use of statutory residential or day-care facilities in the EHSSB area.
• The project also sought to empower users and carers and to ensure that they were not socially excluded or marginalized.

VSB and Help the Aged: Advocacy in Care Project

• The organisations used a Citizen and Peer Advocacy model in order to provide an advocacy service for older people within residential or nursing home care- particularly where they had no relatives or regular visitors.
• The project sought to train older volunteers to identify vulnerable older people in a care setting who had little or no contact with relatives and to ensure their wishes and needs were being voiced.

Conclusions

• Advocacy work is still at the developmental stage and there is no agreed model or definition of advocacy.
• Older people have been disadvantaged by the absence of legislation to protect their rights and organisations concerns with the rights of older people should campaign for legislation to protect the rights of older people.
• Advocacy services should be readily available to older people in order that they can achieve a good quality of life and be active citizens.
• The statutory sector should consider committing itself to the development of advocacy at a strategic level. Projects that involve volunteers should be properly resourced and not viewed as a cheaper option.