Where are all the blokes? Services need strategies to reach older men

Providers of community care and day therapy centres need to consider the range of services they offer, and the language and imagery used to promote them, in order to reach out to older men who continue to access services far less than women.

Dr Anthony Brown, Adjunct Fellow at the Men’s Health Information and Resource Centre, University of Western Sydney, said that older men typically valued outdoor activities and those outside the home, yet many home care services were perceived as providing domestic assistance and other tasks that this generation of men considered to be the domain of women.

“Even the term ‘home care’ can be problematic in that sense,” Dr Brown said.

Dr Brown will tell the upcoming Council on the Ageing (COTA) National Policy Forum that community care providers and operators of day therapy centres need to carefully consider the range of services and activities they provide, and the language and imagery they use in promotional material, as many older men were either unaware of the services, did not perceive the services as being targeted to them, or saw them as highly feminised.

In a 2009 study conducted for the NSW Department of Human Services, Dr Brown and colleagues found that both older men and HACC staff identified many of the same barriers to older men using services more frequently.

“A big issue was just knowing the services existed, many older men didn’t know they were available to them,” Dr Brown told Community Care Review on Thursday, as Australia marked Men’s Health Week.

There was also a perception among older men that community services were feminised, and this was particularly true of day therapy services and home care. While home care provided important services, these were often framed around activities that had traditionally been associated with women’s work, such as domestic assistance, he said.

“Even though those elements of service are an important aspect of care and self-management, they’re not always on the bloke’s radar; they’re not prioritised as much by the older men as by women,” said Dr Brown.

The study was conducted as the department had identified the concerning gender difference in the usage of its services. More recent data shows that older men still use services disproportionately less than older women. Older women make up 70 per cent of home support clients, while they outnumber men at a rate of almost two to one as clients of home care, 2013 data from the Australian Institute of Health and Welfare shows.

Independence versus care

Older men interviewed by Dr Brown reported issues around valuing their independence and self-reliance, which he said was common among the older cohort, as “not relying on charity was a cultural norm instilled in childhood.”

The services interviewed by Dr Brown had tended to use what he called “a language of care, rather than a language of independence.” While services spoke of providing clients with ‘independence’ they were typically referring to the provision of care in order to help clients maintain independence at home. However, older men perceived this as a contradiction; how could one receive help, and be considered independent, they asked.

Dr Brown said:

“I think that contradiction is at the heart of lot of the language services use, because they’re set up with the values of independence but they’re talking a language of care.”

Further, the services’ promotional material often did not include images of older men, and where they did the men were depicted as frail, passive recipient of services. “That might reflect the reality, but I don’t think anyone likes to perceive themselves as the passive recipients of services,” said Dr Brown.

Services interviewed echoed many of the comments of older men, especially regarding perceptions of day therapy centres and uptake of their services. “They were reporting that activities were female dominated. Most of the staff were women, most of the clients were women, and that becomes a barrier for men seeing it as relevant for them.”

Personalised, short-term interventions

In his 2009 report to the NSW department Dr Brown recommended that more personalised services tailored to the individual could help address the concerns of older men. To that end, he agreed that the current roll out of CDC could, in theory, improve the uptake of services among men, but he said this would ultimately depend on how services were implemented on the ground.

He also suggested that services could stress the short-term nature of their programs or interventions, so older men would perceive them as aiding rather than compromising their long-term independence.

Services that had successfully engaged older men had used less formal activities, often involving the outdoors or places where men had traditionally socialised, such as in pubs or clubs, he said.

The COTA National Policy Forum 2015, focusing on gender and ageing, takes place on 2 July at the National Press Club.

Australian Ageing Agenda is the forum media partner.