‘At the end of the day’ is an overused idiom by football players to preface their final verdict of the game, won or lost. You will hear it too as a recurring refrain of the oppressed in the musical Les Misérables.

At the end of the day it’s another day over1

There is a final ‘At the end of the day’ awaiting us all. Countdown signals of our mortality sound at various pitches throughout the humdrum of life. Last summer I was compiling a ‘This is your life’ book to mark my mother’s 90th birthday. The process of choosing preloved family photos to celebrate her decades of living and loving proved also to be a sobering reminder of the milestones of my own life. When the shadow of death falls on young lives, it sends countdown signals of shock into my soul, awakening me to the reality of once anticipated longevity of life now suddenly foreshortened. Atul Gawande, in his recent book, Being Mortal: Medicine and What Matters in the End, poses questions (more often asked by older people) about how we can age with self-respect and dignity, make meaning of our lives, prepare for the ‘end of the day’ and die with grace.2

The therapeutic needs of older people are often overlooked. Despite evidence by NHS England showing that over-65s are more likely to complete IAPT treatment and have better outcomes than those under 65,3 a recent Ipsos / Mori poll indicated that older people with symptoms of anxiety and depression are much more likely to be prescribed medication than signposted to psychological treatment. In October 2017, in an effort to address the lack of a holistic approach to the needs of older people, BACP hosted a roundtable meeting, with leading charities and professional bodies in attendance. They agreed to work collaboratively to promote positive images of older people, raise awareness about their mental health issues, and call for action to meet their needs. One of the needs of older people is to have their spirituality taken more seriously when addressing their mental health issues. Spirituality matters enormously to a great many older people and this need is being raised by our division to ensure that the type of therapeutic support being promoted within BACP’s new older people’s strategy takes this into account. The aims of this strategy have been summarised by Judy Stafford from BACP Healthcare, in the acronym, CARE:

  • Campaign to challenge negative stereotypes, raise awareness of mental health issues, and promote a fulfilling later life, free from depression and anxiety
  • Access and influence policy-makers across the UK to prioritise older people’s mental health, and increase their understanding of the critical role that BACP members can play
  • Review and disseminate the current evidence on the efficacy of therapies, as well as carrying out new research
  • Engage BACP members to share good practice and develop further training and support to increase their work with older people.4

BACP Spirituality division would welcome contact from members with experience of working with older people, particularly about how spirituality has been an important feature and/or resource in the work. If you would like any further information about the strategy or wish to suggest ideas for a research project, you can also contact me or Jeremy Bacon, BACP’s new Older People Lead (jeremy.bacon@bacp.co.uk).

BACP’s new website is now up and running and will enable a much more interactive relationship to develop over time between BACP members, BACP staff and the public. BACP is also keen to support the forming and flourishing of local peer-led spirituality network groups, so if you would like to volunteer to co-ordinate one in your area, please contact Pam Ludlow, BACP’s volunteers
manager, at: pam.ludlow@bacp.co.uk

A final thought: at the end of the day there’s another day dawning.1 May you enter it in hope – with a spring in your step.

Maureen Slattery-Marsh is Chair of BACP Spirituality. To contact Maureen, please email spirituality@bacp.co.uk


1. Kretzmer H. English lyrics from Les Misérables. Original text by Alain Boublil and Claude-Michel Schönberg.
2. Gawande, A. Being Mortal: Medicine and what matters in the end. London: Profile Books; 2014.
3. NHS England. Adult Improving Access to Psychological Therapies programme: older people. [Online.] NHS England. https://www.england.nhs.uk/mental-health/adults/iapt/older-people/ (accessed 14 February 2018).
4. Stafford, J. New Year, New Initiative. Healthcare Journal, January 2018, Vol 1 8 No 1, page 7.