Second opinion: Sure, we all know what ageing is, don’t we?
Irish research on ageing is getting the prominence it deserves overseas
Kevin Molloy, John Walsh and Mai Quaid at the Earn Our Vote launch; they hope older voters’ concerns will be on the agenda. Photograph: Leon Farrell/Photocall Ireland
One of the greatest challenges for us as we age is “bar-stool gerontology”. For many complex subjects – nuclear physics, molecular biology or philosophy – most of us recognise that some learning and education are required to grasp their fundamentals.
Yet, despite the fact that we are at our most complex in later life, it remains acceptable to ignore advances in research on ageing, presumably on the basis of “sure, we all know what ageing is”. Within the health services, it is troubling in 2016 that nursing homes are being designed and rehabilitation services developed without gerontological expertise.
A staggering example of this gerontological illiteracy was the recent pronouncement by the head of acute services in the National Health Service (NHS) in the UK that “loneliness was driving older people into emergency departments”. While loneliness is related to health, study after study shows that older people are much more likely to have an appropriate reason for attending emergency departments than younger people.
Against this background, it is good to report a flowering of research into ageing in Ireland, which hopefully will one day be recognised as a critical success factor for developing age-attuned services. To quote Bernard Isaacs, if you design for the old, you include the young, if you design for the young, you exclude the old.
Two recent conferences, one wide- ranging, the other boutique and focused, brought home the importance and relevance of this research.
The first, the Gerontological Society of America, was held without a trace of irony in the Disneyland Hotel in Florida. The largest scientific meeting of its kind in the world, it covers ageing from molecular aspects of cell ageing to the philosophy of wisdom.
Research from Dublin, Cork and Galway, as well as from Irish researchers in the UK and US, was given prominence. From Dublin there were presentations on older drivers, arts and ageing, and the longevity dividend. Self-neglect, dementia and end-of-life care were the topics presented from Cork. A very thought- provoking paper was delivered by Áine ní Léine, from the Irish Centre for Social Gerontology in Galway, on the hazards of extending the retirement age for vulnerable groups, including women, the low-paid and carers.
An interesting aside was the presence of a reporter from the Irish Echo, Peter McDermott, on a programme funded by Atlantic Philanthropies to acquaint reporters with the subtleties of ageing. His report was a model for engaging the public with research in ageing: Irish reporters might benefit from a similar initiative to ensure that they “get” ageing.
Two weeks later in Beijing, I was the Irish participant among a group of 25 researchers who are continuously developing an exciting project in the care of older people. This is the interRAI, a way of developing a universal language to describe the strengths and disabilities of older people in a manner that can be understood across a range of care settings, from home to hospital to nursing home.
It may seem astonishing to lay people that healthcare workers up to now did not have a common set of parameters to describe problems with gait, balance, continence or cognition, but that was a measure of the casual approach to the complexity of ageing.
The good news is that Ireland has adopted the interRAI as the single assessment tool for older people, in the first instance to measure need in terms of home care packages and nursing home care. This will be rolled out more widely in other care settings.
In so doing, Ireland has not only signed up to a more reliable and scientific way of caring for older people, but also joins a not-for-profit coalition of more than 30 countries that allows for international comparisons and also further research into the best way to care for older people with age-related disease and disability.
If you too would like to develop more insight into the wonders of ageing and ways to promote wellbeing, you might enrol in Ireland’s first massive open online course on ageing which opened this week.
Although one might quibble with the title (“optimal” is preferred to “successful” as the most desirable form of ageing among gerontologists), the content is approachable and insightful, and will help you move from bar-stool gerontology to a more critical and positive perspective on ageing.
Prof Des O’Neill is a geriatrician and an educator on the Trinity College Dublin Massive Open Online Course (Mooc) on ageing. For more: futurelearn.com/courses/successful-ageing