Every so often, Eamon O’Shea will find himself lingering over family photographs taken many Christmases ago at home in Salthill, when the children were still young, and his mother Mai was visiting from Cloughjordan, Co Tipperary. She had dementia then. They all knew it. O’Shea is perhaps best known in Irish public life as a brilliant and soulful hurling coach. But his professional life, as a Professor in the University of Galway’s School of Business and Economics, has revolved around the study of gerontology and, specifically, the policy and practice of how Irish society should deal with dementia. When his mother developed the condition, the theoretical and the data became blurred by the personal. Witnessing the bleak power of dementia quickly stripped away the weaponry and detachment of academia.
“Because you were sitting down in an office here trying to make sense of the literature and public policy, and there was no connection,” he explains one morning over coffee close to his home. In Galway, the leaves are already falling, the city signal for a new college term.
“The human dimension was overriding. You were not an academic. You were not a researcher. You were a son.”
While dementia is a common and devastating affliction, it remains veiled in a mysteriousness that defies medicine. And after his mother died, O’Shea still finds himself wondering about what that decade in dementia was like for her.
“And I look intensely at her eyes in those photos,” O’Shea says.
“Photos where she is just sitting there, and things are going on around her. And the kids are climbing around the place. And I remember taking her to Mass then and to rituals that she was well able for. But when I look at the eyes now, I wonder: how much of what was going on was assimilated or processed? But then I wonder, too: did any of this matter – if she was in an environment where she felt safe, loved, warmed, whatever human dimensions that families give. What a… I mean, can we do anything better?”
That question has been central to his academic pursuit. In a way, it mirrors the message he tried to impart on hurling fields. O’Shea is not a typical anything, but in energy and empathy he stands a far remove from the archetypal economist. He can quote the stuff and the numbers. But when he sifts through his life work, he frequently turns to the personal. One story: he was visiting a residential care unit years ago and was just about to be interviewed on a radio show. As he sat waiting to be brought into studio, one of the residents wandered along, sat down beside him, and looked searchingly at O’Shea, who offered a friendly hello. No reply came back. But the man kept staring. And O’Shea was distracted by the thought of his imminent radio interview. The man kept looking at him. It was a communication of sorts.
“And I tried to stop thinking about the flipping radio thing and said to myself: so, let’s practice personhood, Eamon, here for a while. And I remember being so kind of agitated, myself, afterwards, saying: Did you give that person enough time? Like, how did he actually feel? So, we know, he couldn’t say for sure he met me, but how do you actually feel after meeting me? And that’s one of the things that I’ve learned. I’ve learned that trading your time is a really important part. So even within family situations, having to listen to the same story, it’s very difficult having to make these allowances, but it’s part of the search for that patch of whatever you feel is the essence of the relationship you had.”
I don’t think you can look at dementia as coldly as an economist like me sometimes would
O’Shea will retire from the University of Galway at the end of this year. He delivers this lightly and with a cheerful laugh, as though nothing could be less consequential. But it’s also an acknowledgment that time moves at the speed of light. He retains the panther’s stride of his hurling background. His days have been defined by radically different experiences: university terms working on enhancing our comprehension of a national policy framework to deal with dementia, and his spare time devoted to coaching hurlers in the athletic prime of their lives.
It is thought that about 65,000 people are living with dementia in Ireland right now. That figure is projected to exceed 150,000 by 2045. Each of those people will require at least two carers, and so suddenly, a quarter of a million people are directly involved in a coping strategy. And when you include family members of dementia sufferers, O’Shea reasons, “the number of people being touched by this is huge”.
His research into dementia had begun years before it visited the family home. He was at the University of York in the mid-1980s completing a master’s in neoclassical economics and became influenced by a series of studies on ageing. When he returned to Ireland, he realised that he wanted to apply economics to gerontology. It was an exercise in perseverance and patience. In 1999, he co-authored, with Siobhan O’Reilly, a significant report, An Action Plan for Dementia. “Very little happened on that report,” he says now. “The hope was that it would take flight. It really didn’t. In the 1990s, we were the youngest population in the world. We were on the move. So, there wasn’t a pressure then, as there was in places like Italy and Germany.”
The decades since then have led to a series of green shoots. The Atlantic Philanthropies provided grassroots funding, which sparked political awareness and the formation of the National Dementia Strategy in 2010. “I’m not sure anyone knew what that meant then! But at least it got put on the agenda.” And it brought the political thinking closer to the place O’Shea believes society needs to arrive at when it comes for caring with those with dementia.
“I don’t think you can look at dementia as coldly as an economist like me sometimes would. There is a philosophical value-laden framework you had to think about. It had two concepts: Personhood and Citizenship. If you take those seriously, they become critical. If you think about this unravelling within the person, how then do you deal with the normal things? How do we want our services to respond formally to ensure the notion of the self and identity is protected? Because we potentially all have the potential to stigmatise in our mild way.”
You end up becoming your parents. It is sad – but it is true. You just have to accept it. And it is interesting how that is handed down
O’Shea grew up in the heart of the Tipp’ countryside during decades when the county hurling team walked the divine line between everyday and mythical. Hurling days pepper his memories of growing up. But it’s not the games. What comes to mind is more select. Leaning forward in his chair, he brings to life the Sunday noontimes when the family awaited the return of his father Ned, who worked as a farm labourer. They always seemed to be chasing off to see his older brother Liam play for the club when his father returned. “We would have his good clothes ready for him. And it was regimental. He’d have 15 minutes to eat and change and we’d be gone.”
Later, when O’Shea played for a Tipperary U-21 team that won an All-Ireland title, he used to travel down for midweek games from UCD. He’d often arrive at the train station in Thurles two hours before the game. Not a sinner around. But always, his parents parked and waiting. The details of the games have long faded into insignificance – again, for an economist, O’Shea cares little for the data of old score lines. But he can still see his parents in that car. What he is talking about here is, of course, memory.
“In 20 years’ time you will think of your parents quite a bit as you get older,” he warns.
“It is a funny thing,” he continues, starting to laugh.
“You end up becoming your parents. It is sad – but it is true. You just have to accept it. And it is interesting how that is handed down. The mannerisms. ‘Your grandfather used to say that!’ That is why it is so personal when the memory starts to go. Because you have so many of these bloody memories.”
I would always think that being at ‘home’ is the first place for someone with dementia. Or whatever you think of as home
He was lured into hurling coaching at the elite level relatively late, when Liam Sheedy tapped into his reputation as a visionary coach. (“My mind was blown every time I spoke with him,” Lar Corbett, the decorated Tipp’ forward, wrote in his biography). So, O’Shea began to make the twice and thrice weekly drives from Salthill to Thurles, always a melancholy spin through the stoic country towns. It’s a route that defies modernisation. For motorists, it’s a nightmare. For returning sons, it’s a portal.
“When I cross the bridge from Portumna into Tipperary, I am in a different place,” he says.
“They just come from… everywhere. It is interesting and it certainly is a magical thing. That journey is a bloody nightmare for people. But I’ve always liked it. The coming and the going. So, I never simply ‘drive through’ Tipperary. It is the home place. I never take that for granted. So, with dementia, this process of place and attachment and autonomy, that sense of place is really important. And I would always think that being at ‘home’ is the first place for someone with dementia. Or whatever you think of as home.”
His mother lived at home for most of her 10 years with the condition, cared for by her husband Ned until he died and living independently until the final few years, with the close support of her daughters, Emby and Ann. Her last years were spent in a nursing home. When O’Shea visited her during those years, he might have taken her to Lough Derg for a drive and for a coffee before they’d return to the home. Most outings were fine and enjoyable. But once in a while, his mother would become confused when they arrived back. She’d ask him where they were and he’d say: “We’re back now, you are home.” And his mother would say: “No… But I want to go home.” And they’d deal with it. And he’d wait until his mother was settled and happy and he’d sit in the car for a minute or two to deal with the torrent of emotions running through his mind.
“And I’d think: ‘This… is tricky.’”
He still remembers characters from his youth around the town who would have been considered a bit eccentric. “They’d be inclined to wander.” And, of course, now, he recognises the symptoms. Nobody used the word “dementia” then – O’Shea himself can’t recall it being in the vernacular before the mid-90s. What was at play, in Cloughjordan and towns all over Ireland, was a kind of informal community care. If someone got “confused” they were brought home. It was the same when someone “took to the bed” for a period of time, a catch-all phrase for what was almost certainly depression undiagnosed.
“I didn’t understand it, but when I heard it, it seemed the most natural thing to do. ‘He took to the bed.’ And it was kind of said in a sympathetic or understanding way. Because the same as with dementia, what other services were there? The dramatic intervention was the psychiatric hospital, or for older people, the county home. And these were not welcoming places. I can remember that it was almost threatened on you. So, you did what you could to avoid the last resort.”
Much of O’Shea’s academic life has revolved around moving away from that last resort and nudging Irish society towards a framework which safeguards the dignity of those afflicted with dementia. Much of the community instinct, he believes, was correct. If someone loves classical music, he argues, bring them to a concert even if they aren’t sure where they are. Or a hurling match. They may not recognise the colours or understand the game any more. But they might absorb some vital energy.
“A sensation. The atmosphere. A feeling. I’d rather bet on that than the opposite, Same with music. It is reminiscence therapy. And you allow people to talk even if you have heard the story before. You’ve also often heard the same story from people who don’t have dementia. I could tell you a story about a match and you’d think, ‘Oh, he’s told me that story before!’ We are all guilty a little bit.”
The advancement in the understanding of dementia has improved dramatically since O’Shea published that 1999 report. New home care legislation passed within the last five years has emphasised the importance of the personal and of communication. The Capacities Act, designed to allow people with incapacity to retain independent decision-making in so far as possible, is another breakthrough. The National Dementia Office has published a plan for the next steps.
The immediate priority, O’Shea believes, is further legislation rooting the model of residential or nursing home care to the rights of the personal. Then, to put in place a buoyant funding mechanism, resistant to economic fluctuation. Then, to put in place a buoyant funding mechanism, resistant to economic fluctuation. The other task is to keep listening. In the latter years of his research he met Helen Rochford-Brennan, the Sligo activist living with dementia. After many conversations with her and others, he realised the academic belief that the solution could be found through data had its limits.
I am much richer than my parents, I know that. But I am also probably richer than my adult children, who can’t buy houses right now
“What they taught me was a lot of what I didn’t know or had to be reminded of, even though I had personal experience of dementia. They began to articulate directly what should be researched, what was needed. And that voice has definitely influenced me in how I now think about policy, and so on.”
O’Shea’s inherent optimism is part of his youthfulness. In general, he is in happy agreement with the street philosophy that companionship and friendships and exercise promote healthier later years. He laughs as he confesses to joining a gym in recent times. He was famously indifferent to the weights room as a hurling coach – it meant time away from ball and stickwork. But he has bowed to the wisdom of weight-bearing exercise. Often, he is the oldest person in the gym world of youth, vitality and mirrors.
“By a fair distance! So, you’re there thinking… I’m not going to succumb to thinking that I’m out of place. I am in place here. I move a little slower. But that’s okay! You just gotta get used to me!”
The concept of old-age – of gerontology – has flipped since O’Shea’s boyhood. Celebrities now redefine the physical possibilities of one’s 60s, 70s and 80s. That feeds into everyday life. The archetypal elderly people of 40 years ago, who looked older than time itself, have disappeared. Still though, Ireland is getting older. Occasionally in class, he reminds his students of that. And he warns too that as the years go on, the economy will require people to stay in the workforce for longer.
“Experience and knowledge mean you can attach yourself to the old virtues of ageing which is wisdom. Not as a guru. But there is a more important issue for society – the nature of the intergenerational contract. If that is not rock solid, as in: ‘When I am young, I pay taxes to support people who are older’ – what [academic and author] Michael Ignatieff called the ‘intimacy of strangers’... Older wealth and younger poverty are certainly true. I am much richer than my parents, I know that. But I am also probably richer than my adult children, who can’t buy houses right now. So, we need to be aware that that glue is essential, and it may require sacrifices to redistribute that wealth. And there is another dimension also. And it’s this: What can I bring to the party as I get older that is different to when I was younger? What is it that I can do?”
It’s not a bad question to carry with you.