On Mortality

Photo credit: Tim Llewellyn

'Everywhere I see the mistake of ignoring that people have priorities in their lives besides merely surviving another day. Even in severe illness or frailty, people desire connections to others and to purposes of their own choosing.'

[from BBC Reith Lecture 4: The Idea of Wellbeing].

Dr Atul Gawande's BBC Reith Lectures 2014 on 'The Future of Medicine' have been compelling to listen to.Atul Gawande is a surgeon, writer, and public health researcher. The lectures explore the many challenges and complexities of modern medicine - outlining the limits to what medicine can do, the role of healthcare professionals, and providing insights into what is needed to improve health and healthcare systems. 

Particularly gripping are the stories about some of the people that he describes as part of illuminating specific issues and concerns. The little girl who is trapped under the ice and Peg, his daughter's piano teacher who becomes terminally ill remain vividly in my mind.

Charlotte Higgins writing in The Guardian about the Reith Lectures ('Just close your eyes and listen') comments that they are perfect for their form as podcasts. 

'Why would you want to see the Reith lectures on television? The only way we can visualise the little girl trapped under the ice, her discovery, the ambulance, the CPR by the water’s edge, the theatre, the surgeon’s cut through her chest, is through the imagination.'

It is also fascinating to hear about India and the context of healthcare - how healthcare is changing, the advances that have been made and continue to be made.  

Inspired by the lecture series, I read Atul Gawande's latest book Being Mortal – Illness, Medicine and What Matters in the End.

Previously, I worked as part of the KT-EQUAL research programme - which focused on improving the quality of life of older and disabled people. KT-EQUAL's emphasis on valuing older people and their needs and wishes formed an integral part of developments. One of the recurring themes was to counter the problematising of older age and to consider ways that ageing and health can be improved. 

Both the lectures and this book explore what it means to age and what is needed in later life. Atul Gawande acknowledges advances that have been made and that 'people live longer and better than at any other time in history' but also that ageing and dying represent challenges for medicine. 

In considering conditions and treatment options, he describes the benefits of using an approach which draws from palliative care:

‘Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: 

• What is your understanding of the situation and its potential outcomes? 
• What are your fears and what are your hopes? 
• What are the trade-offs you are willing to make and not willing to make? 
• And what is the course of action that best serves this understanding? 

He emphasizes that this is about having the conversation and not about a tickbox approach to the questions. 

The lectures and the book left me with a sense of hope - hope that even in the most challenging of circumstances people can be enabled to live their lives as meaningfully as possible.

Links: 

BBC Reith Lectures 2014

Atul Gawande's website

Being Mortal - Illness, Medicine and What Matters in the End

'Just close your eyes and listen' article

Interesting comments and useful history of end of life care

Written by S. Bangar

Gail Mountain presents on knowledge transfer relating to KT-EQUAL

Professor Gail Mountain was one of the presenters of a seminar convened by AgeUK on creating impact at the British Society of Gerontology Annual Conference, titled "Global Ageing: Implications for Individuals and Societies".  Gail spoke about the learning that came out of KT-EQUAL, a consortium of UK researchers dedicated to extending quality life for older and disabled people.  Other speakers included John Beard from the World Health Organisation (WHO) and Paul Cann from AgeUK Oxford. There was standing room only for this popular event.

Gail Mountain was also keynote speaker at the launch of the Ageing and Assisted living network, University of Essex on 17th September.  The audience of over 100 included academics, health and social care practitioners and commissioners, members of the lay public, service users and industry.

Age UK’s “Improving Later Life. Understanding the Oldest Old” report available

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Age UK has put together a report focussing on the lives of people over 85, bringing together international expert opinion to discuss challenges and issues faced along with the opportunities encountered and outlook on life taken by this population.

The RAT group’s Professor Gail Mountain is amongst the experts providing opinion and discussing research evidence on the life and health of the oldest old. Her key messages, as identified in the report, are based on previous and current research, including work done within the KT-Equal consortium and PLINY (Putting Life IN Years):

·      “Current assumptions and preconceptions about the inability of the oldest old to use the latest technology need to be challenged – everyone can use technology if they are adequately and consistently supported to do so.

·      As technology develops, even the oldest of us are beginning to use `mainstream’ devices, possibly reducing the need for specialist telecare products in the future”

Improving Later Life. Understanding the Oldest Old, p80

The full report is available to download here on the Age UK website.

Upcoming event: KT-equal workshops on Issues and Perspectives on Digital Technologies and Care

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Tues 9 April 2013, 12.00pm - 16.15pm, Manchester Metropolitan University Business School

Tues 16 April 2013, 13.00pm - 17.00pm, Resource for London, 356 Holloway Road, London, N7 6PA

You are warmly invited to attend these workshop events organised by KT-Equal, a national consortium of UK researchers dedicated to improving quality life for older and disabled people, including RAT group members. The workshop will explore changes, challenges and opportunities associated with new digital technologies for care. Research aimed at improving the lives of older and disabled people has produced a wide range of digital applications designed to help maintain independence in later life.   Examples include on-line digital services, caseload management, and easy communication between service users as well as across service providers.

The workshop aims to:

• Understand the new community care landscape that increasingly incorporates digital technologies 
• Share perspectives across stakeholders  
• Widen the knowledge of issues around innovation of care through use of digital technologies 
• Make new contacts

This workshop has been designed to appeal to practitioners, researchers and care providers (including voluntary organizations and small enterprises) and anyone with an interest in digital technologies for care.

There are two dates offered for this workshop which is being organised as a partnership which includes Manchester Metropolitan University Business School, School of Health and Related Research at the University of Sheffield and KT-EQUAL.

Free to attend with lunch and refreshments included.

For further details and to book:

Tues 9 April 2013: http://mcr9apr13.eventbrite.co.uk 

Tues 16 April 2013: http://ldn16apr13.eventbrite.co.uk

[written by Surinder Bangar]

Occupational therapy event gets Royal seal of approval

Leading researchers from across the UK and North America will gather in London tomorrow to discuss ways of meeting the challenges of an ageing population — in an event hosted by KT-EQUAL.

The Princess Royal, HRH Princess Anne, will introduce the event at the College of Occupational Therapistshttp://www.cot.co.uk/, where she is Patron.

The aim of the event is to exchange expertise between researchers and practitioners so that research findings can begin to be put into practice. So, alongside experts in ageing research, the summit will also include policymakers and professionals from the fields of health and social care.
Key discussion points will include:

• how to improve the design of outdoor spaces for older people, for instance by influencing planning and building regulations
• how to design the built environment to meet the needs of all members of society including older and disabled people
• how to improve the reach of inclusive design in products and in the home
• how best to challenge stereotypes about ageing in wider society

Speakers at the event include the RAT group's Professor Gail Mountain, who has a background in occupational therapy. Gail is also Principal Director of KT-EQUAL.

[Written by Toby Wardman on behalf of KT-EQUAL]

Technology & Ageing photo exhibition tours UK parliaments

A major photography exhibition which challenges preconceptions about older people and technology is touring the UK parliaments.

The exhibition features winning images from a UK-wide competition launched in 2011 by KT-EQUAL, a research consortium dedicated to extending quality life for older people, and Age UK with its partners Age NI, Age Cymru and Age Scotland.

Entitled ‘Left to our own devices’, the original competition ran from October to January and attracted hundreds of entries from both amateur and professional photographers.

Gadgets and gizmos:  © Ian Hinchliffe

A panel of expert judges selected 12 winning images, not just for their photographic merit but for the way they challenged stereotypes related to the central theme of older people's experiences with technology.

The winning images are grouped in four categories, each commenting on a particular area of experience:

• Gadgets and Gizmos: Do today’s devices work for older people? Do they live up to their promise?
• In the Home: How can technology help with the challenges of daily life? Does it help fight loneliness and isolation – or does it perpetuate it?
• Out and About: Can technology help older people to maintain independence for longer?
• an open category

Gail Mountain, Professor of Health Services Research at the University of Sheffield and director of the KT-EQUAL consortium, said:

Out and about: © Vu Duc Loc Tho

“The judges looked at hundreds of great entries from all over the country. We’ve ended up with twelve images that tell fascinating stories about older people and the devices they interact with.

“My hope is that these images prompt everyone – but especially politicians and those who design gadgets – to re-examine their preconceptions, and think about the role that technology plays in all our lives.”

Professor James Goodwin, Head of Research at Age UK, said:

“This competition is valuable because it highlights the potential of technology in this fast-moving world to enhance the lives of older people. It also shows that technological solutions can be life-changing even when they are very simple.”

The exhibition’s appearance in the Parliament Buildings in Stormont, Northern Ireland, marked the first time the winning images have been viewed by the public. The images have also been presented in the Scottish Parliament and the Welsh Assembly, and will finish with a major reception in Westminster in June 2012.

For more details

·         For media enquiries, print copies of the winning images, and photos from the events, contact: Toby Wardman, KT-EQUAL Communications Officer, toby@40k.org.uk