Emerald Group Publishing Limited
Copyright © 2011, Emerald Group Publishing Limited
Article Type: Editorial From: Quality in Ageing and Older Adults, Volume 12, Issue 3
Having lived in the city of Chester in the UK for more than 15 years, I have certainly seen and heard enough street theatre to become an astute judge of performance “quality”. More recently, there has been a bout of young teenage groups – guitars and drums – with a popular following of peers […] and mums and dads of course. But the real quality comes from an older generation of buskers who, I reckon, as part of the boomer generation did exactly the same playing in pubs and clubs in their own youth. And now they are on the streets! One aged local entertainer sings, play guitar and harmonica for hours standing up, another produces sounds like a full rock band – even if he is seated comfortably, and a jazz duo in their seventies (piano and keyboards) turn heads even from the younger generation with the quality of their musicianship.
There is a danger in treating such activity as evidence of “youthfulness” as if the appearance and activity of “youth” sets a standard for us all. The standards all of us need to measure ourselves by include health and quality of life. And this older generation is displaying its ability to maintain standards in diverse ways. My “old boys” school football team had a former pupil playing into his eighties and I recently read of a 91-year-old competitive bodybuilder. The phasing out of the Default Retirement Age (65) in the UK is increasing recognition of the capacity for work in the older age groups, and people see continued employment as part of their quality lifestyle. Some major companies employ older people very effectively – I read that ASDA for example employ more than 1,000 people over the age of 70 and have one checkout employee who is 82.
Of course, not all members of this ageing cohort are out busking or still in full time employment. There are those who are suffering increasingly psychologically as they age and Dan Robotham’s paper examines the implications for the ageing baby boom generation upon mental health policy, practices and services in the UK. The commonest health problems for older age categories are depression and dementia. Robotham surveys the key influences on the lifestyles of the boom cohort – profound cultural and structural changes that affect how they act as an ageing generation. Major service changes run parallel with greater mental health problems for the boomer older generation. Robotham then surveys the sets of influences that might have lead to boomers suffering more mental health problems than previous generations. On the face of it, this generation have had advantages in material and physical wellbeing over previous generations, but wealth disparities and longevity can produce mental health outcomes that are by no means cut and dried. Dan Robotham’s piece should provoke further studies of the key influence upon the mental health of this influential generation.
Peter Gilbert here offers a stimulating survey of various views of spirituality in relation to dying and death. The rationale for this exploration is not only in a larger ageing population, but one which is also increasingly culturally diverse – and this too is a global phenomenon. In the face of so many challenges to our cultural and communal sense of identity, it is enlightening to learn from the many sources Peter Gilbert draws on to explore how we deal with this phase in our life course and still attempt to enhance the quality of the journey we take.
Although this global ageing population is unlikely to suffer the same proportion of health-related problem at the earlier stages of ageing, there is undoubtedly a need to consider the provision of care for the older old as economic recession bites, as the proportion of younger to older members of the population diminishes and as careers in caring continue to look less attractive with low pay and no progressive career structure to attract younger people. Martin Power and Mary Jo Lavelle have examined this situation in some depth in the Irish Republic. Noting how family dynamics and employment structures have changed so dramatically that informal family caring is less likely to be available, there are inevitable expectations of more formal care provisions for older people. Like the UK Government, the Irish Government has established legislation requiring the meeting of certain training standards and, while progress is slow in both the desire for and achievement of the necessary qualifications, there is a fear that, once qualified, many “professionalised” staff will be tempted toward emigration by relatively better working conditions in other countries. After all migration has a lengthy history in Ireland. The authors here consider the range of tensions around the improvement of the care workforce and conclude by stressing the vital importance of raising training and standards for the aged care workforce.
Poor training and low care standards are often reckoned to be part of the complex of causal factors behind the abuse of older people. This can be exacerbated in social environments of high poverty where the vulnerabilities of older adults can be amplified. Against this background, Ana João Santos, José Ferreira-Alves and Bridget Penhale have examined the extent of reported elder abuse in Portugal. Given this is only a recent field of research concern in Portugal, the studies that have taken place show that elder abuse appears to be more prevalent out in the community than in institutionalised care. Thus, suggesting that properly delivered formal care can be protective. Admittedly, this is a methodologically complex field of study and robust measurement devices hard to come by, but there is some evidence that women and older adults living alone, with poorer health perception, with fewer subsistence means, residing in an urban area and presenting lower cognitive ability and physical dependency are at higher risk of overall abuse. The authors make a clear case for developing this early research and for targeting emergent potential causal factors in protecting the more vulnerable members of society.
As policy develops to ensure best formal care – first in legislation and then implemented in practice – formal audit procedures become inevitable if the “best interests” of patients “lacking capacity” are to be safeguarded. Here, Oluwatoyin Sorinmade, Geraldine Strathdee, Catherine Wilson, Belinda Kessel and Obafemi Odesanya at the Oxleas NHS Foundation Trust in the UK honestly report the “scanty documentation” made by clinicians in the case records, opening them up to potential court challenges and, importantly, failing to demonstrate full consideration the patients’ needs. More importantly, the authors offer explanations for why this could occur and it is clear that there are some conflicts in the current UK legislation that pose dilemmas for clinicians. While practical steps can be taken and advice given to improve procedures, there are implications here for policymakers that deserve fuller attention.
We close this issue with pieces from Joe Mulvihill of the Mentoring and Befriending Association and from solicitor David Regan with advice about the abolition of the default retirement age in the UK. Joe Mulvihill summarises the range of types of befriending and the ways it improves the care of older people. In fact, many of the issues we have covered here could certainly be improved by more take-up of befriending opportunities – vulnerability is reduced and quality of life enhanced by contact with and support from a befriender. David Regan offers employers key professional advice for supporting older workers who wish to continue working as long as they can.
The evidence “on the street” is that even buskers are getting older – and at least they are self-employed posing no extra difficulties for employers. And I know we will have really made the breakthrough in befriending when next I stroll through the streets and come across an intergenerational group of buskers – there is little doubt that they can learn a great deal from each other.