The sciences of ageing and improving dementia care
Guest post by Ellie Blake, Secretary of the Cambridge University Science and Policy Exchange (CUSPE).
On 2 February 2022, Dr Martina Zimmermann, Lecturer in Health Humanities and Health Sciences at King’s College London, discussed her work on the cultural perceptions of ageing as part of CSaP’s Future Leaders Fellows seminar series. Dr Zimmermann presented her project - The Sciences of Ageing and the Culture of Youth (SAACY) – to a virtual audience of academics and public policy professionals. The project aims to overcome pessimism about ageing and influence policy change in relation to care.
To begin the seminar, Dr Zimmermann describes how ageing is typically considered as solely a period of decline, with no opportunity for growth and development. Recently there have been several policy documents that discuss issues related to dementia care, but Dr Zimmermann points out that there are gaps regarding implementation at the local level. She explains that the reality is social care is fragmented at a local level, which has been highlighted further by the COVID-19 pandemic, disproportionately affecting certain groups, including carers for those with dementia. Dr Zimmermann suggests that one potential explanation for this disconnect is that the approach to dementia focuses on the need to find a cure, leading to large financial investment in research and diagnosis, but very little into the improvement of dementia care.
Previous projects undertaken by Dr. Zimmermann have aimed to better understand cultural and wider societal conceptualisations of dementia and dementia care by studying literature focused on these topics. A first project looked at texts written by people who care for those with dementia, and in the context of this seminar Dr. Zimmermann stressed that carers frequently feel anger and frustration due to the lack of support for informal dementia carers. A second project focused on the dynamic exchange between scientific and healthcare approaches to dementia and literary representations of the condition across the 1900s. Dr. Zimmermann outlines how dementia is predominantly described as a condition of loss affecting older people.
During the seminar, Dr Zimmermann explains that dementia is generally seen as epitomising the ultimate condition of loss in old age, and although scientifically ageing is an ongoing process of physiological change throughout one’s life, viewing ageing through this lens is difficult in a culture that has such a focus on youth.
“Dementia as the ultimate condition of loss drives an idea that ageing is pathological and requires a cure.”
The SAACY project aims to shift perceptions of ageing; to one that is a physiological change with need for care, instead of a pathological decline in need of cure. It also hopes to influence public policy to help improve dementia care in the future. The project aims to use a combination of methodologies to better understand where these perceptions of old age come from, making use of scientific knowledge, literary analysis, and empirical research. The literary analysis will involve looking at representations of conditions that are typical in older age and answering questions, such as, why we focus so heavily on dementia now? Meanwhile the empirical research will analyse anticipation of and concerns people have about ageing, as well as policy laboratories and public engagement work to share the results with a wider audience.
How can we change the perception of ageing and improve social care in old age?
The audience of academics and policy professionals then discuss Dr. Zimmermann’s presentation, considering how perceptions of ageing can be changed, and the experience of care improved, with a particular focus on how to engage policy makers. One participant highlights that solving these problems from a policy perspective would require two shifts, one to reduce negative portrayals of ageing for example through the images used in the media, and the other to shift away from a wholly medicalised model around dementia care, towards a social model that asks what support is needed in order to balance these two models?
Another participant raises the idea that the commercial sector may be suitably placed to create the shift towards improving the image of ageing. This sparks an interesting discussion about the concept of agelessness: Dr. Zimmermann contemplates whether a shift towards creation of commercial products that are considered ageless would further the issue of people avoiding thinking about ageing as a reality, including, for example, the challenges associated with having lower mobility.
A partipant then asks how to hold the attention of policy makers, while ensuring that outcomes are achieved without adding additional layers of regulation or other new laws? It is clear it has to be made politically appealing, determining how it can be achieved while reducing costs. Another participant highlights that perhaps framing it as a cost-saving measure isn’t the way forward, as care gets unavoidably more expensive over time. Another audience member suggests that politicians are engaged by narratives so this might provide a useful engagement strategy, which another participant furthered this by suggesting a personalised dimension to policy ideas that would allow them to resonate with politicians e.g., the potential benefits to an elderly relative.
It was also raised that it might be useful to disentangle the two issues; the first being that if we all age better as a society, this ultimately reduces pressure on public services, while the other centres around the costs of social care which should perhaps be addressed separately. Dr. Zimmermann emphasised that the two issues will eventually come together, because investment in better ageing will lead to a lower requirement for investment in social care.
The UKRI Future Leaders Fellowship scheme supports talented people in universities, businesses, and other research and innovation environments. It also allows universities and businesses to develop their most talented early career researchers and innovators or to attract new people to their organisations, including from overseas. Learn more here.