Tuesday, 19 November 2013

The intergenerational conflict fib

Intergenerational conflict. Let's make some effort and disassociate these two words. Fiercely negative, this political and media fueled construction is drip by drip, convincing us that the young and the old are involved in some life or death struggle, for scarce resources. 

"Hey, it's the age of austerity!"

"Wait, the stock and housing markets are on a tear!"

So, who's right?

Dr Debora Price, King's College, London considered this toxic groupthink in her remarks: "Challenging Futures: Intergenerational Conflict and Critical Gerontology in the Age of Austerity" for the ERA, Emerging Researchers in Ageing, at the 42nd BSG (British Society of Gerontologists) Conference on 10 September.
As is generally the case, whoever wields the power allows popular discourse to run and flourish, right alongside unpopular counter discourse. It's effective. The roller-coaster titillation diverts attention, albeit momentarily. Meanwhile, the deluge of conficting information becomes so incessant, that most of us are inclined to tune out. And so we do, except the niggling is now in our brains and it festers. Simultaneously, a very, selective, evidence base is supporting this head pounding discourse.
Intergenerational friction has a long, rich history. Today's young have been made to feel that the boomers have hoarded housing, education and health care while less attention has been focused on the increase in boomerang kids; those who return to the safe haven of "home". Previous generations were more likely to be escaping from home, in search of something different and sometimes better. Some boomer parents have made things so much better that the cocoon of home can look infinitely superiour to the big, bad world. University degrees and bags of promise aren't enough and cushy homes with full refrigerators and free wifi are in some cases, turning these hard earned edifices into the next graveyard of ambition.
It's as if a collective terror of ageing has coalesced, resulting in a confusing melange of increasing attacks on the accumulated wealth of the boomers. Then, it gets lumped together with the vitriol heaped on "senior" perks like free bus passes, TV licenses and winter fuel allowances. "Watch out!" These are being gobbled up by the preceding generation, the over 85's who are also regularly accused of bankrupting the NHS and clogging up A&E's.
In 2013, its everyone's turn to be anxious and for good reason. Putting inheritance, the biggest driver of inequality to the side momentarily, some research suggests that only 50% of people over 50 have more than £100K in savings for retirement and another 25% have zero housing equity. These same people are predicted to live another 30 years. Concurrently, financial transfers via the bank of mom and dad have increased significantly in the last 10 years. Stingy, aren't they.
In addition, some 63% representing 7M grandparents in the UK provide essential child care, unpaid and the incidence of intergenerational co-housing has also steadily risen. Selfish, too.
So why is the inequality fib so pervasive, who is it benefiting and whose interests is it serving? The political debate has been structured erroneously and it is really up to us, to speak the truth to power. What can be done? Here are a few ideas to get the new discourse started:

1. In the case of equity release programs, the government enthusiasm is markedly flawed. Those who need it the most have the least housing equity and this makes it highly regressive.
2. More progressive taxation will be necessary to fund social care going forward.
3. Rethink the way that NI money is actually used.
4. Particularly pertinent now, correct the divide between health care and social care, beginning with reclassifying dementia as an illness instead of a social problem.
5. Re-engineer the financing mechanisms in reforms of the NHS and make social care also free, at the point of delivery.
Obviously so simple! But changing the political discourse means acknowledging that the marketization of the welfare state can not be reduced to another left vs right debate. This could be better accomplished by advancing the disassociation suggested above and replacing it with intergenerational cohesion as the new, more powerful discourse. People, seriously, do need people.
Change might be in in the air. Sir Andrew Dilnot, architect and champion for social care funding reform and Chairman of the Statistics Authority recently challenged the views of David Willets, author of The Pinch and Frances Becket author of What Did the Baby Boomers Ever Do For Us. He believes that material improvements in the lives of Britons, already in evidence, will continue to improve. Longer, living boomers and their also ageing, former charges, have every motive to actively participate in contributing substantively to these improvements.

Deborah Gale

Monday, 11 November 2013

How do we make 'elder care' sexy?

I had an interesting chat with Maneesh Juneja last week, ahead of my participation in a panel discussion at Health 2.0 Europe. We were talking about how, despite the current hype in the health technology industry, events specific about technology for elder care often fail to attract large numbers of young technology developers and entrepreneurs. Looks like, despite its importance, developing tools for older people is just not sexy enough for this crowd.

Think about all the cool solutions that have emerged in recent years in the Health 2.0 space. Think about sleek looking activity tracking devices like Fitbit. Think about awesome apps like Runkeeper or GetHealth that motivate people to pursue healthier lifestyles. Think about Scanadu and its promise to enable anyone to conduct sophisticated physical examinations from home (while using a beautifully designed piece of equipment!). These companies are doing a great job in terms of turning things like eating healthy and exercising, perceived by many as tough or boring, into something social, fun and cool. So why can't we do the same for elder care?

Unfortunately, for many, elder care is still a topic to avoid. On a personal level, a large number of people don't want to think about 'ageing' until they are about to retire or suddenly find themselves caring for an older relative. On a professional level, many find the idea of working with older people dull or depressing. If you consider these perceptions,  it is not hard to understand why developing technology for people with dementia or caregivers, for example, fail to appeal to the majority.

I think one of the problems here is that we keep talking about older people as if they were this separate entity that never has anything to do with us. We often forget that we are all (hopefully) going to age ourselves, and many of us will care for an older relative before that. To me it seems obvious that innovation in elder care should be seen as something super exciting since we are all potential users and consumers of these solutions. I certainly want my 'elderhood' to be as awesome as my child and adulthood were and I believe you should feel the same. So it is about time we start thinking more seriously about ways of turning elder care into something really cool, something to be celebrated rather than avoided.

So I guess my questions to you are: How do we get more technology developers and entrepreneurs interested in developing awesome solutions for older people and their caregivers? In other words, how do we make elder care sexy?

I have a few ideas myself and I will be writing about this soon, but for now I would like to hear your thoughts and ideas.


Brenda Reginatto

Health 2.0 EuropeHealth 2.0 Europe is taking place in London, November 17-19th. Brenda Reginatto will be part of the final panel discussion at the pre-conference workshop "Health 2.0 Tools for the Elderly" (November 17th) moderated by Maneesh Juneja.

Friday, 1 November 2013

Health2Dublin: Can technology increase well-being among older people?

After spending a year in France, it’s been great to return to Ireland and find a significant increase in interest in the health tech space. Over the last year, several initiatives in healthcare innovation research have been announced and partnerships between academic centres and enterprises of all shapes and sizes have multiplied. But I was particularly surprised by the community of healthcare innovators that is rapidly growing around here. Health2Dublin is one of these communities.

Health2Dublin is the Dublin chapter of Health 2.0, an international movement known for facilitating and creating worldwide events that promote and demonstrate how information technology can transform healthcare practice. By putting the leaders of the healthcare innovation scene together in one place they are hoping to create the future of healthcare.

Last week I attended my first Health2Dublin meetup, the topic of the evening was "Technology for Healthy Living". I was interested to see whether the 50 or so attendees, many of whom have background in technology, were also thinking about how technology can support older people and their caregivers to live longer, healthier and happier lives. Here is what I found.

Dr John Dinsmore (Trinity College Dublin) opened the evening with a key note talk about how to use technology to manage and promote health. There was a long discussion about the potential role of assistive technologies in increasing well-being among older people who suffer from chronic conditions or disabilities, but the key message for me was the acknowledgement that well-being is a subject concept, and therefore has different meanings for different people.

I know this should sound obvious, but it is not. As healthcare professionals, carers, family members, technology developers, we are constantly thinking about what would be good for our older clients or relatives, based on our own sense of well-being. Dr Dinsmore urged healthcare innovators to engage deeply with their consumers before technology development stage, in order to fully understand their needs, wants and technology literacy levels, instead of making a bunch of assumptions about “how they think older people are like”.  In Dr Dinsmore words “we must understand that it’s not about cool technology; it’s about changing the user experience”. And in order to do that, you must know your user first.

The discussion continued through a panel discussion formed by Liam Ryan (Get Health), Dr Robert Grant (GetHealth) and Dr Ronan McDonnell (Quantified Self Dublin). The message was clear - if you cannot create an enjoyable and engaging experience for the user, your technology is doomed to be forgotten, no matter how cool it is, no matter the user’s age.

The evening concluded with a short demonstration of a new healthcare video messaging application  called HealthSnap, which I will talk more about in another post. Overall, it was a great session. It was great to see such a young and enthusiastic crowd talking about how to improve the care of older people. And, more importantly, how to do it by putting the older person at the center of the debate.

Brenda Reginatto