Editorial

Citation

Poland, F. (2018), "Editorial", Quality in Ageing and Older Adults, Vol. 19 No. 2, pp. 85-86. https://doi.org/10.1108/QAOA-06-2018-056

Co-creating and addressing changes in later life

The variety of papers appearing in this journal over time provides a graphic reminder of the ever-accelerating changes both enabling and oppressive now confronting older people, the services to work with them and research challenges to capture these. This issue identifies such changes and their implications range across domains from abuse linked to family structural changes to examine the potential benefits and harms in using virtual experiential applications and to flag up the potential of arts-based innovative co-creation in dementia.

As advances in means of mobility accompany older peoples’ increasingly complex needs for access for different modes of mobility, we have a timely opportunity to revisit a model of older peoples’ travel and mobility needs published by Charles Musselwhite in this journal ten years ago. While finding the model has continuing validity and usefulness even when applied in a wider range of countries, and alongside a changing demographic, health and functional ability profile of older populations more often living in urbanised environments. However, this re-examination of the model has also highlighted the need for it to be adapted to take account of new dimensions of mobility experience now available and demanded, such as kinaesthetic aspects of mobility enjoyed for its own sake together with corresponding emergence of new types of exclusion from such experiences.

Global economic, demographic changes and trends in other types of mobility are also affecting family structures in many places previously assumed to prioritise elder care in the family. Patel’s study of elder abuse in Uttar Pradesh brings to light and details a serious level of emerging problems in this year, previously hidden both by the privacy practices of families and also by a lack of official recognition and recording. This identifies how migration of many family members to seek urban employment may have created higher levels of dependency but also greater vulnerability and new areas of risk in inter-family interactions for the older relatives they leave behind.

Increasingly, many more societies are coming to provide nursing home rather than family-based care for some groups of older people. This may cut across the expectations of both the older people and their adult children who may until then have been their primary caregivers as well as those in their immediate communities. These experiences are explored by Gün in relation to a purposive sample of adult children of nursing home residents in Turkey. This traced the tensions between parents and children and senses of not meeting wider cultural norms that may make it difficult to accept this newer type of care choice which may be needed to deal with novel wider social challenges. Again this echoes dilemmas now being encountered in many countries.

Care homes themselves are taking on more and different responsibilities for many aspects of older peoples’ care which can open up new areas of risk and demand new and creative solutions for managing these. The practice report offered by Gilbert from work in Australia, uses root-cause analysis and a case study to discuss factors which can affect levels of medication errors in and thereby patient safety in care homes. They examine the case of a man moving from hospital to a care home use this as a basis for indicating potential strategies to identify high-risk situations and events and ways to pre-empt or to mitigate these.

It is now becoming recognised that older people and including people with dementia do not have to only be recipients of others’ creative contributions, but can themselves engage in co-creativity. Zeiilg has drawn on her longer-term research on the place of arts in the lifeworlds of people with dementia, to write an innovative practice paper for this journal, that there is now evidence to challenge such one-way perceptions of creativity to understand what a co-creative artistic practice might look like. She argues that, as people with dementia are shown to be continuing as “embodied, emotional, desiring, creative agents, embedded in relationships and a social context” that this can be engaged to more fully explore their potential for creative action and interaction in continuing to transform their social relationships with others.

Finally, also seeking to transform the possibilities of improved empathy with and experience of living with dementia, Merizzi’s opinion piece explores how new technologies such as the Virtual Dementia Tour described here may be used to do this, but also warns that caution needs to be used and much more robust empirical research is needed to judge the potential for distress and harms as well as benefits in such innovation.

Such articles point up the continuing need for us to recognise, document and evaluate the effects of changes with older people as well as working together to co-create the means to mitigate or harness them.