Dying Well After a Long Life
University of Bath: Tony Walter (PI)
University of Bristol: Liz Lloyd
Cardiff University: Jenny Kitzinger
University of Exeter: Kerry Jones
Background
The most common age at death in England and Wales in 2010 was 85 for men and 89 for women; the number of older people dying will increase in the next 30 years as the ‘baby boomers’ enter their 80’s. Yet older people nearing the end of life (EoL) receive poorer health and social care and palliative care – a failure of philosophy, policy and politics as well as of practice.
Following the National Service Framework for Older People, government rhetoric has shifted towards ‘successful ageing’ and promoting independence, a rhetoric embraced by fit third agers. However, this neglects many older people struggling each day with deteriorating physical and mental capacities. In health policy, the DoH’s EoL Care Strategy has been led by palliative care, whose knowledge base is cancer rather than the multiple morbidities facing many elderly people. The Strategy’s neo-liberal assumption of an autonomous individual freely choosing how to live out a fairly predictable EoL period is problematic for many older people with unclear dependency trajectories and/or less than full mental capacity. Research agendas have largely been driven by current policies, yet scandals such as Mid-Staffs, the Liverpool Care Pathway, the collapse of Southern Cross, and social care funding reveal a policy failure to enable good deaths at the end of long lives. Radically new thinking is required to drive innovative research that can inform philosophy, policy and practice, not only for the frail elderly but also for any with high dependency and mental incapacity who cannot die as free and active agents.
Project summary
Initiator funding was used to create a GW4 community of social science researchers with unique expertise in death and dying across diverse clinical and health service backgrounds and disciplinary training. The community held multiple events to outline a potential research programme encompassing a number of linked projects to develop, including plans for studies to provide evidence for policy papers which could be developed into larger grant applications. The community took these ideas forward into an Accelerator award: Dying with Reduced Agency – People, Places, Principles & Policy.
