Older People and Their Needs A Multi-disciplinary Perspective Edited by Gianetta Corley, Ph.D.

Excerpted from the Preface for Older People & Their Needs: A Multidisciplinary Perspective, edited by Gianetta Corley.

Copyright © 2000 by Whurr Publishers. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Preface

The final decades of the human lifespan are undeniably complex and challenging, both for individuals themselves and for those who accompany them, and much remains to be illuminated and transmitted about how to prepare well for dignity and quality of life during those years. 

This book is presented primarily as a resource for the young postgraduate reader, in professional training, or just trained, for the older person undertaking further professional development and updating. There is also much which will be of value to those countless informal and family carers who are seeking information and support for their demanding, undervalued, and often solitary task.  It is not intended to cover basic knowledge nor is the focus on service delivery or policy, though these are inevitably in the background.  Each chapter author writes firstly for the reader in his or her own profession.  Successful multidisciplinary working demands sound confidence in the value of one’s own professional contribution but also an appreciation of the skills of other professionals.  The chapters allow many glimpses into the way in which different professional people conceptualize their work and put their unique training into practice.  The authors demonstrate a rich resource of practical ideas for wider dissemination and professional use. 

This book is being written as the new millennium approaches and as the matter of welfare reform is still a prominent part of the political agenda.  The public debates, however, are invariably a question of where responsibility should lie for the provision and cost of a basic level of care at the end of life.  Responsibility has been thrust away from the state and back to the individual, family, and the community.  The intention here is to look beyond the debates on funding and resources, crucial as these debates are, and to uncover and pass on innovative ideas. Many of these ideas demand action early in life — action to preserve health including dental care, action to make adequate financial plans, action to maintain family or community networks, action to render housing, public transport and public buildings accessible for older, less mobile people.  It is a matter for regret that there has not been space to include every discipline involved in working to make improvements for older people — those in the sphere of communication and in the leisure, hotel and holiday industry, for example.  It should ultimately no longer be possible or necessary to deny the inevitability of ageing nor to be marginalized by the media idealization of youth. 

Many professions are now training young personnel for life cycle work, breaking down former barriers between training to work only with children, or only with older people.  There is an attempt to look for the common principles which will enable a professional person to apply common skills across the human age span, given appropriate continued professional training and development.  Viewing the life cycle as a continuum, the damaging ghetto-ization of older people and those who accompany them could be gradually diminished.  A feeling of well-being in older age could become a matter for admiration, emulation and opportunity, planned and worked for from the outset. 

The chapters here stand alone and do not necessarily demand sequential reading.  There are nonetheless themes which permeate the whole structure.  The most powerful of these are firstly the presence of rampant ageism in our society, reflected by the undervaluing of the place of older people in it and those who accompany them, and secondly the need for a recognition of the skills required in this sphere, supported by appropriately specialized training. 

The first and last chapters, by a medical practitioner and by priest, both encompass this life cycle — both have a meaningful role as a human life begins and ends.  Chapter 2 concerns the dynamics of financial security and well-being in the context of the ageing process.  Chapters 3 and 4 address issues of nutrition and podiatry vital to lifelong health.  Chapters 5 and 6 look at roles and identity as an older person begins to require nursing or care.  Comparisons between ethnic communities allow increased awareness of different perceptions of roles and support systems.  Chapters 7, 8 and 9 concern relationships and communication with older people in their negotiation of tranquility of mind and in the telling of their unique story.  The position of people belonging to minority ethnic communities is considered by attending to the situation of older Irish people in the UK .  Chapters 10 and 11 turn to matters of physical independence, mobility and continence and to ways of sustaining quality of life.  Chapter 12 is written not from the professional’s angle but from the perspective of family carers.  Current examples are provided which illuminate the struggles for independence of older people today.  Chapter 13 presents an account of the new quality of dementia care achievable in residential settings. 

Multidisciplinary working is difficult to achieve in a culture accustomed to hierarchy, but no one profession has all the skills: each has much to gain from working with others.  Older people benefit well in sustaining their desired independence where the professions have been able to accord them a seamless service.