UCL Grand Challenges


Creative Lives episode 4: Older people, healthcare provision and access in ageing societies

In this episode, Lorna Collins speaks to Neel Desai and Veronica Franklin Gould.

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Lorna Collins  0:01  
Welcome to Creative Lives, a podcast which opens provocative conversations and experiments with big ideas and local practices. My name is Lorna Collins and our topic today is 'Older people, healthcare provision and access in ageing societies'. We have speaking, Neel Desai and Veronica Franklin Gould. Neel Desai is a PhD research candidate at UCL School of Pharmacy. He is a registered pharmacist, who graduated from the School with a first-class honours Masters of Pharmacy degree, successfully completed his pre-registration year in hospital and now he works as a locum community pharmacist. Neel returned to the School, and worked in advanced therapeutics and...I can't even say this. Nanomedicines, Neil, you'll have to explain it to us. He currently focuses on the use of data to inform the sign of age-appropriate medicines. 

And Veronica Franklin Gould founded and is the President of "Arts 4 Dementia". And she leads its social prescribing programme which empowers people at the onset of dementia, to preserve their brain health through the joy of culture, creativity, and wellbeing activity. Her project which is called "Reawakening the mind" won the London 2012 Inspire Mark and Positive Breakthrough Award, in the Mental Health Dementia Awards. So we have a pharmacist, a scientist, and an arts-based researcher or activist in the room. May I call you an activist, Veronica?

Veronica Franklin Gould  1:45  
You can. I was just talking to the artists today, you can very much indeed call me an activist, and our whole conference felt like a giant, communal, activist movement to improve the lives of people from the onset of dementia.

Lorna Collins  2:00  
I'm fascinated to hear both of your thoughts. The first question I have is: what does creativity mean to you and your work? Tell me how you express yourself creatively in your own life and your work with older people and an ageing society. Veronica, would you like to go first?

Veronica Franklin Gould  2:21  
I have loved all the arts lifelong. And that sense of wonder that they bring, whether you're an active participant, which is what we're keen to encourage, or whether you're a recipient, it certainly enhances your life. So in my work, I'm setting out to help people at the onset of dementia. Originally, when I set up the programme, it was to help set up a weekly arts workshops at arts venues to re energise and inspire people to override the strains of dementia and their partners. That since the introduction of social prescribing link workers, were now encouraging this to be extended to people right from the onset. But personally, to protect against cognitive decline, I sing, and I dance, and I swim. I love going to theatres and all sorts of other things as well.

Lorna Collins  3:13  
And Neel, can you tell us about your own creativity in your life in your work?

Neel Desai  3:18  
I was going to say mine is perhaps not as interesting as Veronica's. But, um 

Lorna Collins  3:22  
I disagree.

Neel Desai  3:24  
For me, creativity is well, from a scientist perspective, as a perspective of a pharmacist, it's about identifying a problem that's in front of me, and coming up with an intuitive solution. And I think the most important part of being creative is about making that impact lost beyond just myself or ourselves, and actually making a difference at a societal level, which is exactly what Veronica's initiative does. And being a pharmacist, we work within our local communities, whether it be in hospital or in community pharmacy, but some people might think that there's less scope for creativity in more of a registered, broad profession. But you know, it's about the ways that we interact with people, trying to engage them with their medicines, and try and provide the best way possible to give them the advice so that they continue to live long, healthy and fulfilled lives. At a research level, as some of you may know, doing a PhD degree is very much focused on research, there is a high level of creativity that's required in order to not only expand the knowledge within my personal field, but also to improve myself throughout the years in which I'm doing the research activities. So particularly with my field and as you kindly mentioned, I'm looking at age appropriate medicines. So we're trying to find new and novel ways to interact with our ageing society and the older individuals to gain a bit of a better understanding as to what that medicine-taking experience is like for them, and how we can help them to further improve that experience.

Lorna Collins  4:50  
This is very profound and deeply important. I think it's crucial for us to contextualise these ideas of older people, ageing and healthcare, in our current moment, which is unfortunately, still defined by COVID-19. An endemic rather than a pandemic. So what is the situation, and what are the issues that you are facing in your working lives right now, in this context?

Veronica Franklin Gould  5:17  
Connectivity for those who either don't actually have the internet, like parts of Scotland, you know, outposts also that really, they find it very difficult to get in touch. And those, in our case, we've got cognitive challenges. But there are ways that they can be brought in. And there are tremendous advantages of the camera's eye. Because the camera's eye I don't think it applies as well on Teams, as well as Zoom, but I think it must do. If you look into the camera, it feels to the recipient, that you're looking at them personally. And that really does give that person-centred approach. Otherwise, by gallery view, you can get that interactive feeling so that people are still engaging creatively with others. And in particular, we were running a programme, I can't take any credit for it, but it was with Siobhan Davies Dance, for people with only symptoms of dementia, they were sort of acting in the most constructive way, using the camera, you know, really creatively. It was terribly exciting. So there are always, actually, as Neel was saying, there are ways in life that you can be creative in what you do. And of course, we come to people like Neel, anyway, as you can refer people to social prescribing, can't you as a pharmacist? It's just absolutely terrific. 

And this, it's a whole new world, it really is. Social prescribing opens up possibilities, because you come to the doctor and you, whatever your problems, the doctor can see, you know, you've got other things other than just things that can be treated with them, by medicine, only. And you can have the two, but wellbeing in your whole life through creativity through the arts, it just so uplifts us. Even if people say it's not for me, and other people might say arts are not for me. Well, I was talking to a builder. And he said, "Oh, it's not for me." So I said, "Well, what do you like doing?" So he said, "I like travelling." So I said, "Where do you like travelling?" He said, "I like going to Dubai." So I said, "Well, maybe the social prescriber knows of an organisation that gives the most wonderful talks about Dubai." 

And you can be really fired by that, even if you're sort of stuck at home. I think people are so imaginative in the fields of arts and health, where, you know, that if you interact more with culture and creativity, I mean, this is what's so exciting about life at the moment through social prescribing, it cuts across all departments, all sectors, and generally wellbeing in work and life is enhanced through social prescribing, I believe.

Lorna Collins  7:55  
Thank you, Veronica. That's great. And Neel, what do you think are the most important issues facing older people right now?

Neel Desai  8:05  
Do you know, I think Veronica summarised it perfectly. And I was actually going to suggest some of the same things. So connectivity is one of the big ones I know, particularly at the beginning of that pandemic, you know, older people, and the ageing society were perhaps the most vulnerable, and they were told to shield, effectively. So whether they were living alone, or they were living with families or in a formalised care setting, you know, older people became dependent on others to help them with daily tasks, or whether it be getting groceries or going to the pharmacy to collect their medicines. And even within pharmacies, we were trying to find ways in which we could help some of these more vulnerable people in our society, whether it be delivering more medicines, personally, or whether, for example, in my instance, we were going out and just making sure our neighbours were okay. Do they need any help with their shopping or whatever it would be, walking the dog, for instance. So yeah, connectivity has become a massive thing. And people now are so comfortable with the idea of FaceTime and Zoom. And, you know, even in an office environment where they are comfortable with using Teams as a way of communicating with each other, since, you know, we don't have that face to face contact anymore. 

I think one of the big things that Veronica sort of touched on is also being removed from society almost where, you know, we don't have that almost touching element, that haptic feedback they would normally get. So when we see a loved one, you know, only now as things start to open up, we were really able to go and as Boris says, you can go and hug someone, but please be cautious. Anyway, so there's a lot of things with a pandemic, particularly with the older people. So I think going forward, some of the most important things are ensuring that of course, obviously, all the older adults in our ageing society, they're fully vaccinated with both doses of the vaccine. I think that's paramount, whether it's just them or anybody else across the spectrum of life, and resuming services where possible and enabling that normal life to happen again, where we can have those face to face contacts have that connectivity, and avoid that feeling of potential loneliness. And in Veronica's case, trying to improve that social arts aspect because it sounds like a great initiative. And I definitely know a few people who'd benefit from singing, dancing and with the other events and going back to the theatre, that's something I'm very much looking forward to do.

Veronica Franklin Gould  10:24  
And the wonderful thing is that museums, etc, really do cater for people who are blind and who are deaf is so imaginative. It's just untrue that how they could do this even over the internet. Otherwise, there are these "Arts at Home" packs that can be delivered. And we've been having a series of meetings around the country. And one of them, somebody was saying, "I can't wait, I long for every week, because new materials are going to arrive." And there is that sense of looking forward to doing things that actually we always need that in life daily, maybe the end of the day, maybe it's something special, or you make it up or a wonderful meal, or whatever. And as you can even have creativity in cooking, we're stuck at home, but we can do. We're not so stuck now. But there are lots of ways in which you can be imaginative. And as that happened in lockdown, people chose to be imagined, they chose us. With regard to older people, and you see the colour of my hair, the types of arts, I wouldn't go to for for older people, unless they were physical. So dance and Joe Wicks, as seniors, it's totally funny, it makes one sound terribly elderly, which I don't feel at all. Older people don't think of older people as dotty, even if people have got dementia. The challenge for people with dementia is articulating their thoughts. And if one talks in clear sentences, and gives eye contact, you can actually have tremendously creative discussions as never before, and sometimes even more creative. That's what's so exciting. And always be working towards something with a purpose, whether it's production, or an exhibition, or putting our poems up on the, you know, in the library or whatever. It's always a good thing to give a sense of purpose so that people feel really validated, and part of society. Because you're talking about loneliness, and we, we've got to do everything in our power to stop learning. This is a horrible thing. And loneliness begets all sorts of illnesses, and horrible things like that. So long as people are connected, in the arts are a very good way of doing it. But it doesn't have to be the arts, it can be wellbeing in the countryside, it can be birdwatching, I would suggest it has to be something with exercise, you're exercising your mind, but you need to also exercise that put your arms up and you feel better the moment you do it.

Lorna Collins  12:48  
Thanks for arnicare. And as you were speaking, I was just thinking, Neil, how can pharmacy be creative, or How can you approach pharmacy and your career in a creative manner? You've already said a bit about this. But please can you elaborate a bit more?

Unknown Speaker  13:05  
Yeah, no, sure. So there are different ways in which we can do it. Of course, you know, we can recommend people to take part in some activity, some exercise. You know, for the very first time last year, I sort of took up running over the lockdown period. And I was amazed by how much I could actually run if I actually put my mind to it. But from a pharmacy perspective, you know, there's a number of ways in the last year in which pharmacy has changed, pharmacists and pharmacies have become that first stop instance, you know, that go to place to be because, you know, we're always open we're easy access, you don't need an appointment to come and see us. So it's been very easy for people to come in, and tell us about any of the problems that they're having, and for us to try and help them the best way possible. And whether that be by putting in markers and putting up barriers, and one way systems just to make sure that people don't come and interact with each other, maintaining that social distance, as well as, of course, incredibly important, particularly within a pharmacy environment. But we're also trying to promote that independence in terms of how individuals take their medicine. So as a core part of my research, but it's also a core part of being a pharmacist and working within a pharmacy, if we can get individuals, whether they be older individuals, or even some of the younger individuals to take responsibility for their own health and social care, we're going to have a better society in general, we're more likely to have an active society, one who isn't afraid to take some risks and actually enjoy life. As the saying goes, it's YOLO, right? So you only live once. So if we can't be creative and enjoy our lives take a little bit of risk, in order to see life at its fullest, then I can't say that I'm a pharmacist to tell people "Oh, don't do this. And don't do this..." when we should really be encouraging people to do activities, within limit and within reason, of course, we're not going to tell people do anything that's damaging to their health, or anything otherwise, but for sure, yeah, it's all about ensuring independence within taking and using medication.

Lorna Collins  15:11  
Thanks, Neil. I think that's a really good last point for you to say. Veronica, would you like to say your last point about your work and creativity,

Unknown Speaker  15:20  
I'm really, really keen, we should have a new NICE guideline, or amendment to the existing dementia diagnosis guideline, so that people have access to the arts at the onset of symptoms, so that they don't have to endure months of fear and loneliness, and worry about the diagnosis. Because if they're engaged in weekly arts, weekly arts, lift the spirits give them a sense of purpose of identity, and it's the best possible thing. And we can now stop that frightening fear of stigma and all of that which they no longer need to feel. Because everybody is a person, everybody is a unique person, and they stay that person. And we just need to enable empower them to have access to the greatest joys in life, the arts, well being the countryside, on a regular basis and to feel valued through the US. Thank you.

Neel Desai  16:19  
I couldn't agree more, Veronica, if we can help, you know, in terms of social arts and the health care side, from my perspective, we can combine the two, you know, if you're somebody out there who isn't getting on with your medication, just go and tell your pharmacist, you know, go and tell your doctor, as you said, Everybody is individual, everybody is a unique individual. So all you can do is come and tell us and we will find a creative solution to help you get the most out of your medication and enjoy life to its fullest. So you can go out and have a great time and most importantly, ensure that your well being is looked after.

Lorna Collins  16:52  
Thank you so much Neil decide and Veronica Franklin gold, for what you have shared and for our collaborative thinking. I really look forward to applying these ideas in our creative practice, in our creative lives. Thank you so much to Grand Challenges for producing the podcast, UCL minds for publishing it, and the input of our numerous collaborators behind the scenes. The editing is by the marvellous Nina Quach and the music by the lyrical Tim Moor. We will be back with another podcast in two weeks time.

Transcribed by https://otter.ai