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Disruptive Voices Episode 6: Celebrating Old Age

In this episode, Dr Mine Orlu (UCL School of Pharmacy) shares her positive perspective on ageing, and explains the need for a cultural change in ageing research and policy.

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Celebrating Old Age 


In Episode 6, we speak to Dr Mine Orlu about her positive perspective on ageing, and explains the need for a cultural change in ageing research and policy. She also shares some learning from actively involving participants in her own research and the outputs they have co-created.

Nina Quach  00:04

Hello and welcome back to Disruptive Voices. Today's episode on rethinking and celebrating old age will be hosted by myself, Nina Quach, and my colleague Siobhan Morris.

 

Siobhan Morris  00:14

Hello! Today we are joined by Dr Mine Orlu, Associate Professor at UCL School of Pharmacy. Welcome Mine and thank you very much for joining us today. To begin, you created a network at UCL called CelebrAGE to drive innovation and knowledge sharing on ageing research between colleagues at UCL, but also involving the public and private sectors, charities and the NHS. So can you tell us how this came about?

 

Mine Orlu  00:42

Thank you very much, Siobhan, Nina, and I would like to thank firstly UCL Grand Challenges for the very kind invitation for this podcast. In regards to your question, yes there are many negative connotations associated with ageing, primarily due to the onset of various clinical ailments, diseases, the effect on general wellbeing, and the many challenges faced by those in our ageing population can cause detrimental effects on society. By celebrating ageing, we can replace these perceived notions with the many positives such as empowering the population towards a healthier and more independent living.

 

Mine Orlu  01:19

Having said that, a change in image alone is not enough, as the challenges themselves must be addressed and real innovative solutions must be adapted. And this grand challenge can only be met by inspiring everyone across a range of abilities and aspirations, aided by cross-disciplinary collaboration and I believe by strengthening the links between science, policy and the public. In this respect, UCL has a very strong cross-disciplinary focus in its research infrastructures, ranging from Population Health Sciences to Built Environment and Architecture, and almost all disciplines, all research discplines of UCL have a focus on Ageing research. With all these thoughts, I attended UCL's Future Leaders programme a few years ago. And in this programme, we were invited to work with an individual leadership task, and as part of my leadership task I developed the idea of a creative and novel knowledge exchange network, focusing on accelerating the impact of ageing research at UCL. And CelebrAGE network was born.

 

Mine Orlu  02:21

The idea was born a few years ago, and we managed to secure some funding for the CelebrAGE network activities. Our network aims to drive innovation by delivering cross-disciplinary projects into ageing research and related knowledge exchange activities in partnership with, as you said, researchers, innovators, local communities, charities, industrial enterprises, NHS colleagues, to catalyse ongoing amazing efforts into improving lives of older people and accelerate the real impact of ageing research. In CelebrAGE our core team has expertise in translational healthcare, pharmaceutical engineering, social neuroscience and creative arts, which exemplifies a multidisciplinary approach to wellbeing in older age. We believe this will lead to holistic healthcare innovations that are applicable across the socio-economic spectrum for every individual. And in particular, we would like to successfully further blend UCL's amazing strength in Life and Engineering Sciences, to demonstrate excellence in health care products and medicine, tailored to the needs of older people, and we have the ultimate goal to develop and disseminate global standards for industry to facilitate the implementation of more and more solutions for healthy ageing.

 

Nina Quach  03:39

Can I just take a step back to a point you raised at the very beginning about people often having negative perceptions associated to old age. And yet, as a society we always strive to increase life expectancy and people want to live older, but no one wants to be old. So I was wondering if you could explain a little bit more why this negative perception can potentially be harmful, and how we can rethink it and actually see it as a positive thing.

 

Mine Orlu  04:09

Interestingly, during every birthday, there's an inevitable thought in our minds reminding us we are getting older. But if you really think again, having negative perception about ageing is quite contradictory to our efforts and willingness, as individuals to have more time to enjoy every aspect of life. We are trying to keep healthy, we are trying to keep well, we are trying to follow all the positive, useful inverventions to make quality of life better. And actually healthy age should be seen as the successful outcome of our amazing efforts in trying to let's say embed walking, gardening, eating well, all these you know positive things to our lives.

 

Mine Orlu  04:51

I think believing ageing is something to celebrate will motivate and inspire us for adopting all these healthy lifestyles without too much efforts, if we see the ageing as a reward at the end, a new stage for strength and opportunities. Of course you know we need to reframe the way we think about ageing, we should gain a positive understanding, but of course our job as scientists is to aim for empowering individuals for self-management of their health and wellbeing. If we are all empowered and we can maintain independence, mobility, ability to complete the daily living tasks and hence minimising the complex care needs, less use of health and social care services and reduce the number of hospital visits - and all these efforts will make it real to actually approach ageing with a different mindset and hopefully celebrate ageing.

 

Siobhan Morris  05:47

You mentioned, talking about kind of 'we' and this collective sense that is shared often about ageing, but do different cultures understand age and wellbeing in a different way?

 

Mine Orlu  06:01

I think ageing is quite a global term, but if we look and zoom into the ageing concept, I think it is definitely influenced by the cultural perception, beliefs, concerns, and we really need to think about how people perceive ageing. So I believe there are cultural differences in the way we perceive different notions of ageing, because there are expectations from older people, like, this is a stage when people retire, maybe to focus on their individual lives maybe really trying to get the best for themselves, to look after themselves, to maintain their independence. But actually they are people who have the wisdom, who have the inspiration, who have the energy in their cognitive ability because they've had this life experience.

 

Mine Orlu  06:50

And we are all ageing, you know I'm ageing today, and from your questions it's inspiring me how I need to think about ageing. I have been in this research field for a long time so I believe that the cultural differences should be definitely affected in when we are designing research, when we are trying to bring solutions, when we are designing products and when we are making policy changes, because the needs of older people may be perceived differently. One culture may believe that there is always a disease associated with ageing and they may put their efforts into a certain industry, while the other culture may expect more from ageing population, to look into different aspects. But the more important thing, I think we need to bring a global focus on ageing and work on how we can actually glue, how we can really gel the cultural differences in terms of ageing and how we can empower the individuals to shared their wisdom with the society in global context.

 

Nina Quach  07:49

So if we think about age, along a sort of time spectrum, you have worked in your career with people of different ages, starting with children and now with older people. From your experience and observations, how would you say the sense of identity evolves as we go through different life stages?

 

Mine Orlu  08:09

Yes I had the unique and excellent opportunity to focus on paediatrics, medicine developments for children at early career stages, and then later on I have more focused on medicine design and development for older patients. And during my research studies, I have observed that there are beliefs about younger and older, and there are some scientific facts about ageing that we have to focus on. For instance if we look from  life and medical disciplines lens, the immaturity of the body system in the youngest and likely impairments, decline of the function of the body and organs in the oldest old, are the factors that scientists need to consider. So there's an evolution from a biological side, there is an evolution in terms of the cognitive and the mindset growth, but there is another factor. There is a change as we age, so inevitably our identity change due to various factors, but actually ageing helps us to discover the best version of ourselves as individuals, and science discovers more every day, and offers more solutions, creates more interventions for improving wellbeing. So I think that every individual's identity brings positivity, every age brings wisdom and inspiration to the society and we understand the invaluable impact of ageing, the irreplaceable effect of ageing, and the importance of the identity of older people.

 

Siobhan Morris  09:41

So what can we do to better understand the complexities and diversities of the geriatric population as you were talking about seeing them as individuals, instead of seeing them as a whole, as a homogenous group, how can we start to adjust their personalised needs and care?

 

Mine Orlu  10:00

Every individual accumulates something different in their personal history. So every individual has a different biology, different lifestyle, different expectations from their older age, and it actually pronounces the effect of being individual at older age. If you first look at from the scientific point of view, the factors that our body is exposed, are very different. We live in different countries, in different cultures, we have a healthy lifestyle it's sort of, you know, a period of our lives, it may change due to unfortunate reason as life is dynamic. It's never straightforward, and I think every individual has their own history in terms of the biological development, and unfortunately sometimes the decline of the function of the body. So it really makes ourselves as individuals for the healthcare professionals in terms of our needs.

 

Mine Orlu  10:56

When it comes to a certain disease for instance, we may be diagnosed by the same name of the disease, but we may be at a different stage of that disease. We may suffer from an acute condition, we may unfortunately suffer from a chronic condition. And if you take the example of a chronic condition, we know that the body may respond differently. And while they are responding to their treatments differently, their needs are also changing. For instance, if an individual is diagnosed with a disease at the age of, let's say, 60, they may not have a problem in terms of taking their medicine at the point of administration. Literally, if you talk about capsule formulation, they need to take it for the medical treatment, they may not be facing the difficulty to swallow it. It's just a simple example, it sounds, but unfortunately if their chronic condition requires treatment later on, and when they reach the age of 70 to 75, then the size of the tablet may really make their life very difficult. To take that medicine every day as they may be faced with from throat coordination problems, some dysphasia, some swallowing difficulties. If you consider that individual needs to take their medicine every day for years, that morning when they need to take their medicine may become a real challenge for them, really affecting every day of their lives.

 

Mine Orlu  12:19

So we really need to tailor our thinking about the changes in personalised medicine for instance. If you think about an individual, their living, you know, setting, it may change in time. They mean start living in a two-floor house, but later on they may need to move somewhere else. They may need to change the geographical location, they may need to change the environment they are living in. So our job I think is to really rethink about the changing needs of every individual in terms of their healthcare needs. So when it comes to the biology, definitely the body is changing, even you know with simple administration related factors. But also, if you look more broadly, their needs may change because of the condition that they are living. They may be living with a family, they may be living on their own at a later stage. So I think that personalization is a term that we use in our daily life. We would like to personalise every item that we purchase, because it gives us the belonging feeling. If we purchase a house, let's say, if we even buy a bag we would like to put our initials on it because then we own it, this is our backpack. When it comes to actually really important needs in life like the healthcare and living needs, we shouldn't forget about the interest and there's a real need that requires actually different thinking. And we really need to consider the changing needs of people - especially when they are ageing, because it is nothing constant, it is quite dynamic, and we really need to phrase the word personalization, when it comes to healthcare and living needs of older population, as this changes quite fast and the needs needs are quite prompt. So to really, truly address these needs, we should recognise, and I think there's a power of co-creation of the solutions with older people. This will to really help us to bring these solutions immediately to people's lives for a real impact.

 

Nina Quach  14:14

I was going to mention co-creation actually because, as a researcher, it makes sense to talk to the people whose lives you're actually affecting and see them as active participants of coming up with what kind of research, you're going to be undertaking and have them help you produce the knowledge as well, because they're the people with the experience who can really inform your research. And would you mind telling us a little bit about your recent project in partnership with Age UK where you talked to older Londoners about their experience of resilience during the COVID-19 pandemic?

 

Mine Orlu  14:52

I believe the power of bringing people's and users perception, needs, into the conversation, at a very early stage - and when I say early stage, it can be as early as designing the research study, and it can be also at a later stage when a product is under development, and before implementation of the idea into our lives. I believe, especially older people's opinion with their wisdom, with their experience, will be invaluable. And in our study we work with Age UK London, we would like to have a creative knowledge exchange platform because we genuinely, as researchers, unintentionally bring the end user into our studies at the dissemination stage where we would like to share our findings, because we would like to actually share the positivity, the positive outcome from our research.

 

Mine Orlu  15:42

But actually if we bring the public into our research at a very early stage, as I said, you can really avoid reinventing the wheel sometimes or really empowering that idea by the real solutions, which will have impact in people's lives. So in our study we would like to speak with older Londoners to understand actually how we can recover, and how we can impact on people's lives in a positive direction to recover from the pandemic, because we noticed that during the first lockdowns, older individuals living in their own homes created their own solutions. We would like to understand what are the issues they face, and also what interim solutions they brought into their lives to continue, and let them actually maintain the quality of daily lives. So in that respect, we would like to work with to the local networks of London, who are representatives of the older population, and we would like to discuss on many aspects ranging from housing to pension to finance, to healthcare needs, and hear from them about the solutions that they received, and what were the interim solutions that they created as individuals. This has been a really effective knowledge exchange activity to understand the needs of older population. And finally I would like to add that we would like to work with older Londoners because it has been an amazing opportunity to understand the diverse needs of the ageing population, as there's a heterogeneous need, preferences, and conditions that older people are living in London.

 

Nina Quach  17:15

Can you give some examples of insights and solutions that you have learnt from this project?

 

Mine Orlu  17:23

I think the first discussion was around the need for digital devices and digital solutions, as we need to continue our communication by other online devices, online resources, and it has been amazing to hear about Age UK London's and other charities' efforts in helping older people and letting them to go through the first lockdown. We heard that there were interim solutions again to understand if a non-online digital platform, whether it worked for them to maintain connection with the outside world, and we noticed that actually the solutions, we named them solution, that maybe for the population who are currently working in their professional roles are more familiar or had more opportunity to access these platforms, however for older individuals these solutions weren't accessible.

 

Mine Orlu  18:15

So I believe that things need to be affordable, accessible, appropriate, and acceptable by the end users. And when it comes to the digital world, actually, it is really amazing to see how much they implement these changes into their lives, how promptly they are open to these ideas. But we should not forget about the fact that there's a digital divide, and there is less access not only by ageing population but certain populations have unfortunately less access to these solutions, and this is critical to maintain real connection with the world. And in that respect, we notice that they identified, some residential businesses identified their own solutions to bring these digital solutions into older people's lives, for responding to their needs - either connecting with their families or maybe making, you know, grocery shopping, or speaking with their friends for their social and wellbeing. So I think there has been some solutions but this study showed us that there's a heterogeneous need of older people in many platforms, and we really need to work with them, hear from them, and co-create the solutions together.

 

Siobhan Morris  19:21

I suppose that links very nicely with what you were talking about earlier in terms of policy responses and policy change regarding both how ageing is seen but also policy implementation to, as you say, personalise and create tailored responses. So, a recent report by the UK Government's House of Lords, Science and Technology Select Committee found that there had been minimal progress towards achieving the goal of Ageing Society Grand Challenge in the UK, and it found that a lot has to be done to stay on track to ensure that people can enjoy at least five extra healthy independent years of life by 2035, whilst also narrowing the gap between the experience of the richest and poorest. So as you were just talking about, in your opinion, what policy and cultural changes need to happen in the next five years to achieve this?

 

Mine Orlu  20:19

Firstly, it is definitely important that they are presenting us with the facts and the conditions, the needs, the statistics, because it really raises the awareness, not only for scientists but also for all the investors, all the key stakeholders, clinicians, charities, and public, as well as policymakers. I think this is really powerful to have access to this documentation and understand what are the needs, what is the unmet need, what are the gaps, and what are the solutions that we can bring into life promptly. So from a scientific point of view, I think what we need is a translation of the ideas.

 

Mine Orlu  20:57

At UCL, we are very fortunate to work with UCL's Translational Research Office, and we have a strong collaboration and communication to understand the successful and powerful ways of bringing all these scientific creations, ideas, into life by understanding what investment is needed, what additional stages are required to collect further data, to get a marketing authorization and licence, or an investor, you know, to think about that solution. So I think the translational aspect, should be at the centre of every scientist's daily activities, because it's amazing to have our publications to inspire the academic community, the scientific community and share this knowledge, but I believe that we really need to link the stages of the science to make sure that we are going towards and end point that we create more and more devices, products, clinical solutions, lifestyle interventions, which are really bringing true, positive impact into ageing populations lives.

 

Mine Orlu  22:04

From an industrial point of view, I assume the industrial partners and collaborations would like to see more incentives, because there's definitely clear willingness to work more and more on the products for ageing population, but of course from a business point of view they really need to see some incentives to actually encourage them to invest more time or energy to think about how they can accelerate the impact of their work, their pipelines, to focus on the real needs of older people. And it doesn't sometimes need to be a separate effort, I believe, we just need to think about what additional features a product can have to make it really useful, and acceptable for older people.

 

Mine Orlu  22:47

And I think from a cultural point of view, the interaction between generations should be empowered, because I believe that the generations have many things to learn from each other, and this inter-disciplinary thinking in science is really helping us to approach different generations because certain discipline's target group can be younger people, a certain group may work with adolescents or younger adults, or oldest old. And I believe that if these disciplines start to have these meaningful conversations between them, to let their scientific audience to talk with each other for the ultimate goal of improving the lives of the society, that cultural meaningful conversations really lead us to avoid reinventing the wheel, of course, but really bringing new insights and innovative solutions, for better outcomes in our research outputs, and of course real life solutions for older individuals. And from an individual point of view, I really appreciate all the efforts ongoing ranging from knowledge exchange networks to research centres, to charities, to clinicians, policymakers, public's effort to raise the awareness about the special needs of older population, and also the power of ageing population, to share their wisdom, their intelligence, their inspiration, with us.

 

Siobhan Morris  24:14

How do you think attitudes towards ageing have changed as a result, or even during the COVID-19 pandemic? You mentioned the final point at the end there around generations working together, and I think it's been an interesting time in some sense of celebrating older age. If we think about, for example in the UK, Captain Sir Tom Moore was seen this kind of inspirational figure and the celebration of his life and how old he was in some ways was what was being celebrated in the tremendous work that he was still doing, but then of course there's also been that debate running throughout around the sense that actually we shouldn't be locking down to protect a small, kind of vulnerable, section of a population, and some really vicious public debates around pitting the young versus the old. So I just wondered how you thought the pandemic had changed attitudes towards ageing.

 

Mine Orlu  25:15

I think the pandemic has brought over focus on ageing population, more and more due to the fact that the pandemic is really health related, which is requiring more and more healthcare solutions, not only about protecting the vulnerable populations, but also maintaining the quality of life and at this stage of the pandemic, I think it was a very challenging time, because everything was very unexpected. We were all at an unprepared stage and not always aware of the healthcare needs of vulnerable populations, but actually I think it required us to give very prompt decisions and bring effective solutions into everyone's life.

 

Mine Orlu  26:02

But as I said, they were on the spotlight I think because the issue was health related. And the vulnerability of the oldest old due to the ageing body and organ system, of course, highlighted the healthcare needs of older people. And it wasn't only the pharmaceutical solutions but also their housing needs, their financial needs, their healthcare needs, they were all brought into the spotlight due to the pronounced needs of older population at the age of pandemic. So, I think from that point of view, that we shouldn't see that the needs are more from the older population, I think there are certain fields in life that certain populations need more support. If it comes to healthcare, it's quite inevitable that, as we are ageing, we need more access to healthcare services, but if you look into the younger population, of course they need more access to the services provided by the education sector.

 

Mine Orlu  27:02

So I think the pandemic was around, you know, a very unfortunate condition, and this was the reason that we first, as a society, think about the increasing needs of older people, but on the other side actually showed us how powerful ageing population is in terms of supporting, really supporting, the society, and we have witness observing the amazing efforts of heroes, amazing efforts of unforgettable figures, who will supported the society, and I think this can be only possible with lived experience, with that wisdom, with that positivity, with that, you know, effort without an expectation. Because I think as we age, we do things for the society without an expectation, and it's very rewarding for them to contribute to the benefits of the public. I believe that we have seen, really amazing examples, evidence that the ageing society can really empower the public in terms of their wellbeing, in terms of their immediate needs, in terms of the positivity, the preferences, the needs, and how they perceive from their side, how they spot the real needs, and how they can be in real action to bring, you know, a powerful solution into people's lives. So I think ageing population is one of our assets, and we really need to listen to what they are saying, we need to address what they really need, and we really need to bring prompt solutions for improving the quality of life and independence of ageing population - and in return I think we have the amazing opportunity to learn from them every day.

 

Nina Quach  28:45

Thank you so much, Mine, for sharing your thoughts. It was really, really interesting. I'm afraid we have to wrap up here, but thank you so much for joining us, and thanks everyone for listening, I hope you enjoyed it.

 

Mine Orlu  28:56

Thank you for this opportunity.

 

Siobhan Morris  28:58

Thank you, Mine. Thank you.

 

Nina Quach  29:04

This episode of UCL Disruptive Voices was presented by Nina Quach and Siobhan Morris, and produced by the UCL Grand Challenges team. Our guest was Dr Mine Orlu, and the music is by David Szeszta. For more episodes, visit UCL Minds podcasts or follow us on Twitter @UCLGrandChallenges.