Summary of CADR Conference 2019
21st October, 2019
Annual Centre for Ageing and Dementia Research Conference (CADR).
O'r hafod i'r hendre: The ups and downs of rural ageing
Tue 1st Oct 2019
by Dr Charles Musselwhite
I was delighted to take over as Co-Director of CADR, with Professor Andrea Tales, prior to the annual conference. It was decided to focus the conference on rural ageing and hold the conference away from the typical higher populated urban areas of Wales. 'O'r hafod i'r hendre' is the old Welsh rural farming custom of moving from a summer, upland pasture (hafod) to the winter homestead (hendre - but literally, 'old town'). The title reflects the conference focus on identifying challenges and solutions to ageing in rural Wales touching upon mobility, home, seasonal challenge/fuel poverty and the geographies of rural Wales. The title was selected by Aelwyn Williams a PhD student in the Centre for Innovative Ageing.
Rural ageing is an important issue in Wales: in areas where there are fewer than 50 people living per square kilometre some 25% of the population are over the age of 65 years, compared to 15% living in larger urban centres like Swansea and Cardiff. Rural areas are ageing faster than urban areas too. By 2025, it is predicted that 30% of Powys will be over 65, compared to Cardiff remaining around 15%. Rural areas have their own challenges that the conference addressed and discussed throughout the day.
Anna Prytherch, Rural Health and Care Wales discussed how rural areas get poorer health and social care resource, with workforce, training and infrastructure being centralised around urban hubs, resulting in difficulties with access to health care: including GPs, hospitals and consultants. Poor transport links contribute to this.
Transport was one of the themes in the break out workshops. Rural areas see increasing numbers of bus services being reduced or cut altogether. There are also poor or non-existent pavements for walking or little to no infrastructure dedicated for cycling. Those who have to give up driving therefore face huge difficulties getting out and about in rural areas. Intermittent or poor broadband infrastructure complicate things further. Recruitment and retention of workforce in health and social care is difficult with education and training centres often being centred around the urban universities. But there are changes afoot, with projects in place to improve recruitment and retention, education and training of health and care staff in rural areas, and making better use of community resource in rural areas.
CADR’s Associate Director, Professor Gill Windle from Bangor University, discussed rare dementia. Over 20% of people diagnosed with dementia have a rare form. Their symptoms may affect skills such as speaking, reading, or empathising with others and challenges can include misdiagnosis, fragmented support, feelings of isolation and loss and further reaching impact on families and friends. A Rare Dementia Support group (www.raredementiasupport.org) has been set up to bridge these gaps. But membership is very underrepresented in Wales, especially in rural areas.
There is an also an absence of contemporary research and knowledge about the impact and experience of dementia in rural Wales, despite a higher proportion of the population with a dementia residing in rural areas. The difficulty of recruiting people to studies in rural areas was discussed in a break out group. The lack of internet a barrier in rural areas to signing up to research online, increased time being away from caring responsibilities if travel to a centre to take part is further away as in rural areas, and a lack of transport to get to the centre are all barriers to taking part in research. Losing a driving licence as can often happen during dementia, has a greater more profound effect in rural areas because of lack of alternatives, for example. Information and support and networks are lacking. But, the nature of rural areas also have benefits, as Roberts et al note rural areas have a:
Sense of ‘togetherness’ amongst family caregivers (through online and other support groups)
Strong sense of community in some places – safety and protection
Sense of purpose through opportunities for active contribution –“keeping busy”
Dr Charles Musselwhite, Co-Director of CADR
Carol Maddock, a Researcher at Swansea University, then introduced work she had been doing involving the community in rural India on the SUNRISE project looking at how solar powered homes could be provided for residents. Carol’s work on public engagement and involvement underpins the social nature of what is largely an engineering and construction based project, highlighting the importance to get the public and community acceptance and understand of the engineering solutions being proposed. Carol used participatory arts based methods, such as, body mapping, convoy model of social relationships, occupational mapping and participatory diagramming. The project highlights the importance of understanding community ideas to new buildings and Carol is now involved in a project along with Deborah Morgan, at Swansea University, looking at attitudes of older people to low carbon homes in the UK, and their potential to reduce fuel poverty. This was a theme of one of the break out groups. Wales has a big issue with fuel poverty, loosely described as situation where someone can’t afford to heat their home. A total of 23% of Wales’ households are believed to be in fuel poverty, with older housing being harder to heat, and use of nonstandard fuel in many older properties, especially in rural areas being expensive. Older people could benefit from low carbon homes, but their views must be taken into account. Too often they are excluded from such projects.
There was also a workshop on ageism and discrimination that covered human rights, sadly concluding that ageism is alive and well and how we must all challenge ageism, age-blindness and negative stereotypes about ageing.
We had a wonderful presentation by David Johnston-Smith, an archivist at the Richard Burton Archives, showcasing archive photographs by Raissa Page from around 1978-1993. Raissa had worked as a Social Worker and many of the photographs depicted health and social care in later life. The photographs show the social nature of ageing, depicting images of care facilities, of being cared for at home, of living independently, of getting out and about and of working and hobbies. What was fascinating was how much had changed since then, but also alarmingly how much had stayed the same.
The final presentation of the conference was from Teresa Davies, member of the network in North Wales, DEEP and A Friendly Face, Anna Story, Research Project Support Officer for CADR at Bangor University and Dr Catrin Hedd Jones, Dementia supportive communities lead in CADR from Bangor University. They amplified the words of dementia advocate Chris Roberts about the importance of research, “When one is diagnosed with dementia, research gives us hope, hope that we can be cared for, hope that we can have a quality of life, hope that a prevention can be found and most of all hope that a cure might be found". They discussed the importance of extending dementia networks throughout rural Wales, to make sure people living with dementia have their experiences heard and can input into research, training and development of services and support for the people working in the field.
The conference closed with broadcaster Betti George, an advocate for better care for people living with dementia after caring for her husband David, summing up the day with an audience discussion with a panel comprising of the day’s speakers and CADR work package leads. The conclusion of the discussion was how important community and society, and ultimately people are in holding together rural areas and reducing the negative aspects of rural ageing, that sense of belonging, sense of community and support highlighted in Roberts et al. paper mentioned in Professor Windle’s presentation, above, but with a warning about how such communities in rural areas are changing in nature and becoming more fragmented and less close-knit.
Question and Answer Panel chaired by Beti George
Overall a big thank you to everyone who took part during the day. A real buzz was there at the conference with people from all different backgrounds and all different professional sectors engaging and discussing issues of rural ageing. And finally a big thank you to all those who organised and took time out to make the conference a success.