Current in-depth inquiry
The future of ageing
This in-depth inquiry is exploring the ethical implications of the emerging role of science and technology in helping people live well in old age.
From the outset of our in-depth inquiry on the future of ageing, we have worked to engage with diverse groups of older adults to inform our report and recommendations. This has included running a series of creative engagement workshops to enable our working group to hear directly from older people about their experiences of science and health technologies, and their views on how these might affect their lives in future.
Shane was involved in our engagement workshop with WBACRC
Perhaps predictably, one of the first questions I asked when approached to be Chair of the Nuffield Council inquiry on the future of ageing was: ‘how will people be involved in this work?’. I was glad to receive a positive and constructive answer. Two years on, Molly Gray and I reflect here on how the inquiry has connected with people, and how it has been informed by the people for whom it is most relevant. And therein lay our first challenge: a guiding principle set out by the HRA’s best practice principles for public involvement is that you should ‘involve the right people’ and ‘involve enough people’. No mean feat when ageing is relevant to all of us.
A second challenge was timing. Our plans for involvement were conceived in the winter of 2020-2021, with the impact of COVID-19 still uncertain when it came to thinking about dialogue events, workshops and meetings. Nevertheless, we put forward an ambitious engagement programme with the aim to be as inclusive as we could within the limits of our budget and emerging from the COVID pandemic. We planned:
Liz was involved in our open forum engagement workshop, alongside other members of the GMOPN, and other residents in Manchester (organised in collaboration with Sonder Radio)
Creative engagement workshops
We chose creative methods for these workshops as our experience shows that arts-based approaches can level power relationships when it comes to subjects where technical knowledge might be privileged over other forms of wisdom. Also, being creative provided the opportunity to produce accessible outputs from the workshops, for wider engagement, and which informed the discussions of the working group. In total, 80 people from all walks of life took part in the engagement workshops. All workshops were co-designed with the people and organisations who hosted them and were professionally facilitated. With consent, we collected demographic data from participants to understand whose voices were being aired. The workshops included:
Rachel joined us from Sonder Radio to collaborate on our open forum engagement workshop, with members of the GMOPN, and other residents in Manchester
Summary of dialogue
Following the creative engagement workshops, we ran a small deliberative public dialogue. The aim of the dialogue was to ‘stress test’ the recommendations that have been developed throughout the inquiry to make sure these recommendations are reflective of the views and values of citizens as well as experts. The Nuffield Council on Bioethics appointed the research organisation, BritainThinks to deliver the dialogue. The design of this dialogue in particular was based on three key principles:
Working with professional recruiters, a total of 24 members of the public were recruited from two areas in England: Kent and West Yorkshire. Participants took part in three workshops (one in-person and two online), where they were introduced to the concept of ageing and the current process of research and development within ageing research. Presentations from experts stimulated participants to come up with their own recommendations for reaching a better future for ageing before introducing the inquiry’s emerging recommendations which were discussed and refined in the final workshop. An interactive overview of the dialogue published today details the participant-generated recommendations and conclusions.
Alex was involved in our intergenerational roundtable event, an engagement workshop that took place in Exeter
What we learned
Our engagement activities ran alongside our working group deliberations and our report highlights how and where learning from these activities influenced and guided our recommendations. Working group members joined the engagement activities, and more generally brought their experience of working with older adults in their wider work. However, of course, we are very aware that our engagement was not exhaustive and that there many communities and sections within society that we did not reach, within our timeframe and resources such as travellers’ communities.
At the outset, we thought long and hard about having lay members on the working group. We balanced the need to hear from as many different perspectives as possible with a more restricted format of involvement. As working group members, we also brought to bear our own experiences of ageing to the group as ‘older’ and ‘younger’ people of chronological age, as unpaid carers including for those living with precarious housing and mental health considerations, as members of racially minoritised communities, and family members of older people with vibrant lives but who felt othered by society, science and technology. As a public involvement professional, I often rail against the argument that ‘professionals’ employed within research and/or health spheres can also wear hats/be considered as ‘public’ contributors drawing on their own lived experience. Perhaps, because ageing affects us all, there is room for flexibility here?
My experience of the last two years of being part of this working group, and hearing from everyone I encountered in our engagement activities, has opened my eyes to just how mixed our experiences of ageing are, that old age is not something to be endured but rather enjoyed, and thinking so entrenches ageist and unhelpful attitudes. Science and technology have the potential to help us flourish in later life, by understanding, diagnosing and improving health conditions in older age and developing treatments, assistive technologies and preventive approaches. But only if it does so by placing the people it aims to affect at the forefront of its practice, addressing the unacceptable inequalities that persist into older age, and considers the many ways in which society needs to change in order better to meet the needs of older adults.
With thanks to: everyone who took part in our workshops and the public dialogue; all of our partner organisations who supported our workshops; and Molly Gray, Researcher at the Nuffield Council on Bioethics.