I think the essence of this slide and this talk is how we actually move from
this talk is how we actually move from
this talk is how we actually move from care spaces to caring systems we have a
care spaces to caring systems we have a
care spaces to caring systems we have a lot of discourse around how we improve
lot of discourse around how we improve
lot of discourse around how we improve our hospitals our practices our caring
our hospitals our practices our caring
our hospitals our practices our caring institutions but how do we move on to
institutions but how do we move on to
institutions but how do we move on to caring systems we already when you think
caring systems we already when you think
caring systems we already when you think about that you already notice a slight
about that you already notice a slight
about that you already notice a slight difference in emphasis in preparation of
difference in emphasis in preparation of
difference in emphasis in preparation of this talk I came across a quote in a
this talk I came across a quote in a
this talk I came across a quote in a newspaper about a young couple that
newspaper about a young couple that
newspaper about a young couple that moved to New York City from Dublin this
moved to New York City from Dublin this
moved to New York City from Dublin this was around the time I moved to Ireland
was around the time I moved to Ireland
was around the time I moved to Ireland to moving to a new country allows you to
to moving to a new country allows you to
to moving to a new country allows you to reinvent yourself and I passed a little
reinvent yourself and I passed a little
reinvent yourself and I passed a little bit to think what that means in terms of
bit to think what that means in terms of
bit to think what that means in terms of our topic today the transgenerational
our topic today the transgenerational
our topic today the transgenerational world I’ve moved several times and you
world I’ve moved several times and you
world I’ve moved several times and you saw an illustration from Dundee to
saw an illustration from Dundee to
saw an illustration from Dundee to Dublin recently but I’ve used several
Dublin recently but I’ve used several
Dublin recently but I’ve used several times before and had to reinvent or
times before and had to reinvent or
times before and had to reinvent or readjust readapt had to change I’m
readjust readapt had to change I’m
readjust readapt had to change I’m thinking about our generations a
thinking about our generations a
thinking about our generations a transgenerational world when you think
transgenerational world when you think
transgenerational world when you think about it and reflect about it a moment
about it and reflect about it a moment
about it and reflect about it a moment when your parents were born your
when your parents were born your
when your parents were born your grandparents were born what that world
grandparents were born what that world
grandparents were born what that world looked like when you were born and what
looked like when you were born and what
looked like when you were born and what has happened the last maybe 20 30 years
has happened the last maybe 20 30 years
has happened the last maybe 20 30 years how life around you has changed how
how life around you has changed how
how life around you has changed how people around you have changed people
people around you have changed people
people around you have changed people who might still be here others might be
who might still be here others might be
who might still be here others might be gone and new people like our youngest
gone and new people like our youngest
gone and new people like our youngest TED talk member today have entered this
TED talk member today have entered this
TED talk member today have entered this world so this requires a lot of
world so this requires a lot of
world so this requires a lot of adaptation a lot of flexibility but our
adaptation a lot of flexibility but our
adaptation a lot of flexibility but our our caring systems our healthcare and
our caring systems our healthcare and
our caring systems our healthcare and social care systems our systems that we
social care systems our systems that we
social care systems our systems that we are interacting with are they prepared
are interacting with are they prepared
are interacting with are they prepared to match this diversity this dynamic so
to match this diversity this dynamic so
to match this diversity this dynamic so we’re living in changing worlds and have
we’re living in changing worlds and have
we’re living in changing worlds and have changing lives one of the those changes
changing lives one of the those changes
changing lives one of the those changes manifests themselves in the way
manifests themselves in the way
manifests themselves in the way we think of families still in policy
we think of families still in policy
we think of families still in policy documents and strategies we speak of
documents and strategies we speak of
documents and strategies we speak of family-centered family-friendly policies
family-centered family-friendly policies
family-centered family-friendly policies but rarely do we pause about and think
but rarely do we pause about and think
but rarely do we pause about and think about you know what family actually
about you know what family actually
about you know what family actually means nowadays we’ve great awareness of
means nowadays we’ve great awareness of
means nowadays we’ve great awareness of more diverse families than ever before
more diverse families than ever before
more diverse families than ever before I saw a while back in a little Metro
I saw a while back in a little Metro
I saw a while back in a little Metro free newspaper a clip of I think was
free newspaper a clip of I think was
free newspaper a clip of I think was around the time when and Elton John and
around the time when and Elton John and
around the time when and Elton John and his partner adopting a child is seeking
his partner adopting a child is seeking
his partner adopting a child is seeking to adopt a child forty five permutations
to adopt a child forty five permutations
to adopt a child forty five permutations family we have single-parent families we
family we have single-parent families we
family we have single-parent families we have same-sex families we have
have same-sex families we have
have same-sex families we have multi-generational families we have
multi-generational families we have
multi-generational families we have childless families with nuclear families
childless families with nuclear families
childless families with nuclear families extended families and so on this little
extended families and so on this little
extended families and so on this little illustration here just shows you a
illustration here just shows you a
illustration here just shows you a patchwork of these different notions of
patchwork of these different notions of
patchwork of these different notions of family again if we pause and think how
family again if we pause and think how
family again if we pause and think how well our systems geared up to match the
well our systems geared up to match the
well our systems geared up to match the needs of these diverse families another
needs of these diverse families another
needs of these diverse families another notion of change relates to community we
notion of change relates to community we
notion of change relates to community we can think about how communities now live
can think about how communities now live
can think about how communities now live together work together the spaces they
together work together the spaces they
together work together the spaces they inhabit and I’m thinking about my mom
inhabit and I’m thinking about my mom
inhabit and I’m thinking about my mom who lives in a suburban community in
who lives in a suburban community in
who lives in a suburban community in Germany has lived there about 40 years
Germany has lived there about 40 years
Germany has lived there about 40 years he’s 85 years old now and a lot of
he’s 85 years old now and a lot of
he’s 85 years old now and a lot of things have changed in that community
things have changed in that community
things have changed in that community when she moved in there were a lot of
when she moved in there were a lot of
when she moved in there were a lot of families of probably the same age there
families of probably the same age there
families of probably the same age there were a lot of traditional farm farmers
were a lot of traditional farm farmers
were a lot of traditional farm farmers still in the community active and she
still in the community active and she
still in the community active and she was welcomed she was become became
was welcomed she was become became
was welcomed she was become became quickly a part of the family of their
quickly a part of the family of their
quickly a part of the family of their community now in the last 10 years
community now in the last 10 years
community now in the last 10 years families older family members have moved
families older family members have moved
families older family members have moved out of the community or have died
out of the community or have died
out of the community or have died children like me have moved all have
children like me have moved all have
children like me have moved all have moved abroad and the neighbors are new
moved abroad and the neighbors are new
moved abroad and the neighbors are new their social support structures and
their social support structures and
their social support structures and social environments that she is
social environments that she is
social environments that she is confronted with
confronted with
confronted with is completely different now than was
is completely different now than was
is completely different now than was thirty years ago but now she needs those
thirty years ago but now she needs those
thirty years ago but now she needs those social connections now she needs those
social connections now she needs those
social connections now she needs those links but they’re hard to find people
links but they’re hard to find people
links but they’re hard to find people drive into the city to do their shopping
drive into the city to do their shopping
drive into the city to do their shopping the local shop that used to cater for
the local shop that used to cater for
the local shop that used to cater for immediate needs like milk potatoes and
immediate needs like milk potatoes and
immediate needs like milk potatoes and so on
so on
so on slows down it was not sustainable
slows down it was not sustainable
slows down it was not sustainable anymore that is the shop she could reach
anymore that is the shop she could reach
anymore that is the shop she could reach she doesn’t use the internet she doesn’t
she doesn’t use the internet she doesn’t
she doesn’t use the internet she doesn’t believe the Internet she is not a
believe the Internet she is not a
believe the Internet she is not a digital immigrant or digital native as
digital immigrant or digital native as
digital immigrant or digital native as we call it but she predates the internet
we call it but she predates the internet
we call it but she predates the internet technology the way we communicate the
technology the way we communicate the
technology the way we communicate the way we access information the way we buy
way we access information the way we buy
way we access information the way we buy things shop for things get get connected
things shop for things get get connected
things shop for things get get connected with each other has strange dramatically
with each other has strange dramatically
with each other has strange dramatically in the last 20 years or so
in the last 20 years or so
in the last 20 years or so smartphone density is now higher in some
smartphone density is now higher in some
smartphone density is now higher in some East African countries than in parts of
East African countries than in parts of
East African countries than in parts of Germany so it’s a global phenomenon that
Germany so it’s a global phenomenon that
Germany so it’s a global phenomenon that the way we communicate has changed
the way we communicate has changed
the way we communicate has changed people under 20 or 25 I would say have
people under 20 or 25 I would say have
people under 20 or 25 I would say have seen now more places in this world then
seen now more places in this world then
seen now more places in this world then the older generation could ever dream of
the older generation could ever dream of
the older generation could ever dream of so we’re highly mobile our workforce is
so we’re highly mobile our workforce is
so we’re highly mobile our workforce is highly mobile and yet our older
highly mobile and yet our older
highly mobile and yet our older population but not only them becomes
population but not only them becomes
population but not only them becomes increasingly socially isolated and
increasingly socially isolated and
increasingly socially isolated and lonely so loneliness is a real
lonely so loneliness is a real
lonely so loneliness is a real phenomenon we communicate a real-time
phenomenon we communicate a real-time
phenomenon we communicate a real-time more than ever before instantly through
more than ever before instantly through
more than ever before instantly through Twitter Facebook and so on but
Twitter Facebook and so on but
Twitter Facebook and so on but loneliness is increasing so what do we
loneliness is increasing so what do we
loneliness is increasing so what do we see we see a huge fragmentation of the
see we see a huge fragmentation of the
see we see a huge fragmentation of the way we live the way we communicate and
way we live the way we communicate and
way we live the way we communicate and also the way our services are arranged
also the way our services are arranged
also the way our services are arranged and organized we need to find a way to
and organized we need to find a way to
and organized we need to find a way to overcome this fragmentation and to
overcome this fragmentation and to
overcome this fragmentation and to reconnect the dots that are currently
reconnect the dots that are currently
reconnect the dots that are currently isolated we operate in these silos
isolated we operate in these silos
isolated we operate in these silos we try to create efficiencies in
we try to create efficiencies in
we try to create efficiencies in hospitals through Lean Six Sigma or
hospitals through Lean Six Sigma or
hospitals through Lean Six Sigma or whatever
whatever
whatever managerial mechanisms we try to
managerial mechanisms we try to
managerial mechanisms we try to implement but even connecting
implement but even connecting
implement but even connecting information from the hospital to the GP
information from the hospital to the GP
information from the hospital to the GP becomes difficult with all the
becomes difficult with all the
becomes difficult with all the technology in the world but cannot have
technology in the world but cannot have
technology in the world but cannot have electronic records that follow the
electronic records that follow the
electronic records that follow the patient Social Care
patient Social Care
patient Social Care supposedly integrated completely
supposedly integrated completely
supposedly integrated completely different ways of capturing data for
different ways of capturing data for
different ways of capturing data for instance in Scotland several initiatives
instance in Scotland several initiatives
instance in Scotland several initiatives are underway to rectify that but the
are underway to rectify that but the
are underway to rectify that but the huge challenging effort and then the
huge challenging effort and then the
huge challenging effort and then the communities that develop that change
communities that develop that change
communities that develop that change constantly and the families within those
constantly and the families within those
constantly and the families within those communities the ways they live the ways
communities the ways they live the ways
communities the ways they live the ways that communicate the ways they support
that communicate the ways they support
that communicate the ways they support each other who is the caregiver I’m a
each other who is the caregiver I’m a
each other who is the caregiver I’m a caregiver for my mum but I live about
caregiver for my mum but I live about
caregiver for my mum but I live about 2,000 kilometres away so that’s a new
2,000 kilometres away so that’s a new
2,000 kilometres away so that’s a new reality that we communicate that we need
reality that we communicate that we need
reality that we communicate that we need to communicate and work with so as I
to communicate and work with so as I
to communicate and work with so as I said we are focusing very much on our
said we are focusing very much on our
said we are focusing very much on our structures on making our hospitals
structures on making our hospitals
structures on making our hospitals efficient on improving discharge and all
efficient on improving discharge and all
efficient on improving discharge and all the data that we have so we are the
the data that we have so we are the
the data that we have so we are the length of stay for many conditions have
length of stay for many conditions have
length of stay for many conditions have has decreased at the same time we lack
has decreased at the same time we lack
has decreased at the same time we lack GPS a massive lack of GPS and under
GPS a massive lack of GPS and under
GPS a massive lack of GPS and under utilization of public health nurses for
utilization of public health nurses for
utilization of public health nurses for instance in in Ireland so we desperately
instance in in Ireland so we desperately
instance in in Ireland so we desperately need to reconnect the systems because at
need to reconnect the systems because at
need to reconnect the systems because at the moment they are fragmented we’re
the moment they are fragmented we’re
the moment they are fragmented we’re talking about clinical pathways and
talking about clinical pathways and
talking about clinical pathways and that’s fine we’re talking about stroke
that’s fine we’re talking about stroke
that’s fine we’re talking about stroke pathways dementia pathways but people
pathways dementia pathways but people
pathways dementia pathways but people are not just conditions and more often
are not just conditions and more often
are not just conditions and more often than not when you’re 65 and older you
than not when you’re 65 and older you
than not when you’re 65 and older you just have more than one condition to
just have more than one condition to
just have more than one condition to manage you might have dementia and a
manage you might have dementia and a
manage you might have dementia and a stroke and a learning disability or
stroke and a learning disability or
stroke and a learning disability or something else that need to come into
something else that need to come into
something else that need to come into the picture I think it’s time to think
the picture I think it’s time to think
the picture I think it’s time to think about people pathways relationship
about people pathways relationship
about people pathways relationship pathways rather than clinical pathways
pathways rather than clinical pathways
pathways rather than clinical pathways we need to move the power back from the
we need to move the power back from the
we need to move the power back from the professions into the public
professions into the public
professions into the public decision-making back into people and
decision-making back into people and
decision-making back into people and together with the professions not in
together with the professions not in
together with the professions not in isolation it’s about relationships
isolation it’s about relationships
isolation it’s about relationships it’s about people centeredness community
it’s about people centeredness community
it’s about people centeredness community centeredness family centeredness this
centeredness family centeredness this
centeredness family centeredness this these are the assets that people bring
these are the assets that people bring
these are the assets that people bring to the table then don’t live in
to the table then don’t live in
to the table then don’t live in isolation tank have hobby friends their
isolation tank have hobby friends their
isolation tank have hobby friends their relatives their colleagues they engage
relatives their colleagues they engage
relatives their colleagues they engage in work spaces and so on they have
in work spaces and so on they have
in work spaces and so on they have places of worship supermarkets they
places of worship supermarkets they
places of worship supermarkets they engage with and so on we need to think
engage with and so on we need to think
engage with and so on we need to think out of the box we need to harness the
out of the box we need to harness the
out of the box we need to harness the complexity of these systems in order to
complexity of these systems in order to
complexity of these systems in order to create something that I call a
create something that I call a
create something that I call a flourishing system a flourishing caring
flourishing system a flourishing caring
flourishing system a flourishing caring system and I’m drawing here on this
system and I’m drawing here on this
system and I’m drawing here on this ecosystem notion but also on concepts
ecosystem notion but also on concepts
ecosystem notion but also on concepts that come from positive psychology in
that come from positive psychology in
that come from positive psychology in terms of how people flourish and it’s
terms of how people flourish and it’s
terms of how people flourish and it’s not rocket science it’s five components
not rocket science it’s five components
not rocket science it’s five components that Seligman and colleagues have worked
that Seligman and colleagues have worked
that Seligman and colleagues have worked up there are positive emotions it’s
up there are positive emotions it’s
up there are positive emotions it’s about engagement it’s about
about engagement it’s about
about engagement it’s about relationships it’s about meaning and
relationships it’s about meaning and
relationships it’s about meaning and it’s about achievement if you think
it’s about achievement if you think
it’s about achievement if you think about those we lift these systems from
about those we lift these systems from
about those we lift these systems from individual a individual component up to
individual a individual component up to
individual a individual component up to a system level I think we can do it we
a system level I think we can do it we
a system level I think we can do it we need to enhance connectivity engagement
need to enhance connectivity engagement
need to enhance connectivity engagement and there’s lots of emphasis in Scotland
and there’s lots of emphasis in Scotland
and there’s lots of emphasis in Scotland in Ireland and other places about civic
in Ireland and other places about civic
in Ireland and other places about civic engagement public involvement but we
engagement public involvement but we
engagement public involvement but we also need to be mindful that it doesn’t
also need to be mindful that it doesn’t
also need to be mindful that it doesn’t become tokenism that people are excluded
become tokenism that people are excluded
become tokenism that people are excluded from this engagement practice we’re
from this engagement practice we’re
from this engagement practice we’re talking with the diverse population we
talking with the diverse population we
talking with the diverse population we need to adapt the methodologies the
need to adapt the methodologies the
need to adapt the methodologies the methods how we engage with people
methods how we engage with people
methods how we engage with people whether it’s using sign language for
whether it’s using sign language for
whether it’s using sign language for deaf population whether it’s providing
deaf population whether it’s providing
deaf population whether it’s providing accessible venues for people to come to
accessible venues for people to come to
accessible venues for people to come to to engage and transportation support
to engage and transportation support
to engage and transportation support whether it’s a supply supplying
whether it’s a supply supplying
whether it’s a supply supplying alternative formats for reading and
alternative formats for reading and
alternative formats for reading and understanding the information for people
understanding the information for people
understanding the information for people with learning disabilities and so on so
with learning disabilities and so on so
with learning disabilities and so on so we need to think in terms of diversity
we need to think in terms of diversity
we need to think in terms of diversity not only the easy to reach or easy to
not only the easy to reach or easy to
not only the easy to reach or easy to easy to engage people and it’s about
easy to engage people and it’s about
easy to engage people and it’s about happiness it’s about hope it’s about
happiness it’s about hope it’s about
happiness it’s about hope it’s about positivity when I went to Brazil a few
positivity when I went to Brazil a few
positivity when I went to Brazil a few years back and I visited a hospital one
years back and I visited a hospital one
years back and I visited a hospital one thing that struck me immediately is how
thing that struck me immediately is how
thing that struck me immediately is how the caring professions interacted with
the caring professions interacted with
the caring professions interacted with each other and with the patients there
each other and with the patients there
each other and with the patients there were a lot of smiles people pause the
were a lot of smiles people pause the
were a lot of smiles people pause the liqueur it was to hug each other asked
liqueur it was to hug each other asked
liqueur it was to hug each other asked about their day and there was a lot of
about their day and there was a lot of
about their day and there was a lot of laughter on the bedside there was a lot
laughter on the bedside there was a lot
laughter on the bedside there was a lot of painting drawing a lot of creative
of painting drawing a lot of creative
of painting drawing a lot of creative activity if you wear student nurse you
activity if you wear student nurse you
activity if you wear student nurse you were encouraged if you were a good
were encouraged if you were a good
were encouraged if you were a good singer to sing with the patients and
singer to sing with the patients and
singer to sing with the patients and they did that so they embrace this
they did that so they embrace this
they did that so they embrace this positive holistic understanding of well
positive holistic understanding of well
positive holistic understanding of well create a good environment a positive
create a good environment a positive
create a good environment a positive environment and positive relationships
environment and positive relationships
environment and positive relationships and create a hopeful environment create
and create a hopeful environment create
and create a hopeful environment create an environment that provides nourishment
an environment that provides nourishment
an environment that provides nourishment a while back we wrote a paper about
a while back we wrote a paper about
a while back we wrote a paper about dementia and trying to shift the notion
dementia and trying to shift the notion
dementia and trying to shift the notion away from decline to development things
away from decline to development things
away from decline to development things that you can discover there are armed
that you can discover there are armed
that you can discover there are armed people that constantly evolve and change
people that constantly evolve and change
people that constantly evolve and change if you adopt a notion of change rather
if you adopt a notion of change rather
if you adopt a notion of change rather than defect decline deficiency if you
than defect decline deficiency if you
than defect decline deficiency if you embrace a social model or a relational
embrace a social model or a relational
embrace a social model or a relational model rather than a deficit model of
model rather than a deficit model of
model rather than a deficit model of functional model finally I think really
functional model finally I think really
functional model finally I think really important meaning what matters to people
important meaning what matters to people
important meaning what matters to people we did some work on stroke a while back
we did some work on stroke a while back
we did some work on stroke a while back and asked really what kind of outcomes
and asked really what kind of outcomes
and asked really what kind of outcomes are really picked up by therapists who
are really picked up by therapists who
are really picked up by therapists who work in the community and we found
work in the community and we found
work in the community and we found actually they use the same measures the
actually they use the same measures the
actually they use the same measures the same standardized functional measures
same standardized functional measures
same standardized functional measures that they would use in the hospital
that they would use in the hospital
that they would use in the hospital whether someone can walk a certain
whether someone can walk a certain
whether someone can walk a certain distance or can pick up certain things
distance or can pick up certain things
distance or can pick up certain things but does that really matter when we
but does that really matter when we
but does that really matter when we people yeah it is maybe it means to an
people yeah it is maybe it means to an
people yeah it is maybe it means to an end but what ultimately matters is being
end but what ultimately matters is being
end but what ultimately matters is being down the down the pub with a friends
down the down the pub with a friends
down the down the pub with a friends being back in dance hall to do ballroom
being back in dance hall to do ballroom
being back in dance hall to do ballroom dancing to meet the grandchildren to
dancing to meet the grandchildren to
dancing to meet the grandchildren to lift them up so those things matter but
lift them up so those things matter but
lift them up so those things matter but we need to ask them we also need to
we need to ask them we also need to
we need to ask them we also need to understand the biographies of
understand the biographies of
understand the biographies of individuals of families how people live
individuals of families how people live
individuals of families how people live how they want to live how the desire to
how they want to live how the desire to
how they want to live how the desire to live how they’ve lived in the past no
live how they’ve lived in the past no
live how they’ve lived in the past no need to bang on about being physically
need to bang on about being physically
need to bang on about being physically active if you never been physically
active if you never been physically
active if you never been physically active in your life you know it’s you
active in your life you know it’s you
active in your life you know it’s you need to understand where it’s coming
need to understand where it’s coming
need to understand where it’s coming from
from
from well sit if you have an athletic family
well sit if you have an athletic family
well sit if you have an athletic family yeah it might be a no-brainer to do this
yeah it might be a no-brainer to do this
yeah it might be a no-brainer to do this after you had a stroke to encourage that
after you had a stroke to encourage that
after you had a stroke to encourage that physical activity and from a health
physical activity and from a health
physical activity and from a health perspective I’m not arguing from that it
perspective I’m not arguing from that it
perspective I’m not arguing from that it might be functional but is it meaningful
might be functional but is it meaningful
might be functional but is it meaningful and people need to have a sense of
and people need to have a sense of
and people need to have a sense of belonging as well and experience that
belonging as well and experience that
belonging as well and experience that again a while back we had a little
again a while back we had a little
again a while back we had a little project looking at the difference
project looking at the difference
project looking at the difference between housing and making a home I
between housing and making a home I
between housing and making a home I think it relates very much to place
think it relates very much to place
think it relates very much to place making as well as home making home is
making as well as home making home is
making as well as home making home is not a notion of a physicality per se
not a notion of a physicality per se
not a notion of a physicality per se home is something that has an emotional
home is something that has an emotional
home is something that has an emotional connotation as a social relational
connotation as a social relational
connotation as a social relational connotation it’s where people are happy
connotation it’s where people are happy
connotation it’s where people are happy where they connected where they feel
where they connected where they feel
where they connected where they feel well and this well-being this feeling
well and this well-being this feeling
well and this well-being this feeling feeling well I think is essential and
feeling well I think is essential and
feeling well I think is essential and lastly we need to enable people to gain
lastly we need to enable people to gain
lastly we need to enable people to gain the sense of achievement not necessarily
the sense of achievement not necessarily
the sense of achievement not necessarily it sounds almost patronizing to say
it sounds almost patronizing to say
it sounds almost patronizing to say enable because they bring a lot of
enable because they bring a lot of
enable because they bring a lot of assets people bring assets people have
assets people bring assets people have
assets people bring assets people have assets but we need to recognize them we
assets but we need to recognize them we
assets but we need to recognize them we need to encourage aides agency in people
need to encourage aides agency in people
need to encourage aides agency in people we need to harness that agency to create
we need to harness that agency to create
we need to harness that agency to create the systems that will ultimately help us
the systems that will ultimately help us
the systems that will ultimately help us flourish thank you
flourish thank you
flourish thank you you
you
you [Applause]
”
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