Home > Live Longer Better – A new culture: from “care” to “enablement”

Live Longer Better – A new culture: from “care” to “enablement”

In a career spanning 50 years, Sir Muir Gray has worked with both NHS England and Public Health England to bring about a transformation of care.

Throughout this time Sir Muir has maintained a focus on population ageing and developed a new paradigm to help people live longer better. This aims to compress morbidity at the end of life and to reduce the incidence of dementia and frailty and therefore reduce the need for social care.

Sir Muir has also operated as the Chief Knowledge Officer of the NHS and was awarded both a CBE and later a Knighthood for services for the NHS.

Sir Muir is the keynote speaker at this year’s Active Sussex Conference, which is being held virtually via zoom on Thursday 23 September. His session is titled, ‘Live Longer Better’: A new culture: from “care” to “enablement”, using physical activity as the driver to increase healthspan for older adults’.

Q. Why is it important to be active as we get older?

Activity of the body, the brain and the mind can reduce your risks of dementia and disability and help you live longer. A lot of people think that health problems as we get older are due to ageing, but they aren’t usually due to ageing at all. It’s often due to inactivity.

Learning about activity is the elixir of life!

Q. What needs to change in order to support older people to be more active?

There are some practical barriers for people that need addressing, such as for those that are housebound, because getting out is obviously very important.

There’s also the barrier of digital exclusion because not everyone is online yet, although that’s changing very quickly.

Then there’s the barrier of wrong thinking. Too many people believe you should move less if you’ve got one or more long-term health conditions, but the fact is you should do more and there’s plenty of scientific evidence showing this.So there are practical, digital and psychological barriers. Active Sussex is playing a great role in helping reduce those barriers which is fantastic.

Q. What advice would you give to the Sussex workforce including local authorities, health professionals, charities, and physical activity partners to support the active ageing agenda?

We have to look ahead a bit, and in Sussex – as in all other populations really – the number of people aged over 80 is going to potentially double in the next 10-15 years. But the number of people aged 20 – 60 isn’t going to double.

People sometimes present this as a ‘tidal wave’ of need for health and social care, but this doesn’t have to be the case. We can reduce the need for social care significantly, but we’ve got to shift our thinking from the idea of ‘delivering’ care, to instead ‘enabling’ people to do more for themselves – regaining that lost skill and lost ability.

Q. How is the Live Longer Better community of practice and learning working to change mindsets around aging?

Well, I think we’re very honest and open by saying we need a cultural revolution. We need a completely different way of thinking. We need to be open with people and say that the job of leadership is to change this culture.

One way to do this is by changing the language we use – for example change the word ‘retirement’ to ‘renaissance’! Perhaps stop using the word ‘care’ altogether. Caring about someone is one thing but caring for them is too often doing things for them instead of helping them do things for themselves.

Another way is by reaching large numbers of people in Sussex and get them thinking the right way, properly understanding the relationship between the normal process of ageing, loss of fitness, disease and negative thinking.

Q. What do you want the delegates to take away from the session?

Firstly, to understand that the biological ageing process is not a cause of problems until the late 90s – it’s a lack of movement and loss of fitness that causes problems.

Secondly, that we all are losing muscle strength and fitness, usually from the age of about 22 onwards because most of us have jobs sitting down looking at computer screens and driving cars to and from work. We have not evolved to have a life like we have at the moment. This is an environmental and lifestyle problem.

Thirdly, there are many conditions we can prevent and delay with the help of physical activity and leading healthier lives. Vascular dementia – which is the other main cause of dementia – heart disease and stroke; we can prevent these.

Much of what we think of is due to the effect of diseases but is, in fact, due to the effect of loss of fitness.

My aim is to get people thinking in a different way because that creates the new reality in which older people are seen as making an important contribution to society.

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