Welcome to the GW4 Dying Well Network website and blog.
Background to the Network
The most common age at death in England and Wales in 2010 was 85 for men and 89 for women; the number of older people dying will increase in the next 30 years as the ‘baby boomers’ enter their 80’s. Yet older people nearing the end of life receive poorer health and social care and palliative care – a failure of philosophy, policy and politics as well as of practice.
Following the National Service Framework for Older People, government rhetoric has shifted towards ‘successful ageing’ and promoting independence, a rhetoric embraced by fit third agers. However, this neglects many older people struggling each day with deteriorating physical and mental capacities.
In health policy, the Department of Health’s End of Life Care Strategy has been led by palliative care, whose knowledge base is cancer rather than the multiple morbidities facing many elderly people. The Strategy’s assumption of an autonomous individual freely choosing how to live out a fairly predictable End of Life period is problematic for many older people with unclear dependency trajectories and/or less than full mental capacity.
Research agendas have largely been driven by current policies, yet scandals such as Mid-Staffs, the Liverpool Care Pathway, the collapse of Southern Cross, and social care funding reveal a policy failure to enable good deaths at the end of long lives.
Radically new thinking is required to drive innovative research that can inform philosophy, policy and practice, not only for the frail elderly but also for any with high dependency and mental incapacity who cannot die as free and active agents.