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My first encounter around gerontological study took place a few years ago when, as a master’s degree student in political sociology, I investigated social relations in a nursing home. Naive and inexperienced as I was, I spent days walking down the isles of a medicalised retirement home under the curious stares of residents. I thought I was like those early 20th century anthropologists observing South American Guarani tribes or some other newly discovered civilizations. I would interview any resident willing to tell me their story. One evening, while packing my research toolkit made of a little notebook and an audio recorder, I met a man that I had never seen in the residence before. He seemed impatient and in a rush. Yet, he accepted to be one of my research subjects! I did not know it would turn out to be one of the most inspiring interviews I would conduct. Inspiring and heartbreaking.

He was a very independent man who had moved in the nursing home to follow and support his now severely demented wife. He taught me of the set-devaluation people can feel by being institutionalised. This mid seventies man had been one of the research brains at Airbus a few years back. His engineering skills had made him a well-respected and successful individual. But here, he had lost all peer recognition. Entering the nursing home had been the last step of a long staircase of declining social recognition since his retirement.

Thinking that his knowledge could be valuable to the community, he had prepared a 50-page report suggesting changed in the air-conditioning system of the building. In dispair, he told me that the director, a converted restaurant manager who, in his own words, “understood nothing about older people”, had pushed the report with the back of his hand and had asked him to go back to being just a resident. He, who had received awards and had been congratulated throughout his life was now in his eyes useless with nothing to expect from the future.

His story is only one example of the painful way down older age that many undergo. It suggested to me that the higher place one had reached in life, the steeper and more unbearable the fall as old age hit was. Where was the graceful ageing some promote? In his eyes, “there was absolutely nothing good about ageing,” as another interviewee stated. This is this process that I found wonderfully depicted in the film “the Iron Lady” that I recommended in a previous post. It is also this process that inspired the title of the research project, voluntarily provoking: “is there life before death?”

Since the mid 1990’s, awareness around the risks and burden of osteoporosis has climbed up the ladder of public agendas. It came alongside the discovery of pharmaceutical medicines preventing the loss of bone mass (bisphosphonates). As soon as drugs were made available on Western markets, uptake rates built up. The most renown bisphonsphonate, Fosamax (alendronate) participated in the success of the pharmaceutical company Merck & Co.

The following graph, computed from Hernlund et al (1) describes in DDDs (defined daily dosage) the evolution of the osteoporosis medications uptake rates in France between 2001 and 2011. The increasing trend was very clear between 2011 and 2007. However, 2008 appeared to be a turning point, whereby consumption started declining. Investigating and explaining this trend is the main aim of my PhD.

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The number of osteoporotic people does not seem to have declined, drug prices have very significantly fallen and scanners for diagnostic have never been has widely available as they are now. So I wonder about the phenomenon occurring since 2008. Is the way osteoporotic drugs are perceived changing? Is there a profound change in the way we apprehend care for older people? Were the benefits associated with these treatments overdone (and adverse events underestimated?)? Were too many people being unnecessarily treated?

(1) Hernlund, E., Svedbom, A., Ivergard, M., & Compston, J. (2013). Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden. Archives of Osteoporosis, 8(136). Retrieved from http://www.iofbonehealth.org/osteoporosis-european-union-medical-management-epidemiology-and-economic-burden

At my parents, there is an old mechanic clock. As I was younger I took care of it and particularly enjoyed understanding its little characteristics that made it unique such as the position the weights should be put up to or the little rolling wheel noise that it made before it was going to ring. Watching me working on it, my mother once said,

“After all the efforts you’ve put on that clock, you must inherit it.”

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This phrase made me question the concept of inheritance and its adequacy to present times. As people live longer, the average age of inheritance gets postponed. In many cases, inheritors are older people themselves at the time both parents have passed. Very naively, I concluded that the concept itself was outdated considering that we don’t need that much resources at such an age, so I researched around the topic.

1. Families have realised this a long time ago. Assuming that no live transgenerational transfers of resources occur within families is wrong. In fact, live inheritance are encouraged by States and inheritance at death is increasingly discouraged (at least in France) via very high taxation barriers. This is in fact one of the key arguments discrediting the theory that an intergenerational war between the young left out to pay retirees and the old benefiting from past social advantages, will take place.

2. People need money at retirement. If it is true that younger people need resources to settle in their twenties and thirties, it is also true when entering retirement as income drops dramatically. The assumption that people at 60 wouldn’t benefit from inheriting is flawed.

3. People are having children later. I had initially left aside the other demographic truth that average age of parents at birth of their first child has increased significantly (first birth postponed by nearly 4 years in 30 years in the US). This mitigates the hypothesis that age at inheritance had increased as much as life expectancy.

Despite some valid counter-arguments, this reflexion pushed me to conclude that the old concept of inheritance was not inadequate, but rather was in profound mutation due to the demographic evolution of societies. It is inheritance at death which is inadequate. The fact that inheritance is increasingly separated from death is, I believe, a good thing. Benefiting from someone’s death is morally strange to me. It is even worse so when one benefits from the death of those he/she loved the most dearly.

Half of the work of writing a PhD is around redefining, reorienting and remodelling the research question. I am learning this the hard way. But this is a lesson that I find useful in many other situations.

On a day-to-day basis, we continually find simple solutions to simple problems. A water leak needs proper care. If not too handy, one call to the plumber. An indecent bill later, the problem is solved. In research, we spend so much time and energy on the methods, the research, the reading, the thinking that we often find ourselves wandering and suddenly asking an imaginary friend: “What is it that I am researching? What is the problem? What is my research question?

There are loads of posts on LinkedIn about making the best decisions in your life, about happiness at work and so on. These posts often offer solutions to a number of problems and the reader question whether or not it applies to him/her. Many solutions are proposed, but few posts suggest to properly assess the problem. There are numerous reasons to be unsatisfied/unhappy about work, research family or else, but are we capable of identifying exactly what it is that troubles us, what the exact problem is?

The risk of not taking the time to identify the problem is to jump into solutions that don’t actually respond to the problem. Resources of all kinds will have been thrown into this solution and once quiet has come back, the same uncomfortable feeling comes back with it. All that for nothing: back to square one.

My grandmother is frail. She has difficulties walking, she is at high risk of falling and troubles in her life can easily overwhelm her. As long as days are ordinary, she lives a quasi-normal lifestyle. In a state of frailty, recovery from illnesses takes longer and can be the source of temporary disorientation.

The other day, a friend of mine in his mid-twenties was recounting his recent experience. He had hurt his back at the gym and was bedridden for a couple of days. It was a serious injury. During the worst period, he told me of the state of disturbance he was in. ‘I thought I was dying’ he said. Yet, two weeks later he was there talking to me, having recovered almost fully his physical capacity.

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Later I thought that my friend had been quite frail for a short period of time. Had anything else happened – flu, family grievance or housing issues – he could have quickly entered a serious mental and physical distress. So I thought, my grandmother is not frail, she is frailer: we are all frail to a certain extent and we get frailer as things add up on our shoulders. Older people are frailer because, they can suffer from a number of physical limitations, such as sarcopenia (decrease of muscle mass), osteoporosis (bone fragility), or  loneliness, mental limitations and hearing and vision impairments. Because of that, there is only so much more that an older person can bear. But we all have some kind of limitations at all ages

So I ask you: how frail are you?

Unemployment, distance from friends, physical disability, housing issues, relationship problems, pain, sleeplessness, irritability, etc. All those things and many more, increase our level of frailty and possibly impair our judgement capacities. Because we think frailty is something that older people suffer from, we refuse to look at our own state. At all ages, we must learn to know how frail we are so that we can anticipate and best manage difficulties.

At a pub table, a professor asks me, ‘aren’t you you a bit young to be a gerontologist?’ It is not the first time I am told this. ‘You have time before you have to deal with this!’ I have never been told that I was too young to understand the problem, just that it was too early for me to face the harsh truth of older age ; the same way you hide the eyes of a child in front of a gory scene of a film I suppose. The professor is quite right: there are not many younger people in the department of gerontology at King’s. Despite having turned 27, I am still sometimes perceived as the ‘baby’ of the group.

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But when you jump outside of the university, it is a completely different story. Only a few weeks ago, I attended the presentations by the finalists of an entrepreneur scheme, ‘the fellowship for longer lives’, organised by Impact Hub King’s Cross (London) ; a competition seeking to develop new ideas that could enhance the life of older people. For sure, all people there were gerontologists in a way or another.

So, I’m there, sitting and listening  in this room full of some 60 people until the organisers call for a break. A white-headed woman comes to me and asks ‘do you find it funny that I am the only older person here?’ The older lady is right. As I turn around I realise that the room is packed with young entrepreneurs and students. Hardly any silver head. For once, I just fitted in – age-wise.

What does it say about the way gerontological issues are dealt with? I am not quite sure, it may as  well be a coincidence, but I doubt it. It suggests that younger people are less interested in the social sciences of ageing than in entrepreneurship schemes. This could be true of other fields and not be specific to ageing issues. It could also mean that intentionally or unintentionally we welcome different kinds of people to events. The way we communicate and promote events could reach only a smaller population than we thought initially. I hope that it does not mean, however, that social innovation should be conducted by younger people only.

After this encounter, I found difficult to focus on the presentations. Was this meeting looking like a room full of men arguing for the promotion of women in society? I guess, the lesson I learnt from these experiences is that debates and projects on ageing need to include all age groups so that different voices can be heard, younger and older voices.

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