Coming from the University of Hawaii to Queens University, Belfast (QUB) was more than just a change of weather. The Changing Ageing Partnership at QUB provided me with a new model for interaction between researchers, service providers and older consumers. The project, established by Atlantic Philanthropies to improve the quality of life for older people in Northern Ireland, funds over 20 research projects throughout QUB and I was made part of the research launches. At the first research launch in February I was asked to introduce Dr. Karola Dillenburger as she presented the results of her project on older people caring for adult sons and daughters with disabilities. It was my first opportunity to compare support systems for carers in the U.K. with those in the U.S. and it raised issues I continued to explore over my time in Northern Ireland.

During the six months I was at QUB I also had the opportunity to hear Brice Dickson and Lisa Glennon speak on Making Older People Equal: Reforming the law on access to services in Northern Ireland and Jonathan Skinner on Senior Citizen Social Inclusion through Social Dance. I also heard about work in the Western Health Action Zone in Derry with Siobhan Sweeney and Colette Broll and about fruit and vegetable consumption among older people in Northern Ireland from Dr. Appleton and J.V. Woodside. The work done by Western Health Action Zone on engaging men in physical activity and Dr. Skinner’s work on dance and the older person reflected some of my own interests in aging and health promotion and I was able to incorporate some of their findings into a grant which was then submitted to the U.S. Centers for Disease Control and Prevention

The opportunity to participate as a member of the research committee on a survey for Engage with Age on loneliness and isolation further expanded my horizons. After I was invited to speak on my work at a meeting of an Engage with Age chapter, I asked to be allowed to join them in their weekly meetings. This blossomed into my being included in lunches, social opportunities and various outings. This participation gave me the opportunity to hear about the day-today lives of older adults in Belfast as well as the quality and type of services and programs they needed. I have gotten to know this group as friends and have listened as they have struggled with issues such as:-

• Why has my gas bill tripled over the last month?? I can’t even keep warm now.
• I live in sheltered housing, but I am still so lonely. Sometimes I don’t speak to another person all day.
• What will happen to my wife now that she fell and I have Alzheimer’s disease and can’t care for her at home?
• After a lifetime of physical activity how can I continue it now that I’m blind?

...all of which reminded me that ageing and its accompanying problems are indeed a universal concern.

Among other activities, I also

• Met with the Chinese Welfare Association and discussed with them the special needs of Asian elderly in Northern Ireland
• Visited an Alzheimer’s housing program run by Praxis Care
• Presented on the U.S. health care system as compared to the Cuban health care system for the Belfast Royal Hospital Center of Excellence in Public Health.
• Presented the results of my research to The City of Derry Bogside and Brandywell Health Forum and
• Accepted an invitation by LUMSA University to speak at a conference in Taranto, Italy on long term care and geriatric social work.

In order to complete my own research project, I was given unrestricted access to the Northern Ireland Life and Times Survey data from 2006 which included a carer’s supplement. This allowed me to compare previously collected data on carers in the U.S. and China with carers in Northern Ireland on a measure of self-assessed health status utilizing some rather complex methodological techniques (meta–analysis and ordinal probit analysis) that I wanted to perfect as part of my proposed Fulbright research project. Overall as I review my time here I am left with the following findings and impressions:

• In the UK there is transparency and a willingness to share data itself (not just findings). There is also more emphasis on trying out interventions and less on experimental research methodology than in the United States. This leads to far more community level interventions, rather than the small treatment and control group studies we have in the U.S. As a result the stress is on external validity rather than internal reliability, an emphasis I applaud. I also saw greater use of creative and varied qualitative methodologies. As the profession of social work moves towards evidence based practice, we all need to continue to assess interventions in terms of not only simple success or failure, but by assessing groups who did or did not benefit, the costs (both formal and informal) to achieve the benefit, and the conditions under which these outcomes occurred.
• The National Health Service, as well as the Health and Social Care Trusts and the charities, have a strong commitment to provide long term care options and far more available sheltered housing opportunities than in the U.S. However it seems that inexpensive options to increase health related quality of life in these settings are limited. Through the use of ongoing recreational and therapeutic activity programs in housing and institutional settings, improvements in morale and reduction in isolation could perhaps be made.
• Institutional care, which, while it does not impoverish elders as it does at home, seems to be of the same quality as the U.S. Furthermore, it does not seem to include some of the protections (e.g. required reporting of elder abuse and a system in place to process those complaints) that are available in the U.S. whether in institutional care or in the community. Among these systems would notably be organized adult protective services units that are mandated within U.S. social services departments and nursing home ombudsmen programs.
• An emphasis on addressing issues of loneliness and social isolation, that has been apparent across many age related organizations recently, seems well chosen. In Italy, as well as here, it was interesting to see that combating social exclusion of elders had emerged as a priority. It is clear that older adults are not availing themselves of even the social opportunities that do exist and often do not seem to feel part of the society they helped to build. Cross nationally researchers need to begin to ascertain barriers to participation whether they be systemic (e.g. accessible transportation); environmental (housing design); individually based (e.g. physical limitations, depression or mild cognitive impairment) or a reflection of societal values (a culture of self-reliance rather than interdependence).
• Indications are that Northern Ireland will soon have a multi-ethnic aging society. Increasing numbers of people will come from the EU, South Asia, Africa and beyond for work, family or other reasons and will age in place. U.S research can help provide some clues to the sensitive issues that will be raised and possible ways to address them. Additionally organizations that represent diverse groups, such as the Chinese Welfare Association, need to be ‘at the table’. A multicultural ageing population is coming but there is time to plan for cultural and linguistically specific services that may be needed in the future.
• Northern Ireland (and the Republic) are developing an innovative model for participation of their older population in the political process. Compared to the U.S. this vision involves real collaboration. It should be encouraged to grow into areas such as hiring older people to staff projects and committees, as well as just serve on them. Research here is also more inclusive. Research launches and meetings that I have attended have made efforts to reach out to the senior community. This has resulted in lively exchanges, with valid points and issues being raised by older adults that the presenters may not have considered. I believe researchers have learned as much from (and been challenged by!) the audiences of those sessions as have the audiences from the researchers... a true exchange.
• Interestingly my own research showed that at least on a measure of self-assessed health status, carers in NI are doing better than in either China or the U.S. (in spite of lower incomes). Characteristics of carers were compared using two different methods and in both, it appeared that NI carers were benefitting from carer support policies that have been enacted in the past 10 years. Those items that have the strongest positive effect on self-assessed health status (other than that the carer does not have a chronic health problem) were: income; being employed fulltime; not having to provide medical care; not having sleep difficulties and not experiencing emotional strain. I hope that this research provides direction for interventions to assist carers across all three countries.
• Finally, this opportunity provided inspiration for me to pursue new research and program options. Direct payments to carers, carer allowances, available respite services for carers (including older adults caring for those with learning disabilities), women’s pensions at an earlier age, new designs for sheltered living arrangements for elders and people with Alzheimer’s Disease and the making music and dance available to elders are all exciting ideas for me to explore in my ongoing work.

End of Education and Careers section.