We really should have seen the crisis coming. It isn’t if older people are a forgotten minority. Most of us, whether or not we are old, interact with people who are on a daily basis. And much of our daily fodder in the media tells us about the threat of the “silver tsunami” that is about to hit us.
In reality, the tsunami is more of a gentle wave. And anyway, older people (generally considered as those aged 65 and older) aren’t a single cohesive group. They have different talents, abilities and needs.
But many economists and demographers, in broad-brush assessments based on little more than trend extrapolation, often misrepresent older people by pointing to their dependencies. They “prove” that dependency by setting their number against the population of younger people of “working age” using so-called dependency ratios. These dependency levels are, therefore, not based on actual care and support needs but rather on a population statistic.
There is a minority of older people who have care and support needs. For some, these needs are substantial. But dependency ratios don’t address this and reflects a previous socio-economic era in which older people were “done to” rather than seen as a resource to be used and valued. In presenting such information in terms of dependency, the message that we are expected to take on board is that old means decrepit and decrepit means expensive.
Older people are healthy too
The fact that older people are living longer and healthier lives makes nonsense of such measures. There is no reason why an increase in the number of older people must inevitably mean an overall increase in their dependency on the health and social care system. Research from Harvard University has suggested a net increase in the number of years we live without major health problems.
And where there may be an increase in dependency, this is in large part arises because older people – frequently shunted out of the workforce – have assumed new positions with no expectation that they will contribute to the economic and social lives of our communities.
The good news is that from 2010 until 2035, the number of people older 65 ispredicted to grow by more than 60% from 10.3m to 16.9m. But in terms of dependency ratios, such statistics are seen negatively. If these figrues referred to the level of wheat production, personal happiness, or the population of bees, we’d all be delighted. Isn’t the idea of more people living to an older age something to be celebrated?
The tendency is for many people to answer “no” to this question. The reason for this commonplace response lies in the very real costs associated with care and support for the very frailest or for people with multiple conditions. Dementia care is high on the list of costly long-term conditions, at £23 billion a year. But again, the point must be emphasised that although there are 800,000 mostly older people in the UK with the condition, there are more than 9 million without.
The problem lies in our generally negative view of older age. Those views are reflected in our quick and easy turns of phrase like “over the hill”, “past it”, “old dogs can’t learn new tricks” and the like. They are reflected in people’s lying about their age. And don’t get me started on birthday cards.
The media is sometimes guilty of perpetuating such negative views. But just occasionally a contrary view appears. For example, the positive light in which we see Alex Ferguson. In another context, the 71-year-old former Manchester United football manager would ready for labelling as a dependent, especially with his heart condition.
As much about work and pensions
Maybe the problem lies not in the “facts” about the numbers of older people, but our attitude towards older age and the role of older people in the workplace and about retirement. The word “retirement” kind of says it all. It seems to describe a transition by which older people are expected to move to the sidelines and adopt a new status of second-class citizenship.
Of course, linked with retirement are state pensions. These were introduced in the UK in 1909 – with a qualifying age of 70, later reduced to 65. But today in the EU most people at 65 can expect nearly 10 further years of “healthy life years”. There are plans to review the state pension age in the UK every five years and we can expect the whole notion of retirement to also come under scrutiny.
So the real crisis is not one about any kind of imagined tsunami of need. It is not one about dependence. It is about retirement and pensions.
In this context, the speechwriters missed a chance in the recent Queen’s speech to point not just to our faltering ability to provide services for the neediest older people, but to the contrasting fact that such services become much more affordable if people approaching 65 (and over) are retained in the workforce.
We may, therefore, be able to afford the growing health and social care costs that will be needed by some older people if we approach the challenge with the idea that many will still be paying their way. What will it all cost? I don’t know. But by extending working life by just 18 months there would be an estimated contribution of £15bn to the UK economy and a reduction in government borrowing of one percent. It’s a start.
Malcolm Fisk has received research funding in the last five years from the European Commission, Skills for Care and Development, Care Council for Wales, Amicus Horizon, Sandwell Visually Impaired, The Thomas Pocklington Trust, Blaenau Gwent County Borough Council, Rhondda Cynon Taff County Borough Council, Aneurin Bevan Health Board, Public Health Wales and Nautilus Welfare