Hello. It looks like you’re using an ad blocker that may prevent our website from working properly. To receive the best Tortoise experience possible, please make sure any blockers are switched off and refresh the page.

If you have any questions or need help, let us know at memberhelp@tortoisemedia.com

Sunday 10 March 2019

thinkin • editor’s notes

The challenge of ageing

  • Longevity is a blessing – but we talk about it like a curse. And for all the talk of generational imbalance, older people felt a lot of good-will towards them from younger people.
  • A lot of what needs to happen to support an ageing society is about disability and infirmity: keeping people healthy for as long as possible, and then making the country work better for vulnerable people.
  • Support from the state is hard to access, mean and accessing it often requires families to navigate through an elaborate bureaucratic maze.

By Chris Cook

Tortoise took a ThinkIn to Norwich, in the East of England. Specifically to Ivy Court – a large residential care home. We went to talk about longevity, one of our five big themes – and who better to hear from than a room of real experts on ageing.

We had a lively conversation with a group of residents, a few carers and some external guests, the talk ranging from Norfolk’s red squirrel population through to whether the BBC was good enough for older people.

We asked Elena Kulinskaya, a professor from the University of East Anglia, to talk to us; some of her most striking observations were that increases in longevity have levelled out in Britain. From an actuaries’ perspective, good news. For the rest of us, less so.

But she was an optimist: life expectancy for 70-year-olds rose by 2.7 years for women and 3.7 years for men between 1987 and 2010. Her academic work suggests that about three-quarters of this rise is down to the prescribing of statins. Longevity could start taking off once again when we find another such gain.

I had been keen to avoid the old elephant trap of talking about longevity too negatively; more life is an astonishing blessing. But – for good reasons – we tend to talk about the challenges it raises more than the benefits of it. Longevity is not a crippling pandemic.

However, Brian, a resident, told us that it was important to make sure that increases in life expectancy were in healthy life expectancy. He is quite right: in the UK, female life expectancy rose by eight months between 2009 and 2015, but healthy life expectancy fell. The extra months have all been infirm.

Questions about health quality of life for older people were some of the most important that came up. Longevity and disability are distinct issues – but in an ageing society, especially one where longevity increases are not coming through as healthy life expectancy, they are linked.

Brian, who uses a wheelchair, also recounted the inexplicable use of steps in his local bank. Rachel, the daughter of a late resident, explained that the town centre was poorly laid out for older people: they’re “never considered”. Not enough seating areas, not enough toilets.

Brian (0:17)

Alison Pooley, a lecturer at Anglia Ruskin University, is an expert on how we can make the built environment work better for infirm people. And do not forget the rural elderly, who are often keener on technological solutions to care problems.

Alison knew about this because she has been part of projects involving consulting older people. But, from the residents, a failure to do that – to listen – kept coming up.

“Never considered” was a theme: one resident told us that she always took someone with her to meetings, just to make sure she was heard. The right to dignity is part of our mission at Tortoise; it was troubling to hear fellow citizens feel unheard.

We heard about problems with the way things were physically arranged, even in facilities designed for older people: emergency cords they cannot reach, light switches that are too high and bedrooms laid out with beds (and their occupants) in plain view when doors are opened.

Simon Barnes, one of our contributors, also asked about access to nature: are we doing enough to make it possible for people to connect to the natural world? The residents were pretty cheery about how things were but it was definitely a topic that lit them up.

Again, this might be an area where longevity policy is really about access and disability.

I was interested in whether there were things about modern life, other than the main care system, which placed a strain on families with caring responsibilities. Sam, one of the staff members, explained that bad childcare is a particular problem.

Sam (0:31)

Her mother is trying to care for Sam’s grandfather, but also for Sam’s daughter. It’s a familiar theme: feeble childcare systems feed into problems of care for older people. If Sam were better supported, her mother might have more time for her own mother.

This is not a small problem in the UK, which has a rather poor childcare system: there are 1.3m “sandwich carers” who are looking after young and old relatives simultaneously.

Rachel also mentioned that a carer’s allowance is pitifully thin: £64 a week for people who meet stringent conditions. She also explained how grim she had found dealing with the NHS Continuing Healthcare process: getting the health service to pay for care to which her family was eligible was a nightmare.

Rachel (1:12)

We sometimes use bureaucracy as cost-control: we stop people claiming things by complicating the process. We hide hard decisions with opaque processes. That is true in care, more broadly. Britain is a country that prides itself on the NHS: free healthcare is an article of faith. No wonder Marcia, a resident, told us she didn’t know she’d have to pay for care.

There were a number of happy themes, though. residents were overwhelmingly positive about the attitude of younger people towards them. However tough things are for young people, they do not take it out on the elderly. One resident, Yvonne, had taken a course in English at a local college, and found her fellow students were very decent.

There was a bit of speculation about whether this was because of the particular kindness of the people of Norfolk; I’m not sure we resolved that. But we did agree: there is good-will between the generations, even if there is not good policy.

Further reading