New thinking needed to promote active ageing
OPINION:IN IRELAND and throughout the developed world, people are living longer and healthier lives.
Every decade, life expectancy is increasing by 2.5 years. At least half of the babies born today in Ireland are likely to live to be 100. The Central Statistics Office predicts that over the next 30 years, the number of people over the age of 65 will double and the number over 80 will quadruple.
These developments are a cause for celebration, representing as they do significant improvements in standards of living, lifestyles and major developments in medical science and health systems.
An ageing population has major implications for policy, service provision, long-term planning, and society as a whole across areas as diverse as transport, health, local government, housing, education, work, tourism, enterprise development and participation in society.
Traditionally, government policy, as in other countries, has viewed population ageing as problematic – a time bomb threatening the sustainability of public finances because of the implications for health, care and pension costs. While challenges do exist and require new approaches to address these realities, there are also significant benefits to be gained from greater numbers of older people.
Demographers today increasingly speak of the “demographic dividend”.
Older people are an important consumer group and often wish to work beyond current retirement years, even sometimes starting new businesses. They are an important source of volunteering, and play vital roles as grandparents, carers, mentors and “guardians” of many of our important community institutions. We don’t tend to see it that way, however, in part because older people are often in effect “invisible” – retired from the mainstream and “set aside”.
So we need a new approach. Minister of State for Older People Kathleen Lynch has announced her commitment to producing a national positive ageing strategy before the end of the year. This welcome development affords us the opportunity of setting out what those new approaches might be.
The task is complex. A new strategy should meet the needs of the current older population, particularly the oldest. It also needs to prepare for a new generation of older people with very different expectations for their later years – the “baby boomer/civil rights/protest generation”.
It should address the diversity of the population, from those who are younger, healthier and more active, to those who are frail and in need of supports and services (5-10 per cent); from those living in densely populated regions to those in more remote rural areas; from those seeking to be actively engaged in their communities to those who are not and from the socio-economically advantaged and those who are not.
The strategy can build on the many ways in which Ireland is to the fore in areas such as pension and social welfare benefits, palliative care and the recent developments in the Age Friendly Counties Programme.
Irish older people have relatively high levels of self-reported health and happiness – presumably a consequence of the things we are doing right.
So what exactly is the problem we are trying to address? In our recently published New Agenda on Ageing – To make Ireland the Best Country to Grow Old In, we set out three reasons why we need a new strategy.
Firstly, the quality of life of too many older people is unnecessarily poor, particularly for those who are frail, experiencing multiple chronic health conditions or living alone and at risk of poverty.
The report, which draws extensively on Irish and international research, reveals a number of reasons why this is the case. They range from loneliness, isolation and elder abuse to inadequate transport services, exclusion from employment, discrimination, financial insecurity, inaccessible public spaces related to poor lighting, uneven pavements, lack of benches, and concerns about safety in the home and in the community.
People passionately want to stay living in their own homes and community and don’t want to have to go to nursing homes because of a lack of home-care support.
Secondly, we need better long-term planning to address the issues that are currently at problem level. Chronic disease already accounts for 70-80 per cent of European healthcare costs and 86 per cent of deaths.
As people survive illnesses that previously would have been fatal, the numbers experiencing chronic conditions such as dementia and arthritis will increase dramatically. This increase in numbers will escalate into a crisis unless radically new approaches are adopted and changes put in train now.
Many chronic diseases are preventable, delayable or mitigable through a combination of primary prevention measures, screening and early intervention. They also require a move away from treating such conditions in expensive acute hospital settings to more proactive self-care and care-in-community settings.
Lastly, we need a new paradigm on ageing – a new way of thinking and a new language for ageing. The gap between traditional retirement age and the onset of severe frailty is growing. Most people are healthy and active in later years and seek a “life with purpose”. There is in effect a new life-stage, what active ageing advocate Marc Freedman calls “a new map of life fitted to a new length of life”.
This is European Year for Active Ageing and Solidarity between Generations, which recognises that society has a huge untapped resource of people with accumulated life skills and expertise.
Many of the complex societal challenges that we face require precisely that mix of life experience, time and understanding that older people have in abundance. Surely, we have the creativity and determination to invent the structured opportunities to channel that time and talent into opportunities that match need with interest.
Anne Connolly is executive director of the Ageing Well Network, ( ageingwellnetwork.com) a member of the national steering group for the European Year for Active Ageing and Solidarity between Generations 2012. activeageing.ie