How Ireland can be an inspiration to other countries when it comes to ageing
The danger is the Citizen's Assembly will replicate or amplify negative attitudes towards the complex subject of ageing
Justice Mary Laffoy, chair of the Citizen’s Assembly: In the health arena, the assembly should eliminate ageism in standard services.. Photograph: Dara Mac Dónaill
After discovering – one day before the deadline – that the Citizens’ Assembly had called for submissions for its deliberation on ageing, it was a challenge to marshal my thoughts alongside a particularly busy work schedule.
Order matters: the fact that the assembly placed “challenges” ahead of the “opportunities” of ageing in its call seemed to be a troubling augury of what might come.
The greatest concern is whether assembly members truly welcome and embrace their own ageing, can develop a intolerance for gerontological illiteracy (bar-stool gerontology being one of the great enemies of optimal ageing), and recognise the widespread ageism of ourselves and our society.
If not, the danger is that the Citizens’ Assembly will unwittingly replicate or, indeed, amplify current negative attitudes towards ageing.
It is interesting how quickly UK voters realised that Theresa May’s version of the so-called Fair Deal was a dementia tax
Irish society’s tolerance of the nursing home funding scandal, the blind acceptance of the so-called Fair Deal (where a major eligibility was removed from older people), and tolerance for calls to now charge for community care (while waving through hugely expensive drugs for a small sector of the population) are troubling manifestations of a acceptance of degrading equity to care provision on the basis of old age.
In this regard, it is interesting how quickly UK voters realised that Theresa May’s version of the so-called Fair Deal was a dementia tax – a stark contrast to the gullibility of the Irish electorate a decade previously.
Equally, the assault on the intergenerational solidarity of adequate pensions is short-sighted in the extreme. So is the counterproductive medical screening of older drivers, the safest group on the road.
So, my key message to the Citizens’ Assembly is to acknowledge our individual and collective barriers to recognising the longevity dividend; to understand that expenditure in us as we age is an investment not a cost; to strive for a system that erodes ageism through demanding gerontological literacy throughout society; and to welcome the strategic and financial rewards from embracing ageing as a positive and key element of industrial and financial strategy.
Ageing is about so much more than health
Given these broad issues and their importance to all sectors of the community, the assembly should also question why the National Positive Ageing Strategy is situated in the Department of Health and Children rather than the Department of the Taoiseach: ageing is about so much more than health!
In the health arena, the assembly should recognise the need for: universal training of staff in gerontology; eliminating ageism in standard services (we stop Breastcheck at an age when breast cancer incidence and mortality subsequently skyrocket!) and age-neutral funding policies for any co-payments for health and social services across the lifespan; and ensuring access to effective age-attuned services for age-related diseases and disability.
The good news of increasing (and increasingly healthy) lifespan and falling rates of dementia should not blind us to promoting high-quality support when we eventually encounter our existential vulnerability.
The title of a Canadian paper (I may be frail, but I ain’t no failure) should also alert us to language sensitivities, such as substituting “optimal” for “successful” ageing, “burdensome aspects of caring” for “carer burden” and an absolute ban on the word “elderly”.
In addition, rather than focusing on some angst-ridden vision of future healthcare services, it is to be hoped that the Citizens’ Assembly will understand that the problem is very much in the “now” in terms of age-attuned health services.
How sure can today’s older Irish person be of age-attuned services in hospital and community, or nursing home care provided on modern and supportive domestic models such as the Greenhouse model?
Imagination will be needed to break free from miserabilist failure models of ageing
We are a very fortunate generation, and I hope the Citizens’ Assembly has the imagination to make the leap described by Edward de Bono: “We need creativity in order to break free from the temporary structures that have been set up by a particular sequence of experience.”
Imagination will be needed to break free from miserabilist failure models of ageing so as to embrace and nurture this extraordinary gift, and make Ireland an inspiration to other countries in recognising and liberating the longevity dividend.
The response and actions of the Citizens’ Assembly in approaching this complex subject will be an interesting litmus test of whether this grouping represents a positive development, or is simply a diversion and distraction from the slow, hard grind of developing citizenship and a civic society.