As we’ve often mentioned on this blog, much of the world is facing an ageing population (a “grey/gray tsunami” as some commentators have named it). Many countries face the near future involving a greater percentage of their population in the age bracket 65+ years old. This greater elderly cohort has all sorts of implications for our societies and economies. This tsunami is rushing nearing and more and more are starting to ask: what will happen when it hits?
The Lancet published last month a journal article about the “crisis” in “global elderly care”. This article draws attention to the potential problem, but is light on details about how to deal with the fallout of an ageing population. But at least recognition of the problem is the necessary first step towards dealing with it and the Lancet is certainly aware of the coming tsunami. As it states:
“The world’s population is ageing rapidly at an unprecedented rate. The proportion of people aged over 60 years will double from about 11% to 22% between 2000 and 2050. Population ageing has profound implications for the burden of disease and social and health-care systems.”
Already, according to Lancet, there are creaks in the social care systems in the UK, the USA and China. In the UK, the charity and lobby group Age UK, released a report entitled Crisis in Care 2014 which detailed the lack of funding for social care for the elderly.
“…between 2010—11 and 2013—14, public funding for older people’s social care fell by a massive £1·2 billion (15·4% in real terms), even though it had been stagnant between 2005 and 2010. The proportion of people aged 65 years and older in receipt of social care services has declined from 15·3% in 2005—6 to 9·9% in 2012—13. In 2010—11, around 800 000 people aged 65 years and older received no support from public or private sector agencies. “The figures we have uncovered in this report are catastrophic. Older people who need help and are now not getting it are being placed at significant risk and families who care for loved ones are experiencing intolerable strain”, said Caroline Abrahams, director of Age UK.”
The situation in the USA seems to be a bit different to the UK in that more of the care for the elderly is done by family. In 2013 about 40% adults identified themselves as “family caregivers”. This level of caregiving provides “most assistance to support chronically disabled older people (aged 65 years and older) to live in the community rather than in specialised care facilities”. However there is real concern that this system is not able to continue as the baby boomer generation approaches retirement age.
Finally, in China the trouble is that it is getting old before it gets rich. This means that expensive support systems for the elderly may be out of China’s ability to provide. On the other hand, the traditional family structure which provides support and care for elderly relatives is breaking down (as we’ve seen before on this blog). Lancet reports that a more Western style of care (entering into a rest home) is becoming more common as a result of the one-child policy and massive urbanisation. However, the results are not encouraging:
“According to the China Health and Retirement Longitudinal Study, at the end of 2011, China had more than 185 million residents aged 60 years and older. 32% of elderly Chinese (defined as 60 years and older) reported poor health, 38% reported difficulty with daily living, 40% showed symptoms of depression, and 23% lived below the poverty line.”
So what is the Lancet’s prescription for the elderly crisis?
“A more age-friendly approach is needed to ensure healthy ageing with dignity. To meet this goal, more investment—financial and human resources—is, without doubt an urgent necessity. In a climate of austerity, efforts can also be exerted in other areas, especially disease prevention and health promotion for older people, together with interventions to reduce smoking, alcohol consumption, and obesity. Additionally, better coordination is needed between health care, long-term care, and social services to enhance capacities and ensure sustainable services.”
Perhaps the first step is to recognise that we are entering an age of more elderly populations. Whether or not current aged care systems remain in place following the tsunami remains to be seen. Surely some changes will have to be made before I enter golden oldie territory (around 2050…)