by Rebecca Briant, Student and Receptionist, London, UK
The average life expectancy of humans is increasing at an unprecedented rate. Seen as one of the great achievements of the century, in the last 40 years alone it has risen by 10 years, and in 2011 life expectancy at birth was almost double what it was in 1841(1). But what will happen if our life span continues to increase, and how can we address the issues we will face?
As most people know, with age there comes a natural deterioration of the body. However, what we are already witnessing, and will see more of should trends continue to increase, is an unmanageable presence of chronic, multi-symptomatic conditions in our elderly and increasingly in younger people, which create a huge economic strain on the NHS. The annual cost of health and social care is far higher for elderly people, with more than two-fifths of the national health budget in the UK devoted to people over 65(2) and the number of older people in need of care is projected to rise by more than 60% in the next 20 years(3).
This strain will not be limited to the NHS alone, but will reach into wider society. In the UK the ratio of people of working age to people over 65 could fall from 3.7:1 in 1999 to 2.1:1 in 2040. This has the potential to drive up taxes for those in work, to be able to fund the increasing health and social care spending on the older population(4). There are also the implications on the wider health and social care systems to find long term care for the patients once they are discharged.
Dementia takes a toll
Taking just one illness as an example, dementia is one of the leading causes of disability in later life, with approximately 850,000 people estimated to have dementia in UK by 2015.(5) This is enough people to fill the Wembley stadium ten times over and this number is set to rise to 2,092,945 by 2051- this is more than the entire populations of Liverpool, Manchester and Birmingham put together.
A UK study has estimated that the health and social care costs for dementia almost match the combined costs of cancer, heart disease and stroke(6) but the impact of dementia is more than simply financial. Dementia along with so many of the other illnesses and diseases carries a human toll, not only at the point of death of the ones suffering, but in their reduced quality of life and the distress caused to family and friends, and even to the carers and medical staff.
If these statistics show us the state of society as it is today, then if the trends continue as they are forecast to do, we are looking at a future where this one disease alone could bring the NHS to its knees.
What can we do?
So what can be done to make real and lasting change, preventing the mass deterioration of our elderly rather than simply trying to manage it?
Our focus on a healthy and successful life being one with an ever-increasing life span needs a shift instead to the quality of life lived – not just physical health but the wellbeing of the population. Much of the current burden on the NHS’s time and funds comes from illness and disease that result from life style choices and these health problems only become worse and more complicated in older years.
Research is showing us that around 90-95% of cancers have their root cause in environment and lifestyle, such as diet, stress, smoking etc.(7) Obesity is another major health concern, which is largely preventable, and is a massive risk factor for many other health issues.
This type of research is the starting point for change, where we begin to see that the lifestyle choices of our youth become the quality of life we experience in our elder years.
How we live when we are young shapes how we will be when we are old.
What if by focusing and in some cases vilifying the older generation for their state of ill health, we are missing the key to how to begin to turn the tides on these trends? We cannot solely focus on the older population to solve the issues it faces, we have to involve people of all ages, so that instead of striving for longer life, we foster greater awareness and responsibility for our individual health with the knowing that we will all one day grow old. This will make way for a future where prevention of many illnesses and diseases is in our hands, not because of new technology, medical intervention or the length of our lives, but because of the way we choose to live them. It is an inevitable fact of life that we will all grow older and yet we like to live as if we will be young forever – in the end we see that our choices of lifestyle catch up with us, and at that point the ripple effects are significant.
We can also look at the way we as a society now treat and care for our elderly. No longer do they remain within the family home, they are increasingly living in care homes or on their own. This is not only an added strain on the health care system to find the carers to attend to their needs, but also separates the elderly from society, often causing loneliness and social isolation which in itself, because of the social nature of humans and our need to connect and interact, can be a precursor to disease.
Some homes have already begun to experiment with ways to bring society and the elderly back together, with one home in Finland giving cheaper rent to young people in the city, in return for a few hours a week spent with the residents(8). There are also communal living projects, where groups of older people can group together in purpose built accommodation, developing a community and maintaining independence. Another home in Seattle is combined with a Nursery, bringing the youngest and oldest generations together. (9) Our older generation has a wealth of knowledge and experience to share and we in turn have a duty of care to them, to provide dignity, love, connection, care and respect up until their last breath.
If we begin to tackle these issues from all sides then we can stop these statistics from escalating further. By making changes in the way the whole population approaches lifestyle choices, we can improve overall health with the understanding that it will produce generations who age, with the potential to have less propensity for such large volumes of complex illness and disease.
Just as we all want our children to grow up to have successful careers and relationships, would we not equally want them to grow up and have a respectful, active and joyful old age?
Our entire social perspective of ageing needs a seismic shift away from the current state of denial we have at the idea of ageing, seen in the constant anti-ageing commercials and setting to one side of older people in society, with a very direct focus on youth with little consideration or responsibility taken for the inevitable latter years of our lives. All these things contribute to the issues we face, and it is in starting these conversations that together as a collective society we can begin to age with far more grace and in turn, create far more space for the health and social care system to regain balance, with responsibility for the way we choose to live, each and every one us, at the foundation of what we build from here.