Since 2007, the number of people over 65 has outstripped the number under 16. By 2050 the number of people over 65 will have doubled. The consequence of not addressing this massive demographic shift is an intolerable increase in healthcare costs that could cripple the NHS and plunge thousands of pensioners into severe poverty. There is no doubt that the time to act is now.
To successfully address the problem of an ageing population, it is important first to consider the unique requirements of the current elderly generation.
In the 20th century life expectancy rose by 30 years. However, this gain is meaningless if older people are unable to enjoy a decent standard of living. We should take a broad perspective when seeking to improve the quality of life of those who have spent decades contributing to our country. A fundamental reform of the pensions and benefits available to the elderly, keeping the principle of providing the highest quality of life to as many as possible at their heart, is essential.
In order to achieve this people must start by saving more for retirement. The burden on the state from those who don’t save is argument enought for making these savings compulsory. State pensions should aim to help those who need help from the state only and be based on length of time in UK employment rather than quantity of contributions. After all, the factory worker needs more support from the state in his elderly years than the City lawyer. The new flat rate state pension completely misses the point in this regard.
Healthcare already considers quality of life in making treatment decisions for elderly patients. The use of the Liverpool Care Pathway and Do Not Resucitate Orders provide doctors with the means of ensuring unpleasant and unwanted treatments are not provided to terminal patients.
However all too often elderly patients cannot communicate treatment decisions and can be left in a debilitated state receiving care they don’t want or care that causes them pain. We must make it a priority to improve patient involvement when it comes to end-of-life decisions.
The advanced directive system has long provided a means of recording patients wishes for their future care. However, few use this system, robbing carers of valuable insights into their patients’ treatment preferences. This is a great shame as it could be used to prevent treatments which are both unwanted and expensive being used to extend life without providing quality of life.
Beyond all of this there is a real need to ensure through regulation good quality residential and nursing home facilities, so that they are not seen as places where people go to die but as homes where people can live out the remainder of their lives to the full.
In reforms aimed at dealing with the issues of welfare and healthcare for an ageing population, effective legislation must take account of quality of life. We must seek to ensure that poverty or poor health never curtail individual’s freedoms when it comes to making decisions about their old age.
Anil Abeyewickreme is a Young Fabians member