Families and services are predicted to take the strain of the Britain’s ageing population – see below. What’s in place in Devon to ease the demographic change?
This article titled “Britain’s ageing population: the impact on families and services” was written by Juliette Jowit, political correspondent, for guardian.co.uk on Sunday 24th February 2013 18.45 UTC
Jenny Tomlinson had just retired when her husband James was admitted to hospital with pneumonia. A week later he had been diagnosed with dementia. Plans to travel and learn ballroom dancing were put on hold, and Jenny has been his full time carer ever since, helped by her training as a nurse.
“It doesn’t save me having to wipe his bottom, but whereas for some people it’s very upsetting I just go into nurse mode: that’s how it is and get on with it,” she said.
Dementia is one of the five most common chronic diseases closely associated with old age, and as the government’s own forecasts suggest a 50% increase in the number of people over 65 and a doubling of those over 85 in the next two decades, the House of Lords has set up a special committee to investigate the issues raised by Britain’s aging society, and how well prepared the country is for the dramatic changes they will bring.
Jenny, 64, and James, 73, have 48 hours of home help a week, most of which the couple pay for from their pension and savings. From next month their bank balance will drop low enough to get help from the local authority, which eventually will pick up the whole bill. The council also runs a day centre which James visits twice a week. The Department for Work and Pensions (DWP) pays Jenny a carer’s attendance allowance of £77.45 a week, the Alzheimer’s Society sends a support visitor for two hours a week, and the NHS provides physiotherapy, occupational therapy, speech and language therapy and, of course, a GP or other specialists when needed. Eventually James might need to go into a full-time care home.
These are just some of the services and costs which families and taxpayers will have to provide, staff and pay for on a rapidly increasing basis, the Lords committee found.
The Department for Health (DoH) has been criticised by the committee chairman, Labour peer Lord Filkin, for not taking a comprehensive look at future demands. The estimates they did provide, however, indicate the scale of changes ahead. The central projection is that an aging population alone will drive up health spending 0.6% every year for the 50 years (a forecast far lower than that given by independent experts, who are more sceptical about savings and include private spending). The number of disabled older people is expected to rise from 2.5 million to 4 million between 2010 and 2030, the number of care home residents is likely to rise rapidly, and both public and private spending on social services for older people is projected to more than double over the safe period, even taking inflation into account.
In a joint submission with the DoH, the DWP said pension spending would rise, in their central case, from 5.7% to 8.2% of GDP over 50 years, and the Department for Communities and Local Government expects a 60% increase in households headed by somebody aged 65 or over.
Independent experts provided many of the hundreds of pages of evidence collected over six months Action on Hearing Loss (formerly the RNID) expects the number of people with hearing loss to rise from 10 million to 14.5 million, and the Azheimer’s Society believes dementia cases like James’s will increase by a quarter, from 800,000 to 1 million, in this decade alone.
Statisticians warn that all these forecasts have different levels of uncertainty, caused by unknown factors such as immigration, advances in healthcare, new epidemics, productivity savings and other reforms.
Much of the difficulty in adapting public services will lie in the growing complexity of each person’s needs. When the NHS was founded, nearly 50% of the population died by the age of 65. Now the figure is less than 20%, and older people usually have multiple co-morbidities, which they are likely to have for the rest of their lives.
At home in Bedford, Jenny believes James’s career as a French scholar and prison librarian has helped him maintain good speech and he still recognises family and friends. He gets confused, however, he shakes as if he had Parkinson’s disease, cannot hold his head well, is unsteady on his feet causing regular falls and has almost daily hallucinations – believing sofa cushions are cats or that there are “prisoners in the garden”.
The future cost of such cases is only part of the picture. The impact is likely to be felt in every family in a much more intimate way. Jenny sings with a choir on Monday evenings and does Pilates on Fridays. “That’s it,” she said. “The rest of the time is tied to looking after James, managing the care package, the finances, the house, the shopping and cooking. I wouldn’t want it any other way, but it’s not quite how we expected our retirment to be.”
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