Living longer will bring profound social challenges

A ‘dementia tax’ in the UK has sparked debate. But an ageing population will affect everyone, writes Shelina Janmohamed

Representatives from the Community Development Authority visit an elderly woman at her home in Dubai. Long-term care for the elderly will be a policy challenge in many countries. Jaime Puebla / The National
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A ‘dementia tax’ in the UK has sparked debate. But an ageing population will affect everyone

It is 2017, and what a time to be alive! I mean that literally: we are living longer than ever, higher quality lives and in better health.

At the turn of the 20th century, you’d be lucky to live past 50. But a hundred years later average life expectancy could be anything up to 83 years: the current figure for Japan, which has the highest. This achievement is sadly not reflected all around the world, with many countries where poverty, poor health care and female and infant mortality remain higher. However, global life expectancy is rising. This must surely be good news?

Except we’re not ready for it. The challenges of an ageing global population are only just beginning to be recognised, although it is still not the politial priority it needs to be.

Many of us may already be starting to feel the shift and associated pressures as we try to balance work, children and parents who are growing older.

We talk often of how the world’s population is growing, and understandably, we focus on the growing number of children and youth. It is front and centre for any policymaker, particularly in the Middle East, Africa and Asia, where there are countries with significant populations under 30. Education and employment are urgently required for this demographic bulge.

Alongside the rise in birth rates which underpins this population boom, what we forget is the other reason the population is growing: people are living longer.

According to the United Nations Population Division the “oldest old” (people aged 85 or older) constitute 8 per cent of the world’s 65-and-over population: 12 per cent in more developed countries and 6 per cent in less developed countries. In many countries, the oldest old are now the fastest growing part of the total population. On a global level, the 85-and-over population is projected to increase 351 per cent between 2010 and 2050, compared to a 188 per cent increase for the population aged 65 or older.

There are lessons to be learnt from the ageing European and North American population. We can see it in the current debate in the United Kingdom where care for the elderly is becoming central to the country’s general election campaign. The incumbent prime minister Theresa May has outlined plans to recoup the cost of social care from older people by taking equity out of their homes. It’s proven so unpopular that she did a U-turn on the policy in the midst of the campaign cycle, something unheard of. It was even given its own name by the opposition: the dementia tax.

In fact, among all old age illnesses, dementia is one of the most significant and least understood. According to the World Health Organisation, worldwide, around 47 million people have dementia, with nearly 9.9 million new cases each year. Nearly 60 per cent of people with dementia live in low- and middle-income countries.

The challenges are both in terms of sheer numbers of the ageing population as well as the number of old-age illnesses that most countries have never really had to deal with before. But also globally, we have changing cultural attitudes towards the elderly and about whether we must or even can care for them in the family. Families are increasingly separated geographically, including the rural-urban split which can make care challenging. The changing and very demanding healthcare needs also mean more support is needed for longer than ever and often of a specialist kind that many of us are not equipped to deliver.

Traditionally women carried the full burden of care for children and parents. As the average age of marriages has risen, and as more people work outside the home instead of managing full time housework and caring responsibilities, this challenge of care in the home is in many ways a new social phenomenon.

We also have changing notions of who is responsible for care, which must be reflected in any policies.

What we can learn from the current crisis in the UK is that this is going to become a make or break issue both at a society- wide level but also within families themselves. It might well be that this is the greatest time to be alive, but the question is, how do we make sure it is great for everyone, including our elderly.

Shelina Zahra Janmohamed is the author of the books Generation M: Young Muslims Changing the World and Love in a Headscarf