Older people give so much more than they take from us

While we treat the elderly as a set of symptoms and problems, we ignore what we will be one day


“Older people are not that much different from their younger selves: they want to feel valued; have contact with others; give something back and have control over their lives.” Photograph: George Shelley/ Corbis

Andrew Motion has written a poem for the Joseph Rowntree Foundation’s new website, A Better Life, part of a five-year project to promote a positive agenda for older people. The poem distils fragments of lives past: red varnished toenails on a Llandudno honeymoon; “defending the realm” as a soldier then slaking its thirst as a brewer; Rowena who likes “a slice of sponge cake”. Well intentioned, the poem comes over with as much bounce as a mattress with its springs taken out.

Ageing undoubtedly has its problems, many of them created by those who have yet to cross the threshold and don’t believe they ever will; the invincibility of youth. And yet, ironically, being reminded of the process of decline has never been more strongly signalled and ever earlier. Twentysomethings are told constantly in magazines that what they have they will soon lose without the application of lotions with magical ingredients. There’s gold to be mined in those early furrows.

“Flawless” is the perennial promise of these products but whatever else ageing may be, flawless it isn’t. As Motion’s poem conveys, pity, guilt and invisibility are the traditional templates of growing older. But a stronger, more resilient tale can also be constructed. Indeed, it must be constructed if we are to avoid bankrupting the public purse and forcing yet more people into a ghetto of longevity minus joy, possibly in pain and certainly in isolation. And all because we are padlocked to a welfare state modelled in the 1940s when lifespans were often decades shorter and because we refuse to make the cultural shift that views senior generations as assets – people who can and do contribute considerably, given half a chance.

A glorious gallery of portraits on the JRF website shows just how varied a centenarian can appear. Chronology is no longer an indicator of quality of life. So, how about wealth? Coalition minister David Willetts in The Pinch has tried with brio to ignite a civil war in which the Cavaliers are the baby-boomers, born 1945-1955, the beneficiaries of loadsadosh. Meanwhile, austerity’s Roundheads are today’s youth; jobless; carrying the debt of tuition fees; saddled with delayed retirement to pay the pensions of the flower power generation who can’t, after all, live on “peace and love” alone.

His arguments are a clever distraction. The over-65s are a net contributor to society at a rate of £30bn to £40bn a year because they pay tax, spend money that creates jobs and are volunteers, carers and significant contributors to charity. If they have cash, many cascade it. They are putting down ever larger deposits to secure their children’s futures – in money, time (with childcare ) and housing help. However, Willetts is correct on two points – fairer redistribution is required but from the wealthiest to the poorest, who include the impoverished old. Consider, for instance, Greg Philo’s suggestion of a 20% wealth tax on the assets of the richest 10%. And the welfare state does need to be reconfigured.

The government has promised a white paper in the spring on whom and how to pay for long-term care, but what matters as much is to move the NHS and social care from an unco-ordinated crisis service to a unified organisation that is committed to wellbeing. Liz Kendall, shadow spokesperson for care and older people, is addressing some of these issues in a speech to the thinktank, IPPR. Just as Labour, led by Harriet Harman, dragged childcare to the top of the political agenda in the late 90s, so Kendall rightly argues that it’s time that priority is given to the creation of a modern support service for older people (“care” carries too many negative connotations, not least because care is too often absent).

How do we keep older people resilient for longer? How do we build on, rather than destroy, the material, social and psychological assets they already have? Older people are not that much different from their younger selves: they want to feel valued; have contact with others; give something back and have control over their lives. All this, despite the fact that many of them may have long-term conditions such as diabetes and heart problems that could mean learning to live for decades with a set of symptoms.

In an ideal world, in this context, any assessment by social services would begin with: so what do you enjoy? What are you good at? In that holistic framework, loneliness, for instance, is seen as an issue to be addressed; fresh connections to others encouraged. Instead, a social worker asks only about the practical: can you wash, dress, feed yourself? And even in this, we are going backwards, not forwards.

Eighty per cent of local authorities have raised their eligibility threshold for care to “substantial”. What is free in London’s Tower Hamlets costs £30 an hour elsewhere. Spending on adult social care will be cut by a further £1bn this year. How could it be different?

We need a significant increase in investment in early prevention and a fairer contribution from the individual. Help with odd-jobs; proofing a home to avoid falls (a person is killed every five hours by a fall); using an older person’s lifetime of skills to help others – stuff daughters used to do but less so now they are themselves in paid employment. Prevention means spending a little earlier to save a lot later.

Instead, too often, a stream of unconnected professionals treats an 80-year-old as a set of disparate symptoms instead of a human being with a history and resources that should be part of any holistic help. As a result, we have a spiralling rate of emergency admissions for older people who may not need hospital care at all. Once in, they may be stuck in hospital for days longer than necessary because of the lack of co-ordination. Delayed discharge costs £500,000 a day.

Since the birth of the NHS, more than 40 pieces of legislation have tried to stitch together a seamless service to no avail; professions protect their silos. The government lacks the nerve both to knock heads together or to tell the electorate, with its sentimental attachment to hospitals, that in the 21st century we need fewer of them and more care in the community. So, instead of preparing for a future already on the threshold, the government wastes time and money disorganising the traditional NHS.

In this shambles, one golden line in Andrew Motion’s poem asks a pertinent question: “Is it only when you become like me that you will hear what I have to tell you?”

One Hundred Not Out: Resilience and Active Ageing by Yvonne Roberts available to download from www.theyoungfoundation.org (20 Feb)


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