Referring to 65-year-olds as old people is, well, “old hat”, according to geriatrician Prof Rose Anne Kenny.
“Sixty-five is the new 55,” she says. “It’s the 80-plus group we need to look out for, the ones with multiple conditions.”
News that Ireland’s population is ageing faster than anywhere else in Europe, as disclosed in a Department of Health report published this week, does not surprise her.
“We’ve known this for some time. But we need to get active about preparing for it.”
There might be a little time to do this, the figures show, given that Ireland still has a younger age profile than most of our neighbours – even if we’re no longer the “young Europeans” we used to boast about a few decades ago.
However, the Department’s analysis shows how quickly the situation is changing. Over the past decade, we have added an additional 200,000 to the 65-plus age category. Looking forward to the next 20 years, the number of people aged 85 years and over is projected to rise from 89,000 to a massive 222,000. This age-group already accounts for half of people in long-stay care; 60 per cent of over-80s are at least three medical conditions.
There are currently five people of working age for every one person over 65, but in 20 years this ratio will drop to three to one, the Health in Ireland – Key Trends report noted. This means there will be fewer taxpayers required to support more older people.
That raises questions about how the growing contingent of older people will be supported. One way, which is already happening, is that many people will continue to work past retirement age. Previous governments laid plans to increase the State retirement age but it is uncertain now whether these will be proceeded with.
Prof Kenny, the author of a best-selling book on the science of ageing, says the projected rise in the number of very old people will mean much more access to healthcare is needed.
This pressure is already being felt in hospital emergency departments, which are currently experiencing record attendances, driven largely by increasing number of older people requiring attention. The nursing home and home care sectors are also under pressure, not just because of rising demand but because they are struggling to find staff.
“We should be looking at more proactive determinant of older people’s health status, and predicting issues that may arise, rather than the tradition access model through GPs and emergency departments.”
“We should also be anticipating potential problems and intervening before the stage at which they might arise. But we’re not set up to do that.”
Housing is another area which needs to be age-proofed. A significant contributor to the current crisis is the number of properties under-occupied relative to their size, as Irish society has yet to develop a model for downsizing that meets people’s expectations and needs.
Prof Kenny also highlights the need for a more comprehensive social care system such as existing in the UK.
The ageing of the population isn’t all bad news, she points out. Quality of life increases up to the late seventies, research has shown. As well as increasing our life expectancy, Irish people have increased the number of health life years they enjoy.
“Overall, people are living longer and with more independence and fewer co-morbidities than before,” Prof Kenny points out.
As Alone pointed out, the challenge needs to be presented not as a burden on society but rather a fundamental fact that needs planning and delivery in key aspects of ageing.
“It is great to see people are living longer in Ireland today and that we are reducing mortality rates in all causes of death especially in cancer. But the experience of growing older is still challenging for many,” Alone chief executive Sean Moynihan points out.
“It should be celebrated but also it is a challenge that needs a cross government approach in all areas to ensure we create a just and equitable society to age in. Not all people experience that, and this will grow unless addressed urgently across all areas of health, housing, and income for older people.”
As the Department’s report summarises: “It is good that people are living longer, but we need to ensure that more of these years, particularly in later life, are spent in good health”.