Who do you think should look after you when you are old? What illnesses do you fear the most – and how likely are they to occur? And how old do you have to be to feel 'old', anyway?
BUPA Health Dialog's new survey explores reactions to these questions across twelve countries (1). Its findings are analysed and contextualised by Dr Jose-Luis Fernandez and Dr Julien Forder, Principal Research Fellows of the Personal Social Services Research Unit at LSE, in a report commissioned through LSE Enterprise.
Increases in life expectancy mean that the world's population is ageing. The number of people in the world aged over 60 has almost tripled since 1950 (2). Average life expectancy worldwide has increased during that time from 47 to 68 (79 in the UK). 72 percent of respondents worldwide aged 65 and over do not think of themselves as old.
The link between changes in life expectancy and the prevalence of health problems and of dependency is key to gauging the impact of ageing on the demand for health and social care services.
Much of the gain in life expectancy is spent in physical or mental disability, linked to a few health conditions such as dementia, diabetes, cancer, heart disease, arthritis and stroke. However the World Health Organization finds that much of this illness could be avoided through diet, exercise and stopping smoking. Most adults do not start becoming dependent on others until after they are 80.
But the BUPA Health Pulse Report 2010 finds that the 'informal care network', where families look after their elderly relatives, is disintegrating.
'Across the world,' says Dr Fernandez, 'a combination of societal and economic factors – including demographic changes, the breakdown of the extended family, and the rise in divorce rates, migration and women in the workplace – are eroding the family-supported structures that have historically provided the bulk of the care for dependent older people. With state social care systems also under huge financial strain, a global challenge is emerging about how to support dependent older people in the future.'
In the UK, only 29 percent believe that their families should look after them when they can no longer do so themselves, as compared to 50 percent in the US and 70 percent in India. On the other hand, 60 percent of UK respondents thought that it was their families who would end up taking most responsibility. Meanwhile, over half of respondents stated that they have not prepared financially for old age.
These findings raises the questions of who should take responsibility for caring for older people, and how care can be funded if recipients are to avoid having to sell their homes to pay for care.
The report suggests that increased resources for care services could be funded by social insurance systems, general taxation or incentives to take out private insurance. Collective agreement must be built at national levels, based on the cultural values of different societies. Who should share the responsibility over the funding and provision of support to older people in need? As societies transition to older age, the issue is becoming urgent.
1 - Ipsos MORI interviewed 12,262 members of the general public across Australia, Brazil, China, France, Germany, Great Britain, India, Italy, Mexico, Russia, Spain, and the United States during June and July 2010.
2 - World Population Prospects: The 2008 Revision, United Nations, New York, 2009
Download the report 'Ageing societies: challenges and opportunities'
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