HOW CAN WE MAKE OUR HEALTHCARE SYSTEM FIT FOR OUR AGEING POPULATION? (Clue: Start Young) We’re in the midst of an unprecedented transition in global ageing. Older adults compose a larger proportion of the global population than ever before and that’s set to keep increasing. In the last 200 years, we have doubled our lifespan. In the early 1800s, we could expect to live to around 40-45 years old. Now, we’re living to 80 and beyond. Professor Rose Anne Kenny has been collecting information about what it means to grow older. Eighty per cent of the ageing process up to the age of 80 is governed by environmental factors such as your degree of poverty or affluence, level of stress, engagement with community, relationship with nature, and whether you’re living a life with a sense of purpose and meaning. Loneliness is toxic to physical and mental health. This means that the main factors which impact on your health as you get older have accumulated throughout your lifetime. How can we engage younger people, and engage communities earlier, so that they can modify their behaviours to live longer, healthier lives? If most of our health and wellbeing is determined within our communities, we surely need a more social model of care. Phil Kloer, Deputy Chief Executive of Hywel Dda University Health Board, asked how much support for an ageing population should come from the state? How much from active citizens? How much will be voluntary or a matter of civic responsibility? Kloer also shared another dilemma: most media coverage on healthcare focuses on the urgent problems, like waiting times for ambulances. In a sense, this keeps us fighting fires. The person in front of a health professional is waving and asking for help and they need help. But how do we address the important, longer-term problems? The people at risk of future illness have a much quieter voice and preventative measures don’t get enough attention. We need to find a way to change the narrative. A recurring theme in the discussions was the need for more inter-generational mingling. There was lots of enthusiasm for schemes bringing children into care homes for the elderly, for befriending schemes, and for co-living arrangements that can deliver mutual benefits.
KEY TAKEAWAYS 1. Environmental factors are highly significant. The average age of a healthy lifespan (meaning living without disability or anything that reduces your independent functioning) varies hugely across different regions. For example, the age in Blackpool is 55.3 years, in Surrey it is 69.4 years, and Orkney tops the chart with 75 years. What’s Orkney’s secret? Kenny would love to know. She suspects that a strong sense of community is a large part of it, along with living beside the sea. 2. Kenny advocated ‘slow medicine’. She believes health practitioners need to have more time to talk to their patients and really listen. Fifty per cent of people aged over 65 have two disorders. Fifty per cent of people aged over 80 have five disorders. How can a GP deal with all of that in a six minute consultation? It’s just not enough time. If a GP is empowered to spend more time with a patient, then they can hear what the issues are, identify the right tests and intervene earlier to prevent a catastrophe or crisis further down the line. 3. Kloer identified funding as a barrier to developing more community interventions. Lots of funders like to measure outcomes quantitatively, whereas community-based work is more complex, in a less controlled environment and doesn’t lend itself to mechanistic measurement. You need funders who will support the sense of mission, rather than insist on measured outcomes.
TOP QUOTES “We should aim to have relationships with people in every decade of life” – Planet Assembly participant “Ageism is the leading form of discrimination in the work place. Subtle things can knock confidence. You are as young as you feel. Your confidence and self-esteem actually dictates your inflammatory status which dictates the pace of your environmental ageing. So it matters that we’re not an ageist society” – Rose Anne Kenny “This is the Hay Festival – we need more storytellers to help us change the narrative around care” – Phil Kloer
RECOMMENDED READING Professor Rose Anne Kenny, Age Proof: The New Science of Living a Longer and Healthier Life Cormac Russell and John McKnight, The Connected Community: Discovering the Health, Wealth and Power of Neighbourhoods LINKS TO MORE RESOURCES - Hillary Cottam’s TED talk - Home Share UK - Arts and Health - Solva Care - The Well-Placed Hospital - The Health Inequalities National Support Team (PDF)