Re-Thinking the Way We Live in an Ageing Society

This will be the first posting of more postings of real-live lessons we can learn from Japan and other countries in Europe and Asia, on the ageing issue.

 

Today, living to a ripe old age used to be a rare occurrence, but it is becoming more mainstream. Surviving to these great ages represents a victory over life and speaks to the accomplishments of modern medicine and technology. On the flip side, living to these great ages will increasingly call for a change in the way we structure our lives. For instance, our idea of ageing-in-place, of retiring, of what is considered ‘old,’ of how we age, structure our society and community in general, and more!

 

Just take one example: the Western notion of retirement.

 

When we think of retirement in the West, we think of relatively young healthy happy mobile elderly moving away to the countryside or to one of those all-inclusive retirement community resorts to spend the last few decades/years of life. Stereotypically, the idea conjures up visions of men playing golf all day and of women painting, visiting their grand-children and possibly traveling the world. Behind this image are the company pension plans, IRA savings accounts and the financial backing of reliable national pension and health systems that underpin the support of this retirement machinery.

 

However, changes in epidemiology, living and working structures, the financial crisis, data and budget constraints, suggest that while this kind of retirement may have been applicable to our parents and grandparents, it may not be the way the current young generation (or those under 40) will retire and live out the last days of their lives.

 

For one, increasing liberal values such as women’s liberation, widespread urbanisation, communication technology, and increased longevity have meant that families have become smaller, more dispersed and varied. People are increasingly living alone, marrying later and ageing alone. They also tend to move from one job to another and work for a wide range of different companies in their lifetimes.

 

State social pensions and health benefits in many countries, are also now not as sustainable or reliable as they used to be. In the US for example, the latest study from the SSA projects that there will only be enough revenue to pay for about 75% of scheduled social security benefits after 2033. Also, with all the disagreements in policy on the recently passed ACA (click here for my previous posting), there is a chance that there will be more changes and possible backtracking on progress made on the health care front.

 

Finally, for at least this cohort of elderly, data trends of increased longevity seem to be going hand-in-hand with a growing incidence of chronic disease, which suggests that for many, the idea of ‘healthy ageing’ into ones 80s and beyond may not be feasible—increased longevity may not necessarily translate, as nicely as theory suggests, into many years of healthy full-functioning. To date, data and studies suggest that if one survives to age 85 without the incidence of a chronic illness, there is a high probability that one will not die from a chronic illness. The killer in this case (if not sudden death), will be one of general frailty or mental/cognitive decline (i.e. dementia).

 

The point is this: we do not live forever! There will always be a killer and, increasingly, it will be a more expensive killer– unlike the past, where most of us died from acute episodic diseases, today when we increasingly get older, and surpass living to beyond our 70s and 80s, technology or medicine will only really be able to only marginally improve the quality and longevity of our lives, and only be able to do so at a greater marginal cost.

 

Given these conditions, and the fact that the population over 65 in some ageing countries keeps on surpassing what it used to be, retiring at 65 can no longer feasible or affordable. Can you really expect countries to survive providing similar benefits at similiar retirement ages when 5% of the population was over 65 years of age to a scenario when over 20% of the population will be over 65?

 

My next few blogs will rely less on academic theories –we have too many unproven ones — but more on real-life lessons we can learn from countries with high ageing populations and the approaches they are taking to tackle ageing challenges in their countries.

 

To put the urgency of ageing challenges in perspective, according to the latest figures, Japan’s elderly proportion (proportion of over 65 year olds) was 22.68%, the highest proportion of elderly in the world, followed by Germany (20.38%), Italy (20.35%) and Greece (18.55%). According to projections for just Japan, in 2030, the ratio of people over 50 years of age will be 54%–so ageing challenges are ongoing, and are already real and impactful in many of these countries. 

 

I do not like the situation these countries are in/will be in, nor do I wish any country to face this kind of reality. Large proportions of an aged population affect not only us in healthcare. It affects our society, economy and, ultimately, the survivability of our civilisation!

 

In the past, civilisations crumbled due to famine, war, disease, etc., if countries do not adequately prepare to face the rising challenges of an ageing society, they may be forced to enter a new era of history–where population ageing will take a more active and leading role in the downfall of their civilisations.

 

References:

 

Forbes: “What Young People Need to Know About Retirement” 

http://www.forbes.com/sites/financialfinesse/2012/07/25/what-young-people-need-to-know-about-retirement/  by Liz Davidson, 7/25/2012. 

World Bank. 2012. HNP Indicators.

 

 

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