In England and Wales, the population continues to age. The 2021 Census results confirm there are more people than ever before in older age groups – over 11 million people, 18.6% of the total population, aged 65 years or older, compared with 16.4% at the time of the previous Census in 2011. This included over half a million (527 900) people who were at least 90 years of age (Office for National Statistics, 2022).
Living longer is something that should be celebrated as our ageing population brings with it opportunities, as well as consequences for the economy, services and society. Older people make valuable contributions to societies and the economy, for example, through continued employment, providing informal caregiving for grandchildren, parents and other relatives and volunteering. Ageing touches all parts of economies and societies, from health care and education to employment and taxation (United Nations Department of Social Affairs (UN DESA), 2023).
As people age, however, the risk of becoming ill and frail increases, leading to a greater need for health and social care. As the health and wealth of societies continue to improve, traditional notions of dependency at older ages become less valid, but effective systems of support will still be required – so too will the intergenerational solidarity needed to sustain them (UN DESA, 2023).
The rise in long life is a success story that has come about by improved medical therapies, better housing, greater access to education and moves towards gender equality and empowerment. Yet not everyone will have received the same benefit from the social and economic improvements that have driven longevity. Those with the highest needs have seen their needs become more complex; someone with a social care need will usually have several long-term conditions, which might include neurological conditions such as dementia. Local and national policy makers must be vigilant of patterns emerging not only regarding the numbers of people with social care needs, but also the mix of those requiring care. Ensuring people receive coordinated services that meet their needs, integrated care systems are required to have a highly developed understanding of need in their populations based on reliable datasets aided by projections of need, informed by the latest, best available data and evidence (Raymond et al, 2021).
It is wrong to believe that everyone has the same issues and needs simply because of age. Older people are as diverse as the rest of the population in terms of age, health, capabilities, independence, disability, their caring responsibilities, engagement with the labour market, incomes and the extent to which they are dependent on others – and also in their ethnicity, sexual orientation and gender identity.
Currently, the government is seeking to reform adult social care. Policy makers must be aware of the complexities involved in predicting future need, taking into account increased social care demand in association with an increased prevalence of long-term health conditions. Policies promoting healthy ageing, preventing poverty and encouraging employment and opportunities for suitable work before people reach older age are crucial to improve economic security and reduce inequality among older people. Taking advantage of the skills, expertise and knowledge of older people and other groups that have traditionally been excluded from or disadvantaged in the labour market can help promote equity and ensure old-age support systems are fiscally sustainable.
Despite years to plan, the question posed is whether the country has prepared appropriately for the economic, cultural and political changes an ageing population brings. The Census figures should be seen as advanced warning, demonstrating the national need to change attitudes to ageism, work, supporting older people in poverty and building homes suitable for them to live in.