Getting old will be more fun than most of us think
THE common notion that Britain’s ageing population will create an intolerable burden on the NHS is a myth, an expert on health in old age said yesterday.
Visions of a future in which people routinely lived into their nineties, but spent their extra years in the grip of dementia or other debilitating chronic illnesses, were grossly exaggerated, according to Raymond Tallis, Professor of Geriatric Medicine at the University of Manchester.
Elderly people today were enjoying an unprecedented quality of life and health, and the cost of caring for them would not rise but fall as life expectancy increased over the next few decades, he told the festival in Salford.
The latest evidence indicated that people who lived to great ages did not spend significantly longer in hospital or long-term care homes than those who died younger, suggesting that their overall impact on health costs was negligible. Those who died at 90 had to spend only twice as many days in hospital during their lives as those who died at 45, and there was hardly any difference between those who died in their seventies and nineties. “The extra 20 years of life was not bought at the cost of an extra 20 years in hospital,” Professor Tallis said The proportion of men over 85 who could bathe, feed themselves and go to the lavatory without help had risen from 69 per cent in 1980 to 79 per cent in 1991, and the figures for women had increased from 64 per cent to 80 per cent.
In advanced old age, people were also more likely to succumb quickly to the illnesses that eventually killed them. This was a win-win situation in which the elderly could enjoy a long, healthy and active retirement, and then did not cause a prolonged care burden and block hospital beds when they developed their final illness. This contrasted with the gloomy future forecast by many experts.
“According to the nightmare scenario, serious illness begins at about the same time, but due to the unwise wonders of modern medicine, Mr and Mrs Average are ‘kept alive’ much longer,” Professor Tallis said. “A longer life is bought at the cost of a longer death: medicine adds to the sum total of human woe. In fact, we are spending more time living and less time dying than ever before. It is a cheerful prospect if we play our cards right. A progressive improvement in the quality of old age, in which the health span of a long life gradually approximates the life span, is feasible. We may all look forward to a better and better old age in which we do not place unsustainable burdens on the NHS, our supporters and the Treasury.”
The NHS was doing a good job in geriatric care, despite stories about elderly people on hospital trolleys that were the “tip of the wrong iceberg,” he said. The savings made from early health interventions, such as hip replacements, were huge over the long term, as they meant that there was less need to fund long-term specialist care, and could be improved further. “Everybody slags off the NHS but it is actually delivering quite well, though it could perform much better,” he said.
