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Currently showing: Funding longer lives > Long-term care

10 Jul 13 16:18

The achievement of longer lives brings with it challenges. Thanks to the reduction of infectious diseases in many countries, this not only increases life expectancy but also means we're more likely to suffer chronic disease in later life. For example, dementia prevalence will rise considerably (see image).

This – and the general increase in elderly populations – means the need for long-term care is rising. Conversely, the availability of traditional 'informal' care provision, eg from family, is declining for many reasons:
- Falling birth rates: Birth rates have fallen substantially since the 1960s in most countries
- Increased intra and international migration: Young people are moving to other countries or from rural to urban areas
- More women in employment: Women enjoying higher rates of employment mean that the availability of a 'traditional' care source in many countries has fallen (see image)
- Increasing independence for older people: Thanks to pensions and more choice, older people are less reliant on family members in many societies

Modern communications technology means there are examples of people living in a different country ensuring their loved ones 'back home' receive care (

Sometimes less informal care is seen as a 'decline' in traditional values. But does caring always mean providing the care yourself? What other approaches are there to providing care as well as demonstrating that we do care?

Category: Funding longer lives: Long-term care, Social contract


Gavin Montgomery - 11 Jul 2013, 2:50 p.m.

I might seem counterintuitive, but the elderly could end up caring for the elderly. A recent study in Denmark published in the Lancet compared the physical and cognitive functions of a group of people born in 1905 and measured at the age of 93 with those of a group of 95 year olds born in 1915. The 1915 group, despite being two years older, scored considerably higher and were far better capable of taking care of themselves:

People in wealthy countries, it seems, are not only living longer, they're living better. It's not an experiment I would care to take part in, so I fully intend to take up smoking again if I make it to 60 and the state still allows to me, but it strikes me that a simple solution for elderly people would be to form cooperative retirement communities in which they share resources, help each other and interact with their peers.

Alicia Montoya - 18 Jul 2013, 7:20 a.m.

This is a tough one. I'm Spanish so those 'traditional values' are live and well in my family. Everybody takes care of everybody, we're a tight knit group and sending people off to be cared for by strangers is basically the lowest we can go in the eyes of my grandmother, for instance.

Sadly, she was diagnosed with Alzheimer's a few years ago. My mother had recently quit her job and took my gran (who was living on her own at the time) in to care for her. It got really hard, really quickly. After afew months, some aggressive bouts and lots of tears, my mother gave in and found my gran a (very nice) center with nurses who know how to treat people with dementia.

At the time I thought my mom had given in too easily, not tried hard enough. Today I know she did the right thing.

So while I love Gavin's idea of old caring for old (in fact my gran did care for older people when she was in her 70s and still able) there comes a point when medical help is needed.

Alison McLean - 5 Aug 2013, 4:21 p.m.

There is an interesting example of that being piloted in the UK. The Young Foundation developed a programme called Care4Care and it involves people providing care and support to members of their community and in return they get "Care Credits" which is based on the number of hours of care they have provided. If they get to a stage of needing care they can then use their "care credits". The pilot is being done with Age UK in the Isle of Wight with Age UK and in the first 8 months it had 200 members and over 5000 hours of care credits.

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