Later life 2011 - National and International trends


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  • Except for Japan, the world’s 15 oldest countries are all in Europe. The U.S. population is relatively “young” by European standards, with less than 13 percent age 65 or older, ranking as the 38 th oldest country. The aging of the baby-boom generation in the United States will push the proportion of older Americans to 20 percent by 2030; it will still be lower than in most Western European countries. The older share of the population is expected to more than double between 2000 and 2030 in Asia and Latin America and the Caribbean. Aging is occurring more slowly in sub-Saharan Africa, where relatively high birth rates are keeping the population “young.”
  • This figure illustrates China’s shrinking young and working-age population and growing elderly population. Dramatic fertility decline (due to the success of the “one-child” policy) and improved longevity over the past two decades are causing China’s population to age at one of the fastest rates ever recorded. China now faces the prospect of having too few children to support its rapidly aging population. Meeting the health and long-term care needs of this growing elderly population will result in soaring health care costs and fewer working-age people to share the burden.
  • Wide disparity in birth rates. China noteworthy. Kenya. Less than replacement growth in developed economies will bring different problems.
  • Cardiovascular Disease – 89% of 190,000 deaths per year where in people 65 years or older. Stroke – 80% of 150,000 cases per year are over 65. Stroke is the leading cause of severe adult disability. Diabetes – 2.3 million people in the UK are diagnosed. Prevalence rises with age from one in 20 people over age of 65 to one in five in people over 85 years. Chronic Lung Disease – 900,000 people in the UK diagnosed. In 2004 there were 10,740 deaths – 92% occurred in people 65 years and older. Cancer – incidence increases with age – of the 135,000 deaths in 2004, three quarters occurred in people aged 65 and over. Arthritis – Osteoarthritis affects about 60% of men and 70% of women aged over 65. Osteoporosis – leading case of morbidity and mortality among older people. Up to 14,000 people die following osteoporotic hip fractures each year in the UK.
  • Parkinson’s Disease – The second most common neurodegenerative disorder (120,000 have clinical diagnosis). The incidence increases with age. The average age of onset is in the early to mid 60’s. Sensory impairments : 2 million people in the UK have a sight problem. Of these, 1 in 10 people over 75 years and 1 in 3 over 90 years has a significant visual impairment (RNIB, 2007). Over 6 million people over 60 years are deaf or hard of hearing ( RNID, 2007) . Depression: A quarter of older people living in the community have symptoms which warrant intervention. Around half of these meet the clinical criteria for a diagnosis of depression. Dementia: 683,597 people in the UK have a diagnosis of dementia of these 1 in 20 people are over 65 years and 1 in 5 people are over 80 years.
  • Associations between housing and health exist. They support the argument that good quality housing has a role to play in both physical and mental health
  • Later life 2011 - National and International trends

    1. 1. Later Life 2011 <ul><li>National and International Trends </li></ul><ul><li>Prepared by Age UK Research Department </li></ul>
    2. 2. Overview <ul><li>Demographics and population trends </li></ul><ul><li>Health and wellbeing </li></ul><ul><li>Money matters </li></ul><ul><li>Home and care </li></ul><ul><li>Public policy challenges </li></ul><ul><li>Opportunities for enterprise </li></ul>
    3. 3. Demographics and Population Trends
    4. 4. Ageing in the UK <ul><li>TODAY </li></ul><ul><ul><li>10 million aged over 65 </li></ul></ul><ul><ul><li>1.3 million aged over 85 </li></ul></ul><ul><ul><li>11,000 aged over 100 </li></ul></ul><ul><li>THE FUTURE </li></ul><ul><ul><li>12.5 million over-65s by 2020, 16 million by 2030 </li></ul></ul><ul><ul><li>Fastest growth post-85 </li></ul></ul><ul><ul><li>250,000 aged over 100 by 2050 </li></ul></ul>
    5. 5. UK population pyramid (mid-2009 estimate) Source: ONS 2010
    6. 6. Ageing of the UK population Source: ONS 2010
    7. 7. <ul><li>“ At current rates, life expectancy in the UK is increasing at the rate of about two years for each decade that passes” </li></ul><ul><li>Source: House of Lords Science and Technology Committee 2005 </li></ul><ul><li>Ageing: Scientific Aspects </li></ul>Life Expectancy at birth (UK)
    8. 8. Life expectancy at birth (UK) <ul><li>1980 2000 2010 </li></ul><ul><ul><li>Males 70.8 75.3 77.9 </li></ul></ul><ul><ul><li>Females 76.9 80.1 82.0 </li></ul></ul>(Source: World Bank Development Indicators 20 Nov 09 and ONS Oct 2010 )
    9. 9. Life Expectancy at Birth 1980-82 to 2006-08 (Source: ONS 2010)
    10. 10. Ageing - Internationally <ul><li>Across EU population growth over next 25 years: </li></ul><ul><ul><li>81% over-60s </li></ul></ul><ul><ul><li>7% 18-59 year olds </li></ul></ul><ul><li>Across the world, by 2050 people over 60 will make up </li></ul><ul><ul><li>1/3 of rich world </li></ul></ul><ul><ul><li>1/5 of developing world </li></ul></ul>
    11. 11. <ul><li>Global Population – Aged 80+ years </li></ul><ul><li>1950 – 14 million </li></ul><ul><li>Today – 300 million </li></ul>Longevity Revolution - Global Source: WHO 2010
    12. 12. The World’s 15 ‘Oldest’ Countries (%65+) Source: Haub C, 2006; World Population Data Sheet
    13. 13. <ul><li>“ The number of centenarians in Japan increased almost one-hundredfold from 154 in 1963 to more than 13,000 at the beginning of this century and is projected to increase to almost 1,000,000 by 2050” </li></ul><ul><li>Ageing Horizons, 3,1 (2005) </li></ul>Longevity Revolution - Japan
    14. 14. Italy – population pyramids
    15. 15. China – population pyramids (millions, by age and sex) 1950 2000 Male Female Male Female Age Source: World Population Prospects: The 2004 Revision (2005). 80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Age 2050 Female 80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Male
    16. 16. Life Expectancy and Development
    17. 18. Later life in the UK- an overview <ul><li>Over 1.3 million people are aged 85 or over. One in four children born today </li></ul><ul><li>will live to 100 </li></ul><ul><li>People aged 65 now have an average life expectancy of 82-85 years, the </li></ul><ul><li>last 7-9 years with a disability </li></ul><ul><li>Nearly 2.5 million people aged 65+ in England have care needs </li></ul><ul><li>3.7 million people aged 65+ currently live alone </li></ul><ul><li>821,000 people aged 65+ currently have dementia. is This is projected to </li></ul><ul><li>double in less than 40 years </li></ul>
    18. 19. Later Life – internationally: an overview <ul><li>Of the current total world population of over 6.8 billion, there are over 790 million people aged 60 and over </li></ul><ul><li>Life expectancy at birth ranges from 82.6 years in Japan to 39.6 years in Swaziland </li></ul><ul><li>70% of the world’s older people (60+) live in less developed countries </li></ul><ul><li>60% of people with dementia live in developing countries, and this is expected to rise to 71% by 2040 </li></ul><ul><li>70% of mortality in low income countries is due to communicable disease and 30% to chronic long term illness; this will be reversed by 2030 </li></ul>
    19. 20. Health and wellbeing
    20. 21. While health is clearly an outcome in itself, it is also a key driver of outcomes in other domains, including employment and ability to contribute ELSA (Wave 2, 2006) indicates the two-way relationship between health and wealth: greater financial resources reduce the chances of poor health, and good health has a positive relationship to financial wellbeing <ul><li>Services are hospital focused, prioritising cure rather than prevention or complex case management, commissioning is in early stages of development, question marks over value for money, realisation that some target-driven achievements occurred at the expense of quality. </li></ul><ul><li>National priorities remain but emphasis on local decision making </li></ul><ul><li>Choice as a patient right and a tool to drive up quality along with contestability between providers for contracts framed by ambition to provide care closer to home </li></ul><ul><li>In eight years’ time, demographic change alone would mean that there would be: </li></ul><ul><li>Nearly 2.7 million people aged 75+ with at least one limiting long term illness and over 4.3 million people aged 65+ with LLTI </li></ul><ul><li>People living an average of 7-9 years at the end of their lives with a disability </li></ul><ul><li>Nearly seven million older people who cannot walk up one flight of stairs without resting </li></ul><ul><li>One-and-a-half million older people who cannot see well enough to recognise a friend across a road </li></ul><ul><li>Over 4 million with major hearing problems </li></ul><ul><li>Up to a third of a million people aged 75+ with dual sensory loss </li></ul><ul><li>A third of a million who have difficulty bathing </li></ul><ul><li>Nearly a million with dementia </li></ul><ul><li>Between 4-7 million with urinary incontinence </li></ul><ul><li>One-and-a-half million suffering from depression </li></ul>Why is this important? Policy Trends What do older people think? <ul><li>Mental health – older people’s preference for services include peer support; a range of activities and opportunities of things to do; 24-hour help in a crisis that helps you maintain everyday life; supported housing options, technologies and skills and learning opportunities that enable independent living. More broadly older people suggest the following to improve mental health and wellbeing: improve public attitudes; provision of activities for older people; befriending schemes (esp. those aged 90+); improved access to quality public services, and improving standard of living (mostly younger respondents). </li></ul><ul><li>Community Services –priority areas for action include: improving the range of support for carers; making services personalised and holistic; joining up health and social care so there is one point of call; considering the transport implications of any changes to services </li></ul><ul><li>Intermediate care – help with keeping out of long term care is important e.g. mentoring and advocacy to help them through the health and social care system; more time from care assistants; more availability and affordability of high quality home and telecare; help with practical matters such as laundry, adequate refreshments and warmth. </li></ul>Prevention package Mental health – new horizons Quality accounts New regulatory system Personal health budgets Dementia strategy Stroke strategy End of life care strategy Primary care strategy Transforming community services LINks and local accountability Physical activity strategy POPPS World class commissioning HEALTH
    21. 22. Long Term Health Conditions: The Strategic Challenge <ul><li>There are over 15 million people in England with long-term health needs. </li></ul><ul><li>Long term conditions are those that cannot, at present, be cured, but can be controlled by medication and other therapies. </li></ul><ul><li>The impact on the NHS and social care for supporting people with long term conditions is significant. </li></ul><ul><li>Currently 69% of the total health and social care spend in England is spent on the treatment and care of people with long term conditions (DoH 2008). </li></ul><ul><li>By 2025 the number of people will at least one long term condition will rise by 3 million to 18 million (DoH 2008). </li></ul><ul><li>This will be due to a rise in the ageing population and the increased survival of pre-term babies. </li></ul>
    22. 23. <ul><li>Coronary Heart Disease – 2.6 million people are living with CHD in the UK (89% of 190,000 deaths per year were in people 65 years or older) </li></ul><ul><li>Stroke – 80% of 150,000 cases per year are over 65. Stroke is the leading cause of severe adult disability </li></ul><ul><li>Diabetes – 2 million people in the UK are diagnosed. Prevalence rises with age from one in 20 people over age of 65 to one in five in people over 85 years </li></ul><ul><li>Chronic Lung Disease – 766,000 people in the UK diagnosed. In 2004 there were 10,740 deaths – 92% occurred in people 65 years and older </li></ul>Prevalence of Long Term Conditions (1)
    23. 24. <ul><li>Cancer – incidence increases with age – of the 135,000 deaths in 2004, three quarters occurred in people aged 65 and over. </li></ul><ul><li>Arthritis – Osteoarthritis affects about 60% of men and 70% of women aged over 65. </li></ul><ul><li>Osteoporosis – Up to 14,000 people die following osteoporotic hip fractures each year in the UK. </li></ul><ul><li>Parkinson’s Disease – The second most common neuro-degenerative disorder (120,000 have clinical diagnosis). The incidence increases with age. </li></ul><ul><li>Sensory impairments - 2 million people in the UK have a sight problem. Of these, 1 in 10 people over 75 years and 1 in 3 over 90 years has a significant visual impairment. Over 6 million people over 60 years are deaf or hard of hearing. </li></ul>Prevalence of Long Term Conditions (2)
    24. 25. Prevalence of Long Term Conditions (3) <ul><li>Depression – The commonest mental health condition in the older population. A quarter of older people living in the community have symptoms which warrant intervention. Around half of these meet the clinical criteria for a diagnosis of depression. </li></ul><ul><li>Dementia – Over 820,000 people are estimated to be suffering from late onset dementia in the UK. This overall figure is forecast to increase to 1,735,087 by 2051. Dementia affects 1 person in 6 over 80 and 1 in 3 over 95. </li></ul>
    25. 26. Disability, age and ADL % Dependent
    26. 27. Older people and functional limitations <ul><li>37% of men and 40% of women aged 65 and over have at least one functional limitation (seeing, hearing, communication, walking, or using stairs) . </li></ul><ul><li>This increases to 57% and 65% respectively in those aged 85 and over. </li></ul><ul><li>More than half of men and women reporting any functional disability were unable to walk 200 yards or more unaided without stopping or discomfort. Both prevalence and severity increased with age. </li></ul><ul><li>The number of functional limitations also increased with age with 17% of men and 19% of women aged 85 and over with three or more functional limitations. </li></ul><ul><li>Functional limitations can result in depression and social isolation. </li></ul>
    27. 28. Severe Cognitive Limitation by Age and Gender (US)
    28. 29. Healthy Life Expectancy <ul><li>Life expectancy is increasing and until recently, healthy life expectancy has been increasing at a slower rate </li></ul><ul><li>This has meant that many older people are living longer in poor health </li></ul><ul><li>There is evidence of some success in compressing morbidity and evidence that disability rates are declining </li></ul>
    29. 30. Work and Learning
    30. 31. All those who want to work, need to be in work – however older workers are particularly disadvantaged by lack of educational qualifications - employment rates are significantly lower for those with no qualifications whatsoever Mental activity like learning can also slow cognitive decline reduce morbidity and facilitate healthier lives <ul><li>Lack of interest and feeling too old are the man barriers to learning as people get older. </li></ul>The number of people undertaking learning decreases significantly with age Why is this important? Policy Trends What do older people think? <ul><li>Poor information about availability of learning opportunities and inappropriate courses may explain lack of interest. </li></ul><ul><li>One survey found 43% of older people agree that there is not enough information on what education courses are available and 30% believe courses on offer are not appropriate for older learners </li></ul>Access to learning centres becomes more difficult with age – with FE colleges, adult education centres and the home being main locations of learning WORK AND LEARNING <ul><li>Flexible New Deal; </li></ul><ul><li>Train to Gain programmes; </li></ul><ul><li>Pathways to work; </li></ul><ul><li>Extending Working Life proposals; </li></ul><ul><li>Age Positive initiative on employer attitudes </li></ul><ul><li>Digital inclusion strategy </li></ul><ul><li>Informal adult learning white paper though funding largely focused </li></ul><ul><li>on skilling “adults of working age” up for joining/re-joining the </li></ul><ul><li>workforce </li></ul>Economic activity by highest qualification, 50-69 y/o 0% 20% 40% 60% 80% 100% Degree/ equiv Higher edu A-Level /equiv GCSE A*-C/equiv Other No Qual Those 50+ with no qualifications experience employment rates over 20% lower than those with qualifications – much of the difference explained by illness or disability Employed Unemployed Inactive: sick or disabled Inactive: Other Inactive: looking after family/home Inactive: Retired
    31. 32. <ul><li>Employment supports an individual’s ability to contribute in addition to their material wellbeing (ELSA Wave 3 presentation, Banks and Tetlow 2008). </li></ul><ul><li>All those who want to work need to be in work – and work needs to be promoted as a mechanism for achieving wellbeing and independence in later life </li></ul><ul><li>In line with other OECD countries, Britain has adopted Active Labour Market Policies (ALMPs) to combat unemployment and economic inactivity. </li></ul><ul><li>Government initiatives have generally been designed to combat : </li></ul><ul><li>Youth unemployment, particularly longer-term unemployment (e.g. Future Jobs Fund announced in 2009 Budget) and </li></ul><ul><li>the high cost of unemployment benefits (Welfare Reform) </li></ul><ul><li>Incentives to stay at work likely to increase (ELSA Wave 3) </li></ul>Why is this important? Policy Trends What do older people think? <ul><li>More people enjoy work: </li></ul><ul><li>The majority of those aged 55 and over would prefer to be working full time than not working at all, and it is common for older people to view working as the ‘ideal’ situation for them </li></ul><ul><li>… and want to keep working </li></ul><ul><li>A 2003 survey found over two-thirds of respondents aged between 50-70 who were in, or looking for, a job planned to work in some capacity during retirement or never retire </li></ul><ul><li>The average age at which workers over 50 retired reached its highest level for men (64.6 years) since 1984. For women comparable figures showed an increase from 60.7 in 1984 to 61.9 in 2008. </li></ul><ul><li>The employment rate of those over SPA remains relatively small at 8.8% (Nov 2010), although those between 50-State Pension Age have closed the employment rate gap on the 16-SPA group by 5.3% since 1993. </li></ul><ul><li>ELSA respondents report increasing expectation of working longer </li></ul><ul><li>Increasing the female SPA may also lead to higher employment rates </li></ul><ul><li>According to the latest LMO survey (Summer 2009), employers say they are more likely to recruit 19–24-year-olds (63%) and older workers (60%). </li></ul><ul><li>Employment rates of people aged above SPA vary considerably between regions (range of 8.8% up to 14.3%) </li></ul><ul><li>Poor health, absence of qualifications, and caring responsibilities are key barriers to employment, and these barriers can interact with each other </li></ul><ul><li>Redundancy rates during the recession have increased more slowly in the 50+ age group than any other. </li></ul><ul><li>The impact of projected pension shortfalls on the timing of retirement is not yet clear, but concern about financial security is likely to bring about a further rise in working post SPA. </li></ul>EMPLOYMENT
    32. 33. Money Matters
    33. 34. <ul><li>An individual’s income clearly supports their material wellbeing. </li></ul><ul><li>It also enables independent living and appropriate housing </li></ul><ul><li>ELSA (2006 and 2008) provides strong evidence of a positive correlation between higher income/ wealth and reduced risk of developing most of the age-related chronic conditions, including type 2 diabetes, high blood pressure, raised cholesterol, disability (reduced strength and mobility) </li></ul><ul><li>Currently developments led by market not by Government policy </li></ul><ul><li>Pension reform, including introduction of auto enrolment from </li></ul><ul><li>2012 (DWP developing 10 yr pension communication strategy) </li></ul><ul><li>Money guidance service being developed following Throresen review </li></ul><ul><li>Range of govt info services including ageing strategy, one-stop-shop and increased collaboration with Third Sector, but unclear how these link up </li></ul><ul><li>Financial services sector doesn’t understand what opportunities are available for them in care funding/equity release/advice </li></ul><ul><li>Need for Govt. to oversee private financial industry solutions </li></ul>Why is this important? Policy Trends What do older people think? <ul><li>Confusion regarding choices of pensions, savings and care </li></ul><ul><li>Lack of interest in accessing products online </li></ul><ul><li>Concern about pensions (55-65 year-olds currently finding out that their pensions will not be adequate): </li></ul><ul><li>Increasing reliance on private sector, complexity in products on offer </li></ul><ul><li>Individual exposure to risk – more individuals are directly exposed: a significant percentage of 50-65 year olds are in danger of having replacement rates below benchmarks of adequacy </li></ul><ul><li>Increase in need for info. and advice to access entitlements and make appropriate decisions about finances </li></ul><ul><li>Increasing use of websites as main channel rather than (more expensive) face to face (although Pension Service home visits) </li></ul><ul><li>Digital exclusion now leading to increase in financial exclusion, not just in banking, but increasingly public services and private care funding (poor risks?) </li></ul><ul><li>Greater exposure to financial abuse </li></ul><ul><li>Gaps in support for frail vulnerable older people especially around money management. </li></ul>INCOME (Turner Final Report 2006)
    34. 35. Health and financial status <ul><li>1.8 million pensioners live in poverty. Nearly two-thirds of these are women. </li></ul><ul><li>Older people on higher incomes are more likely to report their health as ‘good’ or ‘very good’. </li></ul><ul><li>People on lower incomes are more likely to report asthma, chronic lung disease and diabetes. High blood pressure is more common among poorer older people. </li></ul>
    35. 36. Wealth and health
    36. 37. Net Worth by Health of Husband and Wife
    37. 38. Pension coverage in UK
    38. 39. Forecast change in public pension spending 2000–2040 (%)
    39. 40. Do Pension Incentives Matter? Survival probabilities, by pension status UK men No Occupational Pension With Occupational Pension
    40. 41. Survival probabilities, by pension status UK women No Occupational Pension With Occupational Pension
    41. 42. Home and Care
    42. 43. <ul><li>Decent and appropriate housing is a key element in quality of life and good health in older age </li></ul><ul><li>Demographic changes, combined with changes in policy on care provision and home ownership have meant - and will continue to mean - an increasing number of the oldest old living longer, and often alone, in their own homes </li></ul><ul><li>Older people (especially single people aged 75+) are more likely to live in older, non-decent homes (English House Condition Survey, 2009) </li></ul>Why is this important? Policy Trends What do older people think? <ul><li>92% of adults say they envisage living in a home they have for life, </li></ul><ul><li>but 23% said their current home was unsuitable to live in in old age (B&Q survey, 2008) </li></ul><ul><li>More older people refusing to purchase preventative services to save money as the result of increased 'choice' and rising charges </li></ul><ul><li>Opinions sharply divided between those who benefit from Assistive Technology and those who see reduced contact with 'human' support </li></ul><ul><li>Concern about inheritance tax is not necessarily exclusive to the very rich. ELSA (Wave 3, Emmerson Muriel 2008) found that 1 in 8 of their representative 50+ sample have assets above the IHT threshold </li></ul><ul><li>Whatever the merits of residential in comparison with living in the community, over 70% of adults surveyed view it negatively: 48% of homeowners 18+ say they can’t think of anything worse than moving into a care home. </li></ul><ul><li>A further 14% say they would be nervous and 9% frightened (B&Q survey 2008) </li></ul><ul><li>5% of people aged 65+ in the UK need but do not receive help with everyday jobs such as hoovering or changing a light bulb </li></ul><ul><li>Continued push on homeownership - experience of Right to Buy generation unable to maintain housing should provide lessons </li></ul><ul><li>Growth in need for local housing advice and advocacy – opportunities for one-stop shop services </li></ul><ul><li>Growing inequality of retirement provision between private and </li></ul><ul><li>public sectors </li></ul><ul><li>Growing regional and local inequality in regard to poor housing Expansion in private rented sector - more older people living in insecure tenancies </li></ul><ul><li>Increasingly difficult to obtain additional resources from PCTs </li></ul><ul><li>Housing support and service charges - growing divide between those receiving benefits and those paying for themselves - likely to increase friction within retirement housing </li></ul><ul><li>Likely increase in numbers of older homeless people resettled in poor temporary accommodation </li></ul><ul><li>Public sector will focus on the most vulnerable </li></ul><ul><li>Possible further decline in specialist housing. Growing debate around mobility (moving to be nearer friends and relatives offering support) and flexibility within social rented sector </li></ul>HOUSING <ul><li>Government encouraging institutional investment more in private rented sector to make up the shortfall in social housing. </li></ul><ul><li>Growing debate around reconciling housing related support, </li></ul><ul><li>social care and health services to deliver independence at home </li></ul><ul><li>(role of common assessment framework) </li></ul><ul><li>Cuts in preventative services - housing related support - more funding diverted to social care Further decline in retirement housing in the social sector - increased focus on the most vulnerable </li></ul><ul><li>Reforms to security of tenure (see Hills report) possibly less security for both private and social residents – issue around offering settled </li></ul><ul><li>accommodation to older people </li></ul><ul><li>Calls for improved coordination - partnership with LAs and PCTs increasing focus on the role of retirement communities - some growth </li></ul><ul><li>Increasing push towards assistive technology to replace or reduce </li></ul><ul><li>housing support workers - increased pressure to cut labour costs through assistive technology but likely to remain marginal for next 5-10 years (except top end of market) </li></ul>
    43. 44. Health and Home <ul><li>The majority of older people live within the community. </li></ul><ul><li>26% of households with someone aged over 75 live in social housing and 68% are home owners. </li></ul><ul><li>5% of older households live in sheltered housing </li></ul><ul><li>5% of older people live in a care home. </li></ul><ul><li>Poor housing has a detrimental impact on both physical and mental health. </li></ul><ul><li>2.7 million households with at least one person aged over 60 are living in a non-decent home. </li></ul><ul><li>Older people are more likely to be living in non-decent homes in the private sector if they are over 75, aged 60 or more and living alone. </li></ul><ul><li>60% of women aged 75 and over live alone compared to 36% of men of the same age . </li></ul>
    44. 45. Care and support at home <ul><li>There are 6 million carers in the UK. </li></ul><ul><li>2.8 million people aged 50 and over provide unpaid care; nearly 1 million of these are aged 65+ and nearly 50,000 are aged 85+. </li></ul><ul><li>There are 8,000 carers aged 90+ (4000 providing 50+ hours of care per week. </li></ul><ul><li>Unpaid carers currently provide 65% of care compared to 25% paid for by the state (10% is privately purchased). </li></ul><ul><li>73% of English local authorities have plans to limit care to people with substantial and critical needs only. </li></ul><ul><li>The growing number of older people means that the need for support from unpaid carers could rise by 30% over the next 35 years (9.1 million). </li></ul>
    45. 46. Empowering older people with supported self-care <ul><li>Older people and their carers want services that will: </li></ul><ul><ul><li>improve their quality of life, health and well-being and enable them to be more independent. </li></ul></ul><ul><ul><li>Be supported and enable them to self care and have active involvement in decisions about their care and support. </li></ul></ul><ul><ul><li>To have choice and control – services built around the needs of individuals and carers. </li></ul></ul><ul><li>The 2006 White Paper Our health, our care, our say , promoted telecare and assistive technology in helping people retain their independence and improve their quality of life. </li></ul><ul><li>The use of the internet by older people, particularly over 75s has increased (from 14% to 27%), many older people continue to be excluded from the benefits of new technologies (Age Agenda 2008, Age Concern). </li></ul>
    46. 47. As people age, the risk of being lonely increases For details of trends in volunteering and digital inclusion, see Appendix <ul><li>Social isolation prevents ability to contribute. It also is a risk factor for health. </li></ul><ul><li>Inactivity and isolation accelerate physical and psychological declines, creating a negative spiral towards premature, preventable ill health and dependency. A recent ELSA study revealed that social detachment reduces quality of life. </li></ul><ul><li>Depression is associated with lack of social support (36% of men and 54% of women with severe lack of social support have high depressive symptoms) </li></ul><ul><li>Social isolation is a cross-cutting issue and the responsibility for alleviating it lies with several Government departments. Policies which may directly impact on social isolation are fragmented but include: </li></ul><ul><ul><li>Linkage Plus aimed to improve outcomes for older people through better joining-up between services and linking older people to services. </li></ul></ul><ul><ul><li>Developments in transport policy including making the freedom pass available, amending community transport regulations and </li></ul></ul><ul><ul><li>Investment of £5.5 mil into intergenerational volunteering </li></ul></ul><ul><ul><li>Individual budgets for those that access social care </li></ul></ul><ul><ul><li>Positive duty as applied to culture and leisure opportunities </li></ul></ul><ul><ul><li>Lifetime neighbourhoods </li></ul></ul><ul><ul><li>Neighbourhood warden schemes </li></ul></ul><ul><ul><li>Informal learning white paper </li></ul></ul><ul><li>29% of respondents to an Age Concern survey saw friends and 36% saw family a few times and month or less </li></ul><ul><li>However many people at mid- to later life may not consider they need to expand their social networks </li></ul><ul><li>44% state they do not need lots of friends </li></ul><ul><li>45% disagreed that they feel lonely from time to time </li></ul><ul><li>Analysis of ELSA wave 3 has found that life satisfaction significantly decreases after certain life events, with many underlying factors clustering around themes of social isolation and lack of support. </li></ul>One person households are projected to overtake married couple households by 2030 Why is this important? Policy What do older people think? Satisfaction with current levels of social interaction could be a barrier to individuals building up social networks Trends SOCIAL INCLUSION 226,000 797,000 923,000 834,000 947,000 1,061,000 1,659,000 254,000 1,048,000 1,460,000 1,415,000 1,792,000 1,559,000 2,359,000 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000   Under 25   25 - 34   35 - 44   45 - 54   55 - 64   65 - 74   75 and over 2026 2003
    47. 48. Public Policy Challenges
    48. 49. Long term challenges <ul><li>A decade of spending cuts – doing more with less? </li></ul><ul><li>Demographic change – a manageable transition (working longer; pensions reform) but we must now prepare our public services </li></ul><ul><li>Income – pensioner poverty stuck around 20% for the next decade despite pension reform </li></ul><ul><li>Healthy life expectancy - remains an elusive goal, avoid longer periods of disability </li></ul><ul><li>Social and technological change – changes in family life, communities and the digital divide – what next? </li></ul>
    49. 50. 2011: Uncertainty and Opportunity <ul><li>UNCERTAINTY </li></ul><ul><li>Older people not immune from the recession </li></ul><ul><ul><li>Job losses hitting older workers </li></ul></ul><ul><ul><li>Rising costs of living </li></ul></ul><ul><ul><li>Impact on savings and annuities </li></ul></ul><ul><li>Now - a focus on employment and skills; an end to forced retirement </li></ul><ul><li>The aftermath – public service cuts must not disproportionately harm older people </li></ul><ul><li>OPPORTUNITY </li></ul><ul><li>A new ageing strategy </li></ul><ul><li>Social care reform - 2011 is ‘make or break’ for the long term </li></ul><ul><li>The Equality Bill – new rights outside work; end forced retirement? </li></ul><ul><li>Pensioner poverty – Child poverty Bill focuses minds on ending pensioner poverty </li></ul><ul><li>Coalition pressing older people’s priorities </li></ul>
    50. 51. Equal citizens, equal rights <ul><li>PROPOSALS </li></ul><ul><li>Use Equality Bill to outlaw age discrimination in goods and services, rapidly and with minimal exemptions </li></ul><ul><li>Support EU directive on discrimination beyond the workplace </li></ul><ul><li>Robust enforcement and promotion of existing age discrimination law </li></ul><ul><li>Extend Human Rights Act to private providers of public services </li></ul><ul><li>INDICATORS </li></ul><ul><li> 68% say politicians see older people as a low priority </li></ul><ul><li> 60% say age discrimination exists in older people’s lives </li></ul><ul><li> 60% say age discrimination exists in the workplace </li></ul><ul><li> 53% say people in very old age are treated like children </li></ul><ul><li> 52% say those planning services don’t pay enough attention to older people </li></ul>PRIORITY: Outlaw mandatory retirement ages (2010 priority)
    51. 52. Enough Money <ul><li>PROPOSALS </li></ul><ul><li>Government commitment to end pensioner poverty </li></ul><ul><li>Public services work together to push take-up of benefits </li></ul><ul><li>Index State Pension to earnings now and improve pensions for women who retired before 2010 </li></ul><ul><li>Urgent review of Fuel Poverty Strategy </li></ul><ul><li>INDICATORS </li></ul><ul><li> 16% (AHC) of pensioners in poverty </li></ul><ul><li> 59-67% of those eligible receive Pension Credit </li></ul><ul><li>56% of employees covered by a non-state pension </li></ul><ul><li>36% of over-60s avoid heating rooms to save money </li></ul><ul><li> 7% of 85+ households don’t have a bank account </li></ul>PRIORITY: Roll out automatic payment of benefits
    52. 53. My life, my care <ul><li>PROPOSALS </li></ul><ul><li>Increase investment in preventative support and information, advice and advocacy </li></ul><ul><li>A fair national system for assessing need and allocating resources </li></ul><ul><li>A radical new long-term settlement for care and support, which increases access and quality, and is fair and affordable for all </li></ul><ul><li>INDICATORS </li></ul><ul><li>410,000 people over 65 with unmet need for help around the home </li></ul><ul><li>67,000 households receiving low-level home care </li></ul><ul><li>347,000 people receiving home care </li></ul><ul><li>£60 gap between average weekly fees for a care home and the standard council payment </li></ul><ul><li> 27,000 people over 65 receiving Direct Payments </li></ul>PRIORITY: Spend an extra £1-2bn on older people’s care
    53. 54. Staying well and feeling good <ul><li>PROPOSALS </li></ul><ul><li>All public services to work to promote lifetime good health </li></ul><ul><li>NHS reform to reflect older people’s needs and preferences </li></ul><ul><li>Improve access to primary care for carers and care home residents </li></ul><ul><li>All health providers to adopt person-centred measures of dignity </li></ul><ul><li>Age-aware workforce development strategies </li></ul><ul><li>INDICATORS </li></ul><ul><li> 24% of over-65s say quality of life has worsened in the last year </li></ul><ul><li> 7.3 years for men and 9.4 years for women of future disability at age of 65 </li></ul><ul><li> 19% of 65-74s and 7% of over-75s do recommended levels of exercise </li></ul><ul><li> 149,000 75+ emergency readmissions within 1 month of discharge </li></ul><ul><li> 64% say health and care staff don’t always treat older people with dignity </li></ul>PRIORITY: Re-direct the NHS to prevent and manage common conditions of ageing
    54. 55. Places to age in <ul><li>PROPOSALS </li></ul><ul><li>Local public agencies to commit to ‘lifetime neighbourhoods’ principles </li></ul><ul><li>Rapid adoption of Lifetime Homes planning standard </li></ul><ul><li>Review policy and funding for supported housing </li></ul><ul><li>During recession, anti-crime initiatives for and with older people </li></ul><ul><li>INDICATORS </li></ul><ul><li>11% of over -65s say they are lonely </li></ul><ul><li>35% of 60+ households live in poor housing conditions </li></ul><ul><li> 26,000 65+ excess winter deaths </li></ul><ul><li> 9-10% of over 75s find it very difficult to access doctor, post office, supermarket </li></ul><ul><li> 6% of over-65s leave home once a week or less </li></ul>PRIORITY: a national ‘offer’ and brand for local older people’s services
    55. 56. Opportunities and contributions <ul><li>PROPOSALS </li></ul><ul><li>Employers to adopt flexible working and ‘age management’ policies, with a right to request flexible work. </li></ul><ul><li>All local public services to facilitate lifelong learning </li></ul><ul><li>IT industry to embrace accessibility and inclusive design </li></ul><ul><li>Public bodies to involve diverse groups of older people in decisions affecting them </li></ul><ul><li>INDICATORS </li></ul><ul><li> 76% say the country fails to make good use of older people’s skills and talents </li></ul><ul><li> 312,000 over-50s unemployed </li></ul><ul><li> 168,000 over-60s participating in state-funded learning </li></ul><ul><li> 60% of over-65s have never used the internet </li></ul><ul><li> 39% of 65-74s and 24% of over 75s participate in formal volunteering at least once a month </li></ul>PRIORITY: ‘age proof’ employment and skills support during recession
    56. 57. Public Policy at Age UK <ul><li>NATIONAL </li></ul><ul><li>COMMUNITY AND SOCIETY </li></ul><ul><ul><li>Income and inequality </li></ul></ul><ul><ul><li>Housing </li></ul></ul><ul><ul><li>Communities and transport </li></ul></ul><ul><li>PUBLIC SERVICES </li></ul><ul><ul><li>Health and healthcare </li></ul></ul><ul><ul><li>Independence and support </li></ul></ul><ul><ul><li>Equality and human rights </li></ul></ul><ul><li>PRIVATE SECTOR </li></ul><ul><ul><li>Employment and opportunities </li></ul></ul><ul><ul><li>Consumer markets </li></ul></ul><ul><ul><li>Financial services </li></ul></ul><ul><li>LOCAL </li></ul><ul><li>Supporting Age Concerns and other partners influence effectively </li></ul><ul><li>National programmes where the key decisions are local </li></ul><ul><li>REGIONAL </li></ul><ul><li>Regional teams working with partners </li></ul><ul><li>INTERNATIONAL </li></ul><ul><li>EU and international institutions </li></ul><ul><li>Partnership with HelpAge International </li></ul>
    57. 58. Opportunities for enterprise
    58. 59. The opportunity….. a large and growing older population
    59. 60. Spending, income and wealth <ul><li>SPENDING </li></ul><ul><li>About £102 billion spent by 65+ households every year </li></ul><ul><li>Rich people spend same amount, whatever their age. Poor people in later life spend less than younger groups with the same income </li></ul><ul><li>INCOME </li></ul><ul><li>Lower incomes on average, but similar poverty rate </li></ul><ul><li>WEALTH </li></ul><ul><li>2.2 million with no savings; 3 million with over £20,000 </li></ul><ul><li>Huge inequalities in wealth, but richer than younger age groups on average (housing) </li></ul>
    60. 61. Distribution of wealth within and between cohorts
    61. 62. Real spending power <ul><li>Over 50’s account for 80% of UK financial wealth </li></ul><ul><li>On average, higher disposable income than under 50’s </li></ul><ul><li>But huge variation in terms of who accounts for it…….. </li></ul><ul><li>Wealth concentrated among current 50 - 64’s: </li></ul><ul><ul><li>80% home ownership </li></ul></ul><ul><ul><li>spend more per week than any other age group </li></ul></ul><ul><li>65 – 75’s already have similar spending power to under 50’s versus… </li></ul><ul><li>40% of retired who rely on state pension: 60% home ownership over 75’s </li></ul>
    62. 63. Assumptions about older consumers <ul><li>Often misrepresented, neglected, ignored </li></ul><ul><li>55% of over 55s agree ‘business and retailers have little interest in the consumer needs of older consumers’ </li></ul><ul><li>Ageism – stereotyping of a whole age group as </li></ul><ul><ul><li>Homogenous ‘others’ </li></ul></ul><ul><ul><li>Warm, friendly </li></ul></ul><ul><ul><li>Incompetent and incapable </li></ul></ul><ul><li>Neglected even for products mainly for older age groups… reinforcing and responding to internalised ageism </li></ul>
    63. 65. Facts about older consumers (1) <ul><li>People get more diverse as they get older… </li></ul><ul><li>Full-time, part-time, retired, caring, grand-parenting, volunteering etc </li></ul><ul><li>8% of people over 65 are from BME backgrounds </li></ul><ul><li>5-7% over over-60s are LGB </li></ul><ul><li>A third of over-65s are disabled, rising to 2/3 of over-85s </li></ul><ul><li>A quarter have symptoms of depression </li></ul>
    64. 66. Facts about older consumers (2) <ul><li>Driving – half of over-70s don’t have a driving licence </li></ul><ul><li>Valuing home – over-65s spend more time at home (80% of the week) and like them more. But some feel trapped at home. </li></ul><ul><li>Living alone – half of 75+ households live alone. 7% over over-65s are often or always lonely </li></ul><ul><li>Not exercising enough – 7% of over-75s meet guidelines </li></ul><ul><li>Having cognitive difficulties – especially over 80s </li></ul>
    65. 67. Facts about older consumers (3) <ul><li>Late adopters, but get there… </li></ul><ul><ul><li>77% of 65-74 year olds use a mobile </li></ul></ul><ul><ul><li>40% aged over 65 have used the internet, including a million almost every day </li></ul></ul><ul><ul><li>1 in 10 60-69 year olds own an MP3 player </li></ul></ul><ul><li>Spend higher share on essentials (food, energy, housing etc) </li></ul><ul><li>A little less susceptible to switching products, advertising etc </li></ul><ul><li>Hate stigmatising products… eg ugly adaptations </li></ul><ul><li>But mainstream products don’t always serve their needs </li></ul>
    66. 68. Impact of ageing on activities of daily living <ul><li>Impacts on hearing, sight, touch, dexterity, muscular strength, mobility etc </li></ul><ul><li>28% of over-65s have significant sight loss </li></ul><ul><li>55% of over 60s have hearing problems </li></ul><ul><li>One third of over-65s have a fall each year </li></ul><ul><li>9 million people have arthritis </li></ul><ul><li>Small print harder to read </li></ul><ul><li>Call centres more difficult to navigate </li></ul><ul><li>Bending and stretching to reach shelves </li></ul><ul><li>Fiddly buttons on clothes </li></ul><ul><li>Sending text messages on mobile phones </li></ul><ul><li>Shopping harder to carry </li></ul><ul><li>Packaging harder to open </li></ul>Facts about older consumers (4)
    67. 69. So, what is the problem? <ul><li>As a society, we have failed to come to terms with the dramatic increase in the number of older people, both in absolute terms and proportionate to the population </li></ul><ul><li>Denial; the difficulty we all have in coming to terms with getting older, our own ageing process </li></ul><ul><li>Older people feel they are marginalised, ignored, stereotyped </li></ul><ul><li>Products, marketing and communications still addressed to the younger generation </li></ul>
    68. 70. Society does not place a high value on old age <ul><li>Sheer numbers mean there is no status or achievement in having defied the odds </li></ul><ul><li>As a revered minority, older people used to carry the wisdom of their tribe and family. But now: </li></ul><ul><ul><li>no longer natural leaders </li></ul></ul><ul><ul><li>diminishing role in extended family </li></ul></ul><ul><li>In a secular / Western society, there is no sense of the development of spiritual wisdom that comes with age </li></ul><ul><li>Experience used to be a basis for respect. But with the impact of technological change the experience of age is increasingly replaced by the expertise of youth </li></ul><ul><li>Longer life seen as a burden, not a benefit </li></ul>
    69. 71. Society is dominated by youth culture <ul><li>Huge pressure to remain looking and feeling young: </li></ul><ul><ul><li>role models are young and beautiful </li></ul></ul><ul><ul><li>men worry about loss of potency, power and success </li></ul></ul><ul><ul><li>women about a decline in their attractiveness </li></ul></ul><ul><li>Business still tends to innovate and grow by focusing on the young </li></ul><ul><li>The majority of people working in marketing, communication and design are under 40 (including Age UK) </li></ul>
    70. 72. Society is bound by cultural conditioning and stereotyping of what old age means and looks like <ul><li>Deterioration and decay, no sex, no fun </li></ul><ul><li>Traditional and conservative, not innovative, lacking in discernment, not interested in style, fashion, technology </li></ul><ul><li>Stereotyped prejudice written into the language: ‘grumpy old’, ‘silly old’, ‘boring old’, ‘dirty old man’ </li></ul><ul><li>Indeed, society tends to shut old age away, rather than living with it </li></ul>
    71. 73. The idea and fact of ageing can be traumatic <ul><li>Coping with ‘retirement’ </li></ul><ul><li>Coming to terms with loss of youth </li></ul><ul><li>Fear of physical and mental decay </li></ul><ul><li>Fear of being alone, isolated, abandoned, helpless </li></ul><ul><li>Of being poor </li></ul><ul><li>Many live in denial: suppressing and denying our own fears we do not put ourselves into the shoes of being an older person……. </li></ul>
    72. 74. Summary: the business case <ul><li>Recognise that business opportunities come with change </li></ul><ul><li>Recognise the complexity of the market </li></ul><ul><li>Think beyond age </li></ul>
    73. 75. The ‘Third Age’ should present rich opportunities <ul><li>The changing lifestyle of ‘retirement’ </li></ul><ul><li>Different priorities and needs </li></ul><ul><li>More time, and different uses </li></ul><ul><li>New interests and opportunities </li></ul><ul><li>More disposable income </li></ul>
    74. 76. Potentially a different life and opportunities <ul><li>Family woman </li></ul><ul><li>Focus on the family </li></ul><ul><li>Spending on them </li></ul><ul><li>Family food and toiletry products: </li></ul><ul><ul><li>value packs to suit all </li></ul></ul><ul><ul><li>chips and pizza </li></ul></ul><ul><li>No time for me </li></ul><ul><li>Family holiday </li></ul><ul><li>Swim with the kids </li></ul><ul><li>DIY face pack </li></ul><ul><li>Family wagon </li></ul><ul><li>Take away </li></ul><ul><li>Old TV and video </li></ul><ul><li>Empty Nester </li></ul><ul><li>Focus on me (us) </li></ul><ul><li>Spending on me </li></ul><ul><li>My food and beauty preferences; </li></ul><ul><ul><li>premium toiletry products </li></ul></ul><ul><ul><li>salad bags and fish </li></ul></ul><ul><li>More time for me </li></ul><ul><li>Tour of China, cruise </li></ul><ul><li>Swim and Yoga </li></ul><ul><li>Weekly professional manicure </li></ul><ul><li>Sporty car </li></ul><ul><li>Meals at nice restaurants </li></ul><ul><li>New DVD system </li></ul>
    75. 77. Thinking beyond age <ul><li>Not helpful to think of age per se. </li></ul><ul><li>Ageing is an individual experience; people age in different ways </li></ul><ul><li>The accumulation of ‘damage’ is dramatically different from one person to another </li></ul><ul><li>People’s response to and ability to cope with the ageing process, differs dramatically </li></ul><ul><li>Basic differences in attitudes towards life become magnified </li></ul>
    76. 78. Attitudes are much more defining <ul><li>Potentially a more complex segmentation than for younger markets: </li></ul><ul><ul><li>less vulnerable to peer group pressure </li></ul></ul><ul><ul><li>less need to conform, more individualistic </li></ul></ul><ul><li>Most helpful segmentation based on understanding a range of feelings about ageing </li></ul><ul><li>Overlaid by attitude towards life per se </li></ul><ul><li>Whilst spending power is clearly a critical marketing variable </li></ul>
    77. 79. Conclusions <ul><li>Immense business opportunities if we are up to the challenge: </li></ul><ul><ul><li>to harness spending power </li></ul></ul><ul><ul><li>provide products which are relevant to a different lifestage and lifestyle </li></ul></ul><ul><ul><li>which help to cope with the process and consequences of ageing (practically, emotionally) </li></ul></ul><ul><ul><li>but, are not limited by age </li></ul></ul><ul><li>To make the most of those opportunities: </li></ul><ul><ul><li>develop ideas about targeting </li></ul></ul><ul><ul><li>more insights and greater understanding </li></ul></ul><ul><ul><li>consider the special needs of this market </li></ul></ul><ul><ul><li>appropriate communication and design </li></ul></ul><ul><ul><li>relevant imagery, not stereotyped and patronising </li></ul></ul>
    78. 80. The way forward... <ul><li>Question the notion of ageing; in society, in ourselves </li></ul><ul><li>Ignore the calendar; chronological age is progressively less relevant </li></ul><ul><li>Develop products which are appropriate to this lifestage, to the ‘third age’ </li></ul><ul><li>Think about the role of these products: </li></ul><ul><ul><li>enabling life and living </li></ul></ul><ul><ul><li>enhancing the quality of life </li></ul></ul><ul><ul><li>simplifying life </li></ul></ul>