Читать книгу Not Dead Yet: A Manifesto for Old Age - Julia Neuberger - Страница 19

Retirement. Free time. A time to do what I want for a change. The end of the daily grind. No more nine-to-five or eight-to-four, and the exhaustingly long hours that we work in the UK compared to anywhere else in Europe. Most of us expect to get our pensions, whatever they are, however adequate or inadequate, when we are anything between 60 and 65. But our life expectancy has shot up dramatically, so that considerable numbers of us already make it to our century, and – if the government actuaries are to be believed – even more of us will do so in the not too distant future. But there is a peculiar contradiction in the way we think about the prospect of getting older. On the one hand, there is this escape from work responsibilities into a world of leisure; on the other hand, we are fearful of what lies beyond that – both individually and as a society.

Life expectancy in industrialized countries such as the UK has doubled over the past two centuries. More recently, life expectancy has also begun to rise across the developing world. In fact, most nations are experiencing continuous upward trends in longevity. But because of this contradiction, this astonishing feat – driven primarily by the successes of previous generations in combating early, preventable deaths – now evokes a curiously mixed response.

‘It is hardly possible to open a newspaper without reading of the increase in life expectancy, and the consequently rapidly increasing proportion of older people in the population,’ said the House of Lords select committee charged with reporting on the science of ageing.1 ‘More often than not these matters are considered for the economic impact they will have, be it on the cost of healthcare or on pensions. The underlying tone of such discussion is often negative, focusing on the ‘burden’ of increased numbers of older people and the threat of the demographic ‘timebomb’.’

The 2001 Census showed that, for the first time, the number of people in England and Wales aged 60 and over was greater than the number aged under 16, but the figures for the ‘oldest old’ were even more striking. In 1951 there were 20,000 people aged 85 and over; by 2001 this had grown to over 1.1 million. Despite some considerable geographical and class variations, the trend is still upwards. Figures published in 2007 suggest that the life expectancy of women had shot up by 30 months in only four years to 85, while the gap between the top and bottom social classes had widened. Not quite an additional year of life expectancy for every year of life, but for those women in the professional classes a very different picture from the usual additional two years of life expectancy every ten years or so.2

Most observers and agencies concerned with forecasting future life expectancy used to predict that it would soon reach a plateau, when the gains from preventing early death had been consolidated. Then – or so they told us – the ageing process would settle down and we would see what it really was, stripped of early preventable deaths. But this never happened. Most evidence suggests that life expectancy within the UK and in other developed countries is still going up at the rate of about two years for each decade that goes by.

What is more, there is some evidence that it is speeding up. Studies in Sweden, where statistics have been kept since 1860, show that the increase in the age of the oldest person, far from slowing down towards a plateau, has been accelerating over the last 20 to 30 years. The UK government Actuary’s Department predicted recently that there could be a million centenarians by 2074.3 We are, in short, getting older and older.

Of course, these figures are based on the most optimistic life expectancy trends. If there is a serious flu pandemic, a late blossoming epidemic of BSE or a health decline due to obesity, it will not be quite so dramatic. Even the government actuary said the likely figure was nearer 350,000, which is still huge compared with the 10,000 or so centenarians now living in the UK. But people in their thirties now have a one in eight chance of living to be 100, and thousands could make it to 110, or even older.

There is still an academic disagreement about exactly what is going to happen. Emily Grundy, professor of demographic gerontology, has warned that the government has seriously overestimated, arguing that improvements in mortality rates in Denmark and the Netherlands have now stopped.4 On the other side is the British Longevity Society’s Myrios Kyriazis, who argues that the government is underestimating the numbers of us likely to reach 100. Like some American scientists, he believes that ‘stem cell technology could completely transform how long future generations live by continually replacing our diseased organs, allowing us to surpass a thousand years.’5 There are more bizarre predictions, especially among the futurist and IT community in the USA, which suggest we will soon be living to 5,000 years.

Similar arguments are going on around the world. There are already 25,000 centenarians in Japan, where there is a special ‘Respect the Aged’ day (19 September), when the latest group of centenarians is presented with a silver cup and a letter from the prime minister. Sri Lanka has an average life expectancy of 74.4 years, and Asian countries generally are shooting up the age expectancy tables, while Africa is showing a decline in age expectancy. Zimbabwe has a terrifying life expectancy of just 37.3 years and Botswana’s is 35.5 years. These are results of a mixture of terrible governments, civil war, malaria and HIV/AIDS. But in most nations the trend is definitely upwards. The real question is going to be what this will mean.

If people live to 100 but still retire at 65, they will be retired – and presumably drawing a pension – for almost as long as they have been working. Some public sector occupations allow people to retire at 60 or even 55. I look more closely at the financial implications of getting older in a later chapter, and certainly pensions will affect how we live in retirement, but the real question is how we will judge success in our old age – and how policy-makers will define an old age well lived on our behalf.

There is a growing, though reluctant, consensus that we will have to work longer, which will postpone the age when old age officially begins. We will probably extend our working lives into our seventies or even eighties, though this may be done part time. But we will take those decisions partly based on the kind of older life we aspire to have – and the truth is that most of us seem likely to find ourselves there without having thought much about that. There is a paradox: as a society, we seem to be fearful of getting very old, yet at the same time want more and improved healthcare to keep us going longer. We fear retirement and worry about the financial resources, yet we resist working longer. We dare not, sometimes, even look too far into the future for fear of meeting ourselves there. It is a paradox that, in some ways, makes effective policy-making far more difficult.

‘Ageism is worse than racism or sexism because there is so little recognition that it is wrong,’ said Sohan Singh, 66:

There is no commission fighting for your rights … Ageing is a little bit like disability in that a lot of the problems are socially created. People may have more or slightly different needs as they get older, but the key thing is to keep people as human beings functioning as fully as possible. It is society that imposes on you a sense that you are old. I feel pretty young.6

In 2006, the journalist Stephen Moss interviewed eight centenarians in the Guardian, finding out about them in the pages of local newspapers.7 He told their stories extraordinarily tenderly and respectfully. But there was a note of surprise in what he wrote, as if he never expected to find what he found. In his interviewing, he was left ‘with one abiding impression: that they had been sustained by love – of parents, partners, and children. Most of all, partners, some long dead.’

It was, he said, ‘much better than the usually quoted epigraph for extreme age – Shakespeare’s “second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything”.’

He did not find much in the way of regrets – ‘the survivor’s story was, at heart, a happy one’ – though Moss felt that they did not always seem as happy as they said they had been. On the other hand, he wrote: ‘They exhibited a stoic calm, an unshakeable acceptance of the hand that life had dealt them.’

They also lived for today. Harry Walker was asked what targets he still had in life, and replied:

There aren’t any. You live day by day. I wake up in the morning and make sure that my legs are still working. I don’t think I’m much trouble to the staff. I regularly go for a walk around the grounds. It’s getting a bit harder, but I’m still living.8

These centenarians, on the whole, despite some forgetfulness, some dementia, a stroke, various frailties and ailments, thought of themselves as relatively strong, healthy, and in good spirits – and one was still driving her car. Not a sad tale at all. It was a surprising story because society fears extreme old age, even fears the thought of so many very old people in our society.

We have two ways of looking at ourselves when old that are contradictory, said Mary Riddell in the Observer shortly after these interviews.9 Are we ‘British pensioners with double cataracts and leaking roofs’, or are we the Greek goddesses to whom immortality is indispensable? Again, this contradiction seems to allow the treatment of older people in ways that we would never allow for someone younger. Mary Riddell cited the case of the British actors Francesca Annis and Ralph Fiennes. They had been together for eleven years; she was then 61, he a mere 43. The public was asked by the media to forgive Fiennes’s affair with a singer on the grounds that Annis is ‘so old’– and cheating on a long-term partner is clearly all right if she is old. Yet, if we are to live to 100 or more, 61 is barely middle age.

As for couples who are both elderly, they get treated with the greatest contempt. Like Richard and Beryl Driscoll, both 89 and married for 65 years, who were separated for seven months because Gloucestershire social services refused to pay for Mrs Driscoll to be in a care home alongside her frailer husband, even though she was blind.10

The question that Mary Riddell asked – What is all this extra life for? – is really the question at the heart of this book. Instead of allowing a gradual state of impermanence to take over – short-term marriages and relationships, constant cosmetic surgery, new ideas and yet more change – older people could call a halt to some of this, and ask the public at large to think again. But all this requires a real debate about what old age is for. Until we think about that a little more deeply, we will carry on treating older people as second-class citizens, and none of this will make much sense. And behind that question lies the issue of how we judge when old age is fulfilled and worthwhile, that state of being and aspiration which policy-makers call ‘healthy life expectancy’.