Remember ME - You Me and Dementia

May 23, 2011

UK: How will we care for the centenarians of the future?

.
LONDON, England / The Guardian / Culture / May 23, 2011

Comment is Free
Those born today will be in their prime by 2050. But they won't be living here unless we change attitudes to immigration

By Danny Dorling

By 2066, there are predicted to be over half a million people
aged over 100 in Britain and diminishing resources to care for them.
Photograph: Edmond Terakopian/AFP/Getty Images


The future potential care bill for the elderly in Britain is so great that it could threaten family ties, according to a report released by the Organisation for Economic Co-operation and Development yesterday. It suggests that, by 2050, the country will spend more than a fifth of its entire national output on services for the elderly.

In my new social atlas, Bankrupt Britain, I document with Bethan Thomas how the current economic woes have revealed a whole series of potential financial, residential and moral future bankruptcies. The harsh truth is that by 2048, advances in medicine, a better-ordered society, and even huge amounts of care being provided by the young elderly, will not be enough to help us care for our rising population of the very old. Last year, the Department for Work and Pensions upped their estimates of future centenarians considerably, to suggest that there will be more than half a million aged over 100 by 2066.

To aggravate the situation, there is great uncertainty over how many young people there will actually be around in the future in Britain, compared to how many we need. When the present Queen was just a couple of years on the throne, and then again a dozen years later, she was told wildly different stories about how many future subjects she should expect to reign over. Her advisers were uncertain, but such uncertainty matters when we try to prepare for our dotage.

In 1955 and 1965 projections, published by the precursors of the Office for National Statistics for the UK, population around the time of the millennium differed by some 22 million people. The 1955 projection of 53 million by 1995 was far closer to the final outcome than was the 1965-based estimate of 75 million by 2001. We tend to overestimate future populations rather than underestimate them. The 1965-based projections, published around the Queen's 42nd birthday, projected that there would be more than 1.5 million babies born in the year 2000, a projection that turned out to be over twice the actual number.

When the 2011 census results are released in less than a couple of years' time, we will find out again if we have been over-estimating the population and perhaps then we will recognise that we do need censuses, we do need to plan and we could be much better organised than we are.

However, better organisation only gets you so far. No matter how well we organise ourselves in future, we do have a problem with how few youngsters there are projected to be in future in Britain. Even if (like almost every other nation state in Europe) we disband the households of servants that royalty and the super-rich have established to care for them, so that the cost of these servants can be redistributed to allow the rest of us to be cared for more efficiently, there may well not be enough younger people to go around in Britain. It is when people find that this is the case that the fear of an each-for-their-own attitude prevails most strongly.

Most of the world's population who are projected to be very elderly in 2050 are not living in those places where the vast majority of people currently being born are projected to live. Those born today are people who will, by 2050, be in the prime of their lives. But almost all of them won't be living in Britain, unless we change our attitude to immigration (in this country and across all of Europe) – the greatest fall in fertility in the world recently has been in eastern Europe, so we shouldn't expect help from Polish carers in future.

If our current population and household projections are allowed to run their course then, just as there was a 73% rise in single (mainly elderly) households between 1981 and 2008, with just a 12% rise in households containing more than one person, so too we should expect a similar rise over the course of the next 27 years.

However, as we can see, though, from the contradictory advice given to the Queen, there is nothing inevitable about projections. They have been out by millions before, mainly because what actually occurs is very much out of our hands. A higher proportion of single-occupancy households is what you get when you combine an ageing population with a curtailment of immigration.

Britain's full up, you might say, and – apart from when petrol prices rise suddenly and incomes fall – our roads are pretty full. But that has more to do with people taking more journeys in Britain than is usual in Europe, than with British population density being too high. Many of the more affluent British currently emigrate in great numbers to some of the most densely populated areas of Europe to enjoy their retirement in the sun: to Malta, to the Spanish Costas and other hotspots.

We have as many emigrants as immigrants, it's just that being a very unequal country the exchange has not always been that fair – more affluent Brits out (for at least the colder part of the year) and more poorer immigrants in.

This imbalance is a product of the inequalities we tolerate. Inequalities which, if they are allowed to increase unabated, result in a very unattractive image of a future society. Not the kind of place that will find it easy to care well for that first tally of half a million centenarians. I'm "young" enough to be among that cohort. If I should live that long I have a huge vested interest in Britain changing for the better beforehand.

© Guardian News and Media Limited