The future of ageing

Implications for who bears responsibility for healthy ageing

Individual, family and state responsibilities for healthy ageing

Increasing awareness of the malleability of ageing – whether through existing public health and health promotion measures, or through innovations in geroscience – raises important questions about responsibility for our future health. If we can increasingly influence the way we age, either through our own health-related behaviours or through willingness to take new medications, do we have a duty to do so? And how might any such individual responsibility to ‘age responsibly’ affect the responsibilities of others (the state, our families, health and care professionals, the insurance sector) to support us financially and care for us when required? Such arguments about the nature of personal responsibility need to be considered in the wider picture of the social determinants of health and the many factors that affect or limit our opportunities for choosing to live healthy lives.

Impact on personal freedoms

The way that responsibilities are exercised by others may also have a significant impact on individual freedoms. Decisions by the Government, by regulatory authorities, by individual care homeowners, and by insurers, during the COVID-19 pandemic have had a very direct impact on care home residents’ abilities to make their own choices – for example preventing them from deciding for themselves how to balance their risk from infection with the importance of remaining in direct contact with family and friends.

Intergenerational solidarity and fairness

The idea that the age shift in the population should be viewed necessarily as a ‘burden’ on younger people has been strongly challenged, with emphasis on the ‘longevity dividend’ that could be achieved by better inclusion of older people both in the workforce and as consumers (see also section 2 on attitudes to ageing). Moreover, there is good evidence that preventative approaches that support healthy ageing offer scope for significant reductions in both health and social care costs.

Nevertheless, many of the factors identified as affecting our ability to live well in old age – from adequate housing and accessible transport to the challenge of sustainable funding of the social care sector – have significant financial implications both for now and into the future. Even with the contribution of successful developments in biomedical research and technological innovation, there is clearly a financial cost to transforming society to one that is accessible to, and supportive of, people as they age. The need for this kind of investment is sometimes put in terms of conflict between older and younger generations – particularly when younger people appear to be particularly badly affected by public funding cuts. However, it could also be seen in terms of sustainability of approach for all generations, nearly all of whom will themselves reach later life.

Question 10

Please comment on the responsibilities of the various stakeholders (older people themselves, their families, professionals, wider society, the state) with respect to a healthier old age – including with respect to intergenerational solidarity and fairness.

Issues you might like to touch on in your response include (but need not be limited to):

• the responsibilities of the state to act to support healthier and inclusive ageing;
• the extent to which we are to be held responsible for the way we grow old;
• the implications of this for wider social policy - e.g.
  • in terms of where the responsibility lies for funding/ providing / regulating care required in connection with the mental or physical consequences of ageing?
  • in terms of protecting personal autonomy and choice;
• the implications of current approaches to ageing policy for future generations.