Podium: Can we postpone the side-effects of old age?

Melanie Henwood From a speech by the health and social care analyst to the Health and Care group for the Millennium Debate of the Age

THE SOCIAL inclusion of older people has many implications for public policy. Health and care issues cannot be looked at in isolation from education, employment, housing, transport, social and leisure opportunities, and, of course, income maintenance. The current rhetoric of "joined-up government" acknowledges the importance of a holistic approach, but the reality has still a long way to go to match that.

Whether or not people are living longer and healthier lives, or whether they live longer lives in poor health, is of great significance. Not just for the individuals themselves, but also for the knock-on effects in terms of the need for health care and support.

The "compression of morbidity" is a term that demographers use to refer to the idea that people can live longer lives, with the period of ill- health or dependency compressed into a short period at the end of their lives. This can be contrasted with the current experience of many older people, who spend perhaps the last third or quarter of their lives in poor health and discomfort. Clearly, the big question must be: how can we ensure that the compression of morbidity becomes a reality?

Think about the images associated with old age - the characteristics of the "doddery old dear" that are currently in use in a commercial for gravy, or Shakespeare's vision of the Seven Ages of Man, which ends in the doom-laden "sans teeth, sans eyes, sans taste, sans everything".

Old age, according to these stereotypes, is characterised by poor mobility - joint problems, and a tendency to fall; by failing sight and hearing; by dementia, and by incontinence. Hardly an attractive picture, but none of these conditions is necessarily a feature of growing older.

Of course we all grow older, and there are certain features of this ageing process that appear to be unavoidable, although they are changing. These are things such as the loss of elasticity of skin, the slowdown in cell replacement, the thinning of bones. But these are not illnesses. There need to be clear strategies for preventing the development of many of the chronic conditions that are suffered, and for reducing ill-health and disability associated with the conditions that are often experienced in old age.

The postponement or avoidance of chronic illness is something in which we all have a vested interest. Reducing the need for medical intervention and for long-term care is better for all of us; it would promise a better quality of life, and offers the prospect of far less onerous demands on public expenditure.

Conditions such as strokes, osteoporosis, osteoarthritis, dementia, sensory impairment and incontinence are not the only ones in which there is scope for prevention and morbidity compression. However, they are probably the most important areas in which we should begin. It is likely that improvements in any of these areas would have wider, spin-off benefits elsewhere, such as in improved mental health and the reduction of depression in old age.

But these benefits will not happen just like that; we cannot leave them to chance and simply hope (with fingers crossed) that morbidity compression will develop naturally over time. There has to be an active investment in ageing research, and in prevention and rehabilitation, as well as in treatment and cure. In short, there has to be a commitment to a strategy for healthy ageing, not forgetting quality of care and support during the final days.

Too often the curative focus of modern medicine regards any death as a failure. Death, it is often said, is the final taboo of the 20th century. As we enter a new century, it is time to break the taboo and to take back control of an area that has been medicalised, professionalised and sanitised out of everyday experience.

The themes of control, autonomy and independence were recurrent throughout the work of the health and care group. We recognise the centrality of such issues to the lives of older people; the wish to retain control is a powerful motivation, and there is no reason why this should change as the end of life approaches.

PROMOTED VIDEO
Arts and Entertainment
TVDessert week was full of the usual dramas as 'bingate' ensued
Arts and Entertainment
Clara and the twelfth Doctor embark on their first adventure together
TVThe regulator received six complaints on Saturday night
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment
Vinyl demand: a factory making the old-style discs
musicManufacturers are struggling to keep up with the resurgence in vinyl
Arts and Entertainment
David Baddiel concedes his show takes its inspiration from the hit US series 'Modern Family'
comedyNew comedy festival out to show that there’s more to Jewish humour than rabbi jokes
Arts and Entertainment
Puff Daddy: One Direction may actually be able to use the outrage to boost their credibility

music
Arts and Entertainment
Suha Arraf’s film ‘Villa Touma’ (left) is set in Ramallah and all the actresses are Palestinian

film
Arts and Entertainment
Madame Vastra and Jenny Flint kiss in Doctor Who episode 'Deep Breath'

TV
Arts and Entertainment
Steve Carell in the poster for new film 'Foxcatcher'
filmExclusive: First look at comic actor in first major serious role
Arts and Entertainment

TV
Arts and Entertainment
Kingston Road in Stockton is being filmed for the second series of Benefits Street
arts + entsFilming for Channel 4 has begun despite local complaints
Arts and Entertainment
Led Zeppelin

music
Arts and Entertainment
Radio presenter Scott Mills will be hitting the Strictly Come Dancing ballroom
TV
Arts and Entertainment

TV
Arts and Entertainment

TV
Arts and Entertainment
The Doctor and Clara have their first real heart to heart since he regenerated in 'Deep Breath'
tv
Arts and Entertainment
Beyonce performs in front of a Feminist sign at the MTV VMAs 2014

music
Arts and Entertainment
Miley Cyrus has taken home the prize for Video of the Year at the MTV Video Music Awards 2014

music
Arts and Entertainment
Peter Paige and Scott Lowell in Queer as Folk (Season 5)
tvA batch of shows that 'wouldn't get past a US network' could give tofu sales an unexpected lift
Arts and Entertainment
books... but seller will be hoping for more
Arts and Entertainment
John Kearns winner of the Foster's Edinburgh Comedy Award with last years winners: Bridget Christie and Frank Skinner
comedyJohn Kearns becomes the first Free Fringe act to win the top prize
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Ukraine crisis: The phoney war is over as Russian troops and armour pour across the border

    The phoney war is over

    Russian troops and armour pour into Ukraine
    Potatoes could be off the menu as crop pests threaten UK

    Potatoes could be off the menu as crop pests threaten UK

    The world’s entire food system is under attack - and Britain is most at risk, according to a new study
    Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

    Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

    Seoul's plastic surgery industry is booming thanks to the popularity of the K-Pop look
    From Mozart to Orson Welles: Creative geniuses who peaked too soon

    Creative geniuses who peaked too soon

    After the death of Sandy Wilson, 90, who wrote his only hit musical in his twenties, John Walsh wonders what it's like to peak too soon and go on to live a life more ordinary
    Caught in the crossfire of a cyber Cold War

    Caught in the crossfire of a cyber Cold War

    Fears are mounting that Vladimir Putin has instructed hackers to target banks like JP Morgan
    Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years

    Salomé: A head for seduction

    Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years. Now audiences can meet the Biblical femme fatale in two new stage and screen projects
    From Bram Stoker to Stanley Kubrick, the British Library's latest exhibition celebrates all things Gothic

    British Library celebrates all things Gothic

    Forthcoming exhibition Terror and Wonder: The Gothic Imagination will be the UK's largest ever celebration of Gothic literature
    The Hard Rock Café's owners are embroiled in a bitter legal dispute - but is the restaurant chain worth fighting for?

    Is the Hard Rock Café worth fighting for?

    The restaurant chain's owners are currently embroiled in a bitter legal dispute
    Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival

    In search of Caribbean soul food

    Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival
    11 best face powders

    11 best face powders

    Sweep away shiny skin with our pick of the best pressed and loose powder bases
    England vs Norway: Roy Hodgson's hands tied by exploding top flight

    Roy Hodgson's hands tied by exploding top flight

    Lack of Englishmen at leading Premier League clubs leaves manager hamstrung
    Angel Di Maria and Cristiano Ronaldo: A tale of two Manchester United No 7s

    Di Maria and Ronaldo: A tale of two Manchester United No 7s

    They both inherited the iconic shirt at Old Trafford, but the £59.7m new boy is joining a club in a very different state
    Israel-Gaza conflict: No victory for Israel despite weeks of death and devastation

    Robert Fisk: No victory for Israel despite weeks of devastation

    Palestinians have won: they are still in Gaza, and Hamas is still there
    Mary Beard writes character reference for Twitter troll who called her a 'slut'

    Unlikely friends: Mary Beard and the troll who called her a ‘filthy old slut’

    The Cambridge University classicist even wrote the student a character reference
    America’s new apartheid: Prosperous white districts are choosing to break away from black cities and go it alone

    America’s new apartheid

    Prosperous white districts are choosing to break away from black cities and go it alone