/ Health

Should we be more upbeat about later life?

Our ageing society signifies an improvement in living and working conditions. Our guest, Suzanne Hall, asks if we’re right to be ‘downbeat’ about later life.

This is a guest post by Suzanne Hall. All views expressed are Suzanne’s own and not necessarily shared by Which?.

Our ageing society is a medical triumph, and signifies just how much living and working conditions have improved.

However, as research for the recent Ipsos MORI Perennials report shows, growing older is typically portrayed as a ‘narrative of decline’, and old age is misunderstood.

Which? News: how to plan for a positive later life

We don’t even have consensus on when old age starts; if you ask a 16 to 24-year-old they will tell you that old age begins at what must feel like the ancient age of 61, whereas a 55 to 64-year-old will say it doesn’t start till 72. In Spain, you’re old at 74 whereas in Saudi Arabia old age comes almost twenty years earlier at 55.

Regardless of when we think old age starts though, globally we share remarkably similar associations about what it means to be old.

We identify old people as wise (35%), both respected (25%) and respectful (23%), and kind (21%). But we also label them as frail (32%), lonely (30%) and unfairly treated (23%).

Taken together, this creates what American social psychologist Amy Cuddy calls a ‘doddering but dear’ archetype which shapes how we think about our later life. Around the world, only a third (33%) of us are looking forward to our old age.

A negative image of later life?

That we have this negative image of later life matters. On average, people who are negative about old age die 7.5 years earlier.

It also means we collectively bury our head in the sand about what we need to do to prepare. We vastly underestimate how much we need to save in a private pension; in order to get an income of £25,000 per annum in retirement you need to save £315,000 but the average guess was just £124,000.

Our perceptions of later life mean that older people are under-served – by policies that don’t meet their changing needs, by employers who cast them aside, and by companies which don’t design things they want or need.

But are we right to be so downbeat about later life? As we find in so much of our work, our perceptions are out of kilter with the reality.

People in later life are some of the happiest in society, and most Western studies show happiness levels increasing from our sixties until at least our mid-seventies.

Older people are also more digitally connected than ever. While there is still a gap to be closed, it is narrowing; ONS data shows that recent internet use in the 65 to 74 age group increased from 52% in 2011 to 80% in 2018. Older people have huge economic power – in the UK the over 50s account for nearly half of all consumer spending – and they represent a mighty political force.  

Changing perceptions

Yet we rarely see this side of later life portrayed. There are some notable exceptions in advertising – Helen Mirren for L’Oréal, Joan Didion for Celine and Isabella Rossellini for Lancôme, rehired in her sixties two decades after being sacked for being too old.

But, this handful of examples isn’t enough to change perceptions and, in Great Britain fewer than one in five (18%) think that advertising, TV and the media makes old age seem exciting and full of potential.

There is clearly a need for radical change, and government, business and advertisers all need to wake up to both the challenges and opportunities presented by the ageing society. But there are simple steps we can all take to ensure we have a more fulfilling later life.

Firstly, to dispel the myths we have about old age, we need to get to know old people. Yet despite being advantageous for everyone concerned, inter-generational friendships appear to be uncommon.

It is not just socially where older people’s wisdom and experience could be beneficial – 94% of employers believe that older people could be the key to bridging the skills gap.

And, we can all start making changes now, which will improve our lives later down the line. It’s never too late to make a positive difference – whether that be eating healthily, exercising more, building strong social connections or boosting retirement savings.

Research has found that even people in their 90s could improve their overall wellbeing by increasing the level of light activity they participate in regularly. Our future is very much in our hands.

This was a guest post by Suzanne Hall. All views expressed were Suzanne’s own and not necessarily shared by Which?.

What are your views on the perceptions of later life? Do you agree there’s a negative perception? Let us and Suzanne know what steps could be taken to help change views in the comments below.

Comments

This is a timely post as it’s possible the first genuine senolytic drugs will go on sale in the West within a matter of months.

The science of ageing is now well understood, and the big pharmaceutical companies are almost ready to bring the first anti-ageing drugs to the market. Because the cost of keeping people alive with various age=related conditions is so great, it’s likely that the NHS will prescribe these as they now do Statins, for folk above 50.

These drugs will not extend life expectancy. however; what they will do is extend healthy, disease-free life until the inevitable happens. And that can’t be bad.

It seems very early days to predict that senolytic drugs will combat senescent cells. However, giving a healthier later life rather than extending a declining one would be good for people, and good for the NHS if it reduces the demands on its services.

The last I heard about Statins was they are not the magic prevention predicted for many people.

The House of Lords (old people) seems to want to make many other old people’s lives more miserable – abandon the triple lock pension, free tv licence, bus passes, winter fuel payment, make them pay NI………. https://www.which.co.uk/news/2019/04/is-the-future-of-the-state-pension-triple-lock-in-doubt/

I do think some “benefits” should be income related and only paid to those who need them. However that should apply to all of us. A huge number of people benefit from free prescriptions when at least an annual card costing £2 a week would give as many all they need without further cost, and no doubt help the NHS’s coffers.

Perhaps the worst things about getting old are the onset of illness and disability, but moreover the knowledge that you are much nearer a terminal event but do not know how painful or uncomfortable that is going to be.

From New Scientist and Nature:

“In the past decade, we have made a major discovery,” says Richard Miller, a gerontologist at the University of Michigan. “We have proven that you can slow the ageing process using drugs. Ten years ago, people would have said, ‘That’s science fiction, there’s no reason to suspect that can ever be done’,” he says. “Those people have been proven wrong. It’s doable.” This isn’t just slowing ageing in worms, flies or even mice, it is in humans too.”

“In January, a team led by Mayo Clinic researchers reported results from a pilot trial targeting a lung disease called idiopathic pulmonary fibrosis. This condition has an unknown cause, but is characterised by a build-up of senescent cells. In the trial, 14 people were given doses of two drugs – a leukaemia treatment called dasatinib and a plant pigment called quercetin – over three weeks. They tolerated the drugs well and showed some improvements in symptoms.

That is miles away from being proof they cure anything. But also in January, Unity Biotechnology, a firm seen as one of the companies most likely to succeed, announced promising results from an early clinical trial of a senolytic for osteoarthritis. Approval in a clinical trial for a specific condition is a necessary first step for any anti-ageing drug.”

“The good news is that safe interventions that increase longevity are available to all. Intermittent fasting has been shown to work, and exercise appears to be a senolytic. Spermidine is found in many foods, especially the fermented Japanese soya-bean dish called natto. These may be less tempting than a pill, but they are definitely safe.”

“One of the most reliable ways to make an animal live longer is to starve it. Caloric restriction and periodic fasting have been shown to extend both lifespan and healthspan in every animal they have been foisted on, probably because they activate some of the protective pathways that are progressively blunted by ageing.”

“Last year, resTORbio published the results of a clinical trial to see whether mTOR inhibitors can reverse immune system ageing. In it, 264 people over 65 were given two drugs – not rapamycin itself, but newer compounds that work in a similar way – followed by a flu shot. Older people often fail to respond to the injection and influenza is a major cause of hospitalisation and death among this group. But those given mTOR inhibitors responded much more powerfully to the shot and caught fewer respiratory infections. A bigger clinical trial has since confirmed the effect. This year, resTORbio hopes to move into the final stage of clinical trials, before filing for regulatory approval in 2021.”

I suspect things in the anti-ageing world are moving far more quickly than we might imagine. Part of the reason for that is simply because no society can afford to keep the unhealthy alive for long periods if we continue to see an ageing population in poor health. The aim of these drugs is to extend health span, since that not only helps society but also the individuals concerned, since we all need to feel healthy and able to contribute to society.

I won’t subscribe to taking drugs ‘forever’ without dire medical need. I have refused statins (my blood pressure has ALWAYS been high, first noted when I joined the RAF in 1962) and I have no intention of profiting the big pharms with yet another ‘miracle drug’.
If the population growth isn’t already destroying the planet, think of the effects that extending life by another 10 or 20 years will have on the planet.

These new drugs are not aimed at extending life; they’re purely aimed at extending the time during which you will remain healthy and free from debilitating conditions. The problem we face is not over population per se; it’s caring for those with conditions that limit mobility and impose massive stress on our resources.

It’s not life span – it’s health span.

The April issue of Which? magazine came with a supplement entitled “Solutions for living independently” which contained encouraging messages, useful information and there were no real surprises.

When I moved home about three years ago I thought about my future needs. If I need a stairlift there is room for one, a room downstairs could be turned into a bedroom if needed, and the house is new enough to be unlikely to need any major work in the near future. I wanted more manageable gardens that would require less maintenance. Light soil might not be very fertile but it’s wonderfully easy to keep weed-free. For me, living independently means not having to bring in a gardener.

At present I can drive and volunteer with a couple of societies. One day I might have to get onto a mobility scooter and participate in activities in the village hall.

If I need long term care I appreciate that I may have to sell the house to pay for it. That does not worry me because I have not been here long enough to have strong ties. I do envy a friend who lives a short walk away from the centre of a local town.

I’m more optimistic about later life than when I retired.

I only received my “Solutions for living independently” supplement the other day and have not read it all yet. On a quick flick through I was surprised by this tip in the home safety checklist on Page 8 – “Improve lighting. Fit high-voltage light bulbs and shades that don’t block or reduce light . . . “.

Disregarding the curious reference to high-power bulbs as “high voltage” [thankfully generally unobtainable and somewhat reminiscent of the ‘four candles’ sketch – “bathroom plugs . . . 13 amp“] I think that is dubious advice that might lead people to putting a higher powered lamp in a fitting than the recommended wattage and possibly causing a fire. Modern light fittings tend to use appropriate diameter lampholders to limit the power of the bulbs inserted so as to correspond with the characteristics of the fitting [i.e. a SBC or SES lampholder means that only a lamp with a small cap and low maximum wattage can be used in the fitting] but I have noticed that many older people still have old fittings in their homes and a stock of incandescent lamps that will go in any of them.

On a first reading I wondered about “high voltage shades” as well but realised there was a comma missing.

I suggest this section be reworked for any future edition.

High voltage light bulbs have been widely available in industry – operating off 415v supplies. I doubt Which? meant these.

“shades that don’t block or reduce light“. The purpose of a decent shade is to block light from where you do not want it or to redirect it – higher-angle light causes glare, the enemy of vision. Older people are particularly susceptible to glare with the onset of cataracts – even a slight degeneration in the lens scatters light to make a “veil” over what they are trying to see (like a dirty car windscreen). So it is very important to control light – that is why we have shades and not bare light bulbs..

John – I strongly support the advice for older people to have decent lighting and I hope that readers will understand even though the wording was not correct. It’s high time that all lamp packaging gave priority to the lumen output rather than wattage, since the latter is only an indicator of the heat produced. With low energy lighting you can use use a brighter lamp in a fixture than would be possible with a traditional or halogen bulb and remain well within the wattage rating.

“Brighter” – more lumens – is not necessarily good. The light needs to be properly controlled and distributed.

I doubt many people know what a lumen is but, in my experience, many domestic light bulbs show the light output. They also show the incandescent wattage equivalent, something many people can understand.

It struck me on a quick read of parts of the booklet that much of the advice given on different aspects of independent living would lead to considerable expenditure if followed.

People might be unnecessarily persuaded to buy the high definition reading lamps that are frequently advertised but which can cost hundreds of pounds to buy and could be expensive to run [I have never seen any information on energy consumption in the advertisements]. Suitable standard or table lights with appropriate shades and positioning, or other forms of task light, would be satisfactory in most cases in my opinion.

I feel that people in later life are susceptible to recommendations that would cost a lot of money for not much extra benefit; that’s not to say that the advice in the booklet is inappropriate but that caution is necessary since some advertisers of products aimed at those in later life can exaggerate their value by reference to health or well-being statements and suggest they will be more beneficial than they really are. After all, they are commercial companies, not welfare organisations, and they know that many elderly people are quite affluent. Unfortunately most are not and should not be taken advantage of.

” high definition reading lamps” ?? I’d like to see some evidence to support the claims made for them. “Revolutionary”? – unless provide a high lighting level (illuminance) without glare is revolutionary (something the lighting industry has done since its inception) then “revolutionary” needs explaining. Perhaps Which? would investigate – Institution of lighting Professionals and the Society of Light and Lighting (part of CIBSE) will have experts in lighting and vision who would help. Then a word with the ASA perhaps.

It seems that the lamps in the “high definition” reading lights are halogen types which are likely to be rather expensive to use and replace and will not have a very long life.

They will also give off quite a bit of heat which might explain why the models shown in some of the advertisements appear somewhat skimpily dressed. One company’s website posts glowing reviews from customers. No wonder.

In my floor-standing reading lamp is an R80 3000K LED spotlight that I bought for £1. It cost £1 and in a basket of reduced price odds & ends in B&Q. It is bright and allows me to read small text for extended periods without glasses and without eyestrain.

There are various websites advertising high definition reading lights. I looked at one and the secret seems to be the inclusion of an inefficient 35W halogen spotlight in lamps costing hundreds of pounds. The effusive advertising offers the opportunity to parody the motor industry. The ultimate lighting machine. The power waste of dreams.

Having said that, good task lighting is particularly helpful to older people.

John Temple says:
26 April 2019

At just turned 76 I suppose I have to admit I am beginning to get a bit older. I seem to be busy, busy, busy – but some of that is because everything seems to take far longer – 1.5 to 3 times as long as I think it did when I was younger. I volunteer one afternoon a week at the local community coffee shop – but will have to finish that soon as I now find I cannot easily manage more than 1 ½ hours on my feet at a stretch without a sit-down– very frustrating. But until less than a year ago (i.e. over age 75) I walked 2 miles to do my volunteering – now I drive. I do try to walk any distance less than a mile. I still help every week at church with a young people’s group (currently teaching a few of them to play chess), and also with another group once a month, whilst other church activities get my wife and me out of the house twice on Sunday and a further 1 or 2 times a week. On top of that, my wife goes to a weekly craft group, and I drive her there. I have been logging my computer use recently (family say I spend too long on it!) – averages about 3 hours a day – no games (I can’t stand the idea) but emails, Internet searches, keeping up with Extinction rebellion and other “green” issues. Family keep us busy too. Alas it is only occasional “Grandparent child care” –they all live at least 2.5 hours’ drive away. However last Thursday (just before Easter) I “did” 2 London Museums with our daughter and 2 grandsons. On those evenings I am not out, we watch a lot of TV – but as a mind-stretcher (BBC4, “Question time” etc) or historical drama rather than so called “Reality TV”, Quiz programs or “soaps”. Give me a program by Hannah Fry, Marcus du Sautoy, Jim Al-khalili or Brian Cox any time. And I regularly (about every 2 months) lambast (by email) our MP on one or another issue on which the Government is failing us. Somehow I also manage to keep the lawn cut- not quite sure how I fit that in.
But we have benefited from some “big plusses” (1) Good health – the NHS came in when I was very young and we knew the dangers of smoking and alcohol and acted on that (2) We got on the housing ladder early on, and have a mortgage-free place of our own (3) Full employment throughout my life and a decent final-salary related pension – not enormous, but enough that we have no money worries. I really fear that neither my children nor grandchildren will be so fortunate; successive Governments of all complexions have really wrecked their chances. And the incipient disaster from Global warming and climate change if we can’t stir our current inept Government into action will outweigh any of the fears we had about Nuclear war when I marched with CND as a student.

Welcome John – you’re definitely keeping busy, and you sound so much like so many other people who engage with us at Which?, including people who write to their MPs! Though you might not have the time to squeeze this in, there are plenty of topics for you to get involved with here and we’d love to see you more often. You can introduce yourself to the wider community in our ‘Welcome Lounge’: https://conversation.which.co.uk/discussions/welcome-lounge-introduce-yourself/

John’s post is very encouraging. Through societies I know other people who are in mid to late seventies and still very active, both mentally and physically.

I’m seventy. I consider myself to be on the threshold of old age, but I don’t feel at all old. Many of my contemporaries, however, say things like , ‘It isn’t pleasant, growing old.’ Not encouraging. I find it very interesting. Especially when I claim such privileges as saying exactly what I think!

Great to hear from you Jane and how positive you are. My mum is nearly 70 too and when I think back to my grandma at the same age, my mum is much younger. I think age is ‘old’ is changing each generation, which reflects some of what Suzanne says above in her post.

My grandpa lived to 95 years old and was working up until he was 92 or 93, including traveling to the US for meetings and conferences. He was incredibly motivated and an inspiration to me – his body let him down, but his brain was incredibly sharp until the end.

My last little thought is sharing this amazing video about Gavin (25) and Julie (76). They met by chance in a market four years ago and they’ve had each other’s backs since: https://www.facebook.com/bbcthree/videos/vb.7519460786/2037404026556276/?type=2&theater

A mere youngster Jane. I am 83 but don’t dwell on the subject often. An occasional bad day but just push through it . Had to fight the quacks off at the doc’s and hospital , seemed that once they got their hooks in to me they just had to find something wrong so kept investigating . In the end signed myself off and carried on with the lawn bowls and ground management to keep occupied . On the box see some a lot younger than me who are physical wrecks , they retired and put their feet up , nature took the hint. You have the right idea, live every day to the full and become indestructible.

Hi

Hi Tom – Anything we can help with?

My previous home – a bungalow – was bought by an elderly lady who wanted to move nearer her family, who live in the next street. She still drives but has some mobility problems. I was interested to find out what changes she has made to the house. There is now a large walk-in shower, a step up to the front door and a side door in the detached garage, making access much easier. I presume that the family is looking after the garden.

All these conversations about how later life is changing reminds me of a family friend who went paragliding with her grandson when she was 84.

If my later life is anything like as active and full as my mum’s and her friends I will be very happy.

John McDonald says:
25 October 2019

A pension pot of £315,000 produces an income of £25,000??? Wow, let me know how that can happen, even when you include the State pension!

Presumably you are not the John McDonald? 🙂 A sensibly invested SIPP that errs on the cautious side could produce around 3- 4% in my experience – less charges. So that would be up to £12600 a year while preserving the capital. Taxable in all probability. I suppose if you are not risk averse you get, possibly, get more at the risk of potentially severe loss of capital value. With any SIPP you could, at some point, increase the income up to a point by using the capital.

An annuity is an alternative, but then you may lose control of your capital. Information here – https://www.which.co.uk/money/pensions-and-retirement/options-for-cashing-in-your-pensions/annuities/annuity-rates-aly8c2z86kds

Deciding how best to use a pot would be a whole lot easier if you knew the date of your demise.

Its great to see so much positive thought around ageing, particularly as at 59, I’m on the cusp of being an elderly person (some might say I’m there already!). But, in my experience, we still have a long way to go as a so-called progressive country in valuing and supporting our older citizens in later life.

In trying to support my elderly parents over the last 5-6 years as their health has declined, I have faced what I can only describe as ‘institutional ageism’ in many agencies that should be there for them. I’m sure I’m not alone in experiencing this and I think its time those of us who are ‘coming up’ recognise this and make sure we are prepared to fight our corners in this increasingly market-driven and public service bashing culture.

The medical profession (who I have a lot of respect for) sadly seems to place people on a conveyor belt slowly edging towards death once they have reached a certain point in their lives, particularly those with dementia, and there is little you can do about it. About 5 yrs ago my mother fractured her hip, which was subsequently pinned but within months the bone crumbled resulting in her ending up with one leg shorter than the other. The Alzheimers’ diagnosis was bad enough, but the loss of mobility has completely wrecked her life and apart from a built-up shoe that was all the NHS could do for her. On top of that, a year ago she was diagnosed with oesophageal cancer following a scan. We received excellent advice from the local hospice immediately following the diagnosis telling us what to expect as the disease progressed, but she’s still very much alive (though incredibly frail now) and what has been lacking is practical advice on how to support her on a daily basis. This of course, has been much worse since the Pandemic when it’s impossible to speak to anyone. Fortunately, my mother has been incredibly frugal over her life-time – my parents never went on holiday or had expensive hobbies – so managed to save a good pot of money. This means they have the luxury to self-fund care at home and the care staff are lovely and care deeply for her. However, as an only child and based some 4 hours away from them it is stressful, frustrating and exhausting to have to trawl through the internet to puzzle out things that could and should be simply given out on advice sheets. As with many things, some solutions are simple but not if you are unaware of them. Here’s some examples:

Has anyone ever heard of a ‘Sara Stedy’? An invaluable aid to moving frail elderly people around the house that I’d never heard of until one of the carers mentioned it to me. I’m keeping my mum’s one for when I need it!

When is the right time to get someone assessed for a hoist? It turns out that this is when a person can no longer support their own weight but the assessment takes ages and meanwhile, mum mostly has to stay in bed as 2 staff are needed to move her and the agency is short-staffed. I also assumed I would have to buy this (like the Sara Stedy – which wasn’t cheap, even second hand) but its something the NHS will lend you.

How do you stop an immobile person getting muscle wastage? My mum is so frail she can no longer stand. I read on an American site that we can boost her energy and help build her muscles up by adding Whey Protein Powder to her food. It might be too late for her now – why did no-one suggest this to me earlier?

What foods do you give a person who finds it difficult to swallow? For months together with the carers I’ve been trying to identify foods that she can swallow and actually likes. There is some information on national agencies’ websites but you have to look for it and it’s too general.

Is it possible to get a prescription to stop a person from over-salivating? This is a common occurrence with dementia patients and also with throat and chest cancer patients and is extremely miserable for the sufferer. I had not idea that it can be helped by medication. Mum’s been suffering for months and when I discovered that there are things that could be done (again on a US website) I had to suggest this to the GP despite both her and the Hospice knowing about it.

The list goes on. I’m sure some of these issues are common to many people but could I find information on the Age UK or Cancer Uk sites? Did my mum’s GP or the hospice suggest any of these things? I wonder how many elderly people without a friend or family member and with little money cope. It seems to me that when people get to a certain age and face illness, the medical profession gives up on them. Of course, we know the inevitable is going to happen, but surely we have a duty to honour the lives of our loved ones by ensuring that their last weeks, months or years are comfortable and pain-free as much as possible. If the NHS doesn’t have the resources to deal with this (they don’t – fact!), then there needs to be access to shared resources gleaned from the experiences of families and carers and friends that can help us understand and help with the problems that old age can bring. The information that Which? has on their website is great – perhaps this could be expanded to include more day-to day practical advice? I certainly would be happy to contribute.

Hi Fiona – I cannot offer much more than encouragement and can identify with supporting elderly parents at a distance. After my father died my mum gradually found it harder to swallow, even soft foods. I was concerned about the possibility of cancer but the problem was diagnosed as a pharyngeal pouch, which is common in the elderly. In her late 70s my mum was effectively taught to swallow which helped her to eat properly again, albeit not quickly. It’s worth checking that any elderly person is eating enough of a reasonable diet but finding food they like makes it easier.

Fiona – I strongly support what you have said about the problems of looking after elderly people and the impression given by the medical and caring professions.

My parents died in their eighties but I was young enough to cope with both of them as their health declined and to help my widowed mother after father died. They did not have lingering ends to their lives because serious illnesses overcame them, but some members of my family in their seventies are trying to look after parents in their nineties and that is a terrible strain, and there is not sufficient recognition of the effect this is having on their own health and well-being.

Thank you for the points you have made about the help and remedies that are available but seemingly withheld.