WE NEED SOCIETY TO CHANGE AS WELL AS INDIVIDUALS
There is no doubt that ageing is a long biological process with two effects. One is the loss of maximum level of ability, even Roger Federer will have difficulty in continuing to play the highest level in his forties even though he were to train ten hours a day. Combined with this is a loss of resilience namely a loss of the ability to respond when challenged, for example by a change in environmental temperature or a trip or infection. These are real effects but by themselves do not have a significant impact on quality of life until the mid-nineties.
Redesigning ageing will focus on the three modifiable processes – loss of fitness, disease and the wrong beliefs and attitudes but we do have to be realistic about the challenges that many people face including
However as we have emphasised the most important and modifiable factor in the environment in which people grow older is a social environment that creates negative beliefs and attitudes. There is still a very important factor which is poverty but that is more difficult to modify
We need a revolution to change that but we are in a revolution, at least in healthcare, or , to be precise we are in the third revolution .
There is no doubt that ageing is a long biological process with two effects. One is the loss of maximum level of ability, even Roger Federer will have difficulty in continuing to play the highest level in his forties even though he were to train ten hours a day. Combined with this is a loss of resilience namely a loss of the ability to respond when challenged, for example by a change in environmental temperature or a trip or infection. These are real effects but by themselves do not have a significant impact on quality of life until the mid-nineties.
Redesigning ageing will focus on the three modifiable processes – loss of fitness, disease and the wrong beliefs and attitudes but we do have to be realistic about the challenges that many people face including
- Poverty; for many people the problems of old age are complicated by low income, for example hypothermia can occur because a person’s biological thermostat does not respond as well to a cold environment, but the principal cause of hypothermia is a dwelling too cold for safety because of income problems.
- Social care is limited and can be expensive even if the appropriate care can be found.
- Not all diseases are preventable. For example you need good luck and probably the right genes to avoid rheumatoid arthritis or Parkinson’s disease
- The NHS, which plays a vitally important part in the diagnosis and treatment of disease is obviously under pressure, but ageist refusal of treatment is now much less common. In fact a new problem and opportunity has emerged, namely the overdiagnosis and overtreatment of problems of older people with little, no or negative value resulting from the individual’s treatment. For example in the last year of life there is overuse of high technology care of low value but an inadequate investment in district nursing and care assistants who could help older people die in their own homes.
However as we have emphasised the most important and modifiable factor in the environment in which people grow older is a social environment that creates negative beliefs and attitudes. There is still a very important factor which is poverty but that is more difficult to modify
We need a revolution to change that but we are in a revolution, at least in healthcare, or , to be precise we are in the third revolution .
- the first was the clean water, public health revolution of the nineteenth century driven by politicians
- the second has been the amazing high tech medical revolution of the last fifty years driven by industry and science
- knowledge,
- citizens and
- the smartphone, as the picture at top of this page shows