The wealthy world is ageing, fast
In 1950 around one in every 12 people...
...in high-income countries was over 65
By 2050, it’s expected to be more like one in four...
...and it’s storing up a big problem
It is a feat that we can live longer...
...and that we can enjoy being alive for longer
But it’s expensive
When people retire they start to cost society more money...
...and the costs will soon be unsustainable
What’s becoming increasingly clear is that the three-stage model of life...
...where you educate, you work, you retire is fundamentally broken
Current approaches to care for the elderly...
...are a massive drain on society’s resources
If you look at it from an economical perspective...
...we are spending too much money on doing the wrong things
And these mistakes cost more than just money
I don’t feel that the older population are valued
I think we may be an inconvenience
So how can societies provide high-quality but affordable care...
...for their growing elderly populations?
Both today and into the future?
Yamakita, Japan
News crews have been sent to cover...
...the final graduation ceremony at Miho Elementary School
What makes this national news is that 12-year-old Raiki Kodama...
...is the only pupil in his year group
The 146-year-old school will close after Raiki’s graduation
The town’s population has dropped by around 30%...
...over the past three decades...
...and there simply aren’t enough pupils to keep a school open
Japan is the oldest nation on Earth...
...with the highest proportion of elderly people in its population
The changing shape of societies in the developed world...
...is clearly shown by UN population data
In 1950 there were more than double the number of people...
...in their 20s compared with those in their 60s
But today the number in their 60s has nearly tripled
The number of children and retirees relative to those...
...of working age is known as the “dependency ratio”
When this changes it can mean that there are fewer workers...
...to support the elderly, which has serious economic consequences
An ageing population, of course brings lots of...
...good and exciting things but it’s expensive
The cost of pensions, the cost of health care which is largely...
...spent on people in their last years of life
It’s very costly
When people retire in their 60s they tend to spend less...
...pay less in taxes and cost society more
A shrinking workforce can also cause GDP growth and investment...
...to slow, which threatens economic stagnation
Some countries such as France have made repeated attempts...
...to shake up their pension systems...
...including by raising the retirement age...
...but this has led to fierce protests
There are other ways to reduce the dependency ratio...
...such as encouraging immigration of skilled workers...
...and improving child-care provision...
...to encourage more women to work
But these aren’t enough
A lot of this is about tweaking around the edges
And if you really think of the magnitude of the challenge here...
...the more fruitful thinking lies in a really, quite a fundamental shift...
...in how we think about different life stages
Many people are already challenging these traditional attitudes to ageing
At an age when most would be thinking about retiring...
...68-year-old Julie Ford has reinvented herself as an entrepreneur
Hi Brigid, hi Nicola, how’re you doing?
I’ve been involved in health and fitness and I’m a PE teacher of 45 years
Yes, let’s get out in that fresh air
And then I was diagnosed with breast cancer and I was physically still fit
Two very important things smiling and breathing
If you can only do one at a time...
...can you just please breathe?
Julie designed and built a training aid called Instepp and runs workout classes using it
Resistance training is the best for strength
Scientifically proven that moving with resistance is the golden ticket of exercise
Julie is part of an online community called Rest Less...
...which helps retirees who want to keep working
It was set up by Stuart Lewis
Everything we do is tailored to this demographic of...
...people in their 50s, 60s and beyond
There’s a wide range of life-needs that people have...
...and we’re trying to meet them across health, community and social networking
Offering advice on jobs, pensions, further education and even dating
Rest Less helps people navigate one of the biggest transitions...
...they will face in their lifetimes
You’ve worked 45 years, 50 years of your life, and suddenly you stop
Well, what do you do? It is very difficult
You just need to look at the impact of someone who’s been out of work for...
...two years to see the impact on their physical health, but also their mental health
It’s the same when you enter retirement
For some people, it can be quite a lonely and desolate time
But extending their working life might not be practical for everyone
People don’t all experience ageing in the same way..
...and that’s a really important thing to keep in mind
I mean, a starting-point is, of course, what kind of job you did all your life?
Well, not everyone can work until they’re 90
That still doesn’t take away the fact that within the rich world...
...90% of people will now reach their 65th birthday and...
...most of them will still have plenty of healthy years ahead of them
Encouraging people to make use of these healthy years...
...could unlock economic potential that’s being lost in retirement
To make the most of this...
...increasing life expectancy, to reap a so-called longevity dividend...
...you do need to make sure that you set the infrastructure up to make that possible
More flexible ways of tapping into, say, your pension savings...
...to employers taking a more open-minded approach
We’re invaluable in society and I think we should be used, or made use of
More flexible attitudes to retirement could help reduce the economic burden...
...of increasingly elderly populations
But eventually, most people will need some form of medical or social care...
...and that is expensive
A lot of countries just haven’t really grappled...
...with the need to set up a decent social-care system
Social care used to happen a lot in the family...
...it used to be informally covered, as we would call it
There were always carers, but they were just unpaid carers
It’s daunting because there are an awful lot of people that will need it...
...and it’s a labour-intensive thing to do
In many developed countries when people can no longer care for themselves...
...a typical answer is to move them out of their homes and communities...
...into residential care
But as well as being increasingly unaffordable, this model of care...
...can fail to address the emotional needs of elderly people
The rich world have taken a fairly reactive approach to care for the elderly
The traditional approach has been, essentially, warehousing people in nursing homes
The metrics of success have often been things like has a person had any falls...
...have they lost any weight or did they have any bedsores...
...and because they became the important metrics...
...institutions started operating around those things
I think what’s got lost in social care is a more community-focused approach
In the Netherlands, an organisation called Buurtzorg...
...is re-establishing this community approach to care
Ramona van den Arend is a Buurtzorg nurse working in Ede
Today, she has three male patients to visit, all with complex needs
Central to Buurtzorg’s method is using local nursing teams who know the community...
...and who are given real autonomy in managing their workload
You work together as a group, as a team and together you...
...discuss what kind of tasks everybody takes in the team
One of her patients today is 82-year-old...
...Mr van de Meent, who suffers pain from cancer in his ear
Managing her own timetable means Ramona can give him the special care he needs...
...to stay living safely in his own home
In health care, it’s always changing how many clients you have, what is needed...
...how much time we need to spend at the clients
So it’s necessary that we can take decisions ourselves
Buurtzorg was set up by Jos de Blok...
....who had himself been a community nurse for nearly a decade
So my idea was we just start from scratch...
...and we just ask nurses to do what they think they should do
Not on protocols, not on products
Look at the problem and try to solve the problem in the most effective way
The other key part of Buurtzorg’s philosophy is setting aside time to talk to the patient...
...and build a deeper understanding of their needs and aspirations
I think the most important thing that when you come at the client’s house...
...it’s important to listen, that you take the time to hear somebody’s story
It might seem inevitable that spending extra time with patients would drive up costs...
...but in Buurtzorg’s case, the opposite is true
If we trust people and we ask them to do what they think is needed...
...then we use the capacity more effectively than we’re doing now
Separate studies by Ernst & Young and KPMG...
...found that Buurtzorg delivered over 30% cost and 50% time savings...
...compared with existing Dutch care systems
In a sector known for high staff turnover...
...it now employs over 10,000 nurses in the Netherlands and is operating in 30 countries
As well as being efficient, giving nurses independence...
...also protects the independence of those in their care
Ageing populations threaten societies with shrinking workforces...
...economic stagnation and crippling costs for pensions and care
Simply throwing more money at the issue is not going to be enough
From a societal perspective, I think we’re missing the huge opportunity we have...
...to help people age better, to live better lives
Dealing with ageing is an opportunity, but also a problem...
...that keeps getting kicked down the road
We can’t just keep postponing actually dealing with it...
...or wishfully thinking that tweaking around the edges...
...around the retirement age will fix it
Needs a much, much bigger, more fundamental rethink
I’m Tom Standage, deputy editor of The Economist and editor of The World Ahead
To read more of our future-gazing coverage, click on the link
Thanks for watching, and don’t forget to subscribe