Later life in over 100 slides (August 2012)

Later Life 2012

National and International Trends:

Later Life in 116 slides

Prepared by Age UK Research Department
Last updated 1 August 2012

For source information, see the Later Life factsheets in the Age UK Knowledge Hub
http://www.ageuk.org.uk/professional-resources-home/knowledge-hub-evidence-statistics/

Overview
 Demographics and population trends
 Health and wellbeing
 Money matters
 Home and care
 Social Inclusion
 Public policy challenges
 The older consumer
 Attitudes and discrimination
 Opportunities

Demographics and
Population Trends

Ageing in the UK

 TODAY
– 10.3 million aged over 65
– 1.4 million aged over 85
– 12,500 aged over 100

 THE FUTURE
– 12.5 million over-65s by 2020, 16 million by 2030
– Fastest growth post-85
– 250,000 aged over 100 by 2050

UK Population estimates and projections (2010-
based), ONS 2011

UK population pyramid (mid-2010 estimate)

Source: ONS 2011

Ageing of the UK population

Source: ONS 2010

Life Expectancy at birth (UK)

“At current rates, life expectancy in
the UK is increasing at the rate of
about two years for each decade that
passes”

Source: House of Lords Science and Technology Committee 2005
Ageing: Scientific Aspects

Life expectancy at birth (UK)

1980 2000 2011

Males 70.8 75.3 78.2

Females 76.9 80.1 82.3

Source: World Bank Development Indicators 20 Nov 09 and ONS Oct 2011

Life Expectancy at Birth 1980-82 to 2006-08

Source: ONS 2011

In the UK, the over 85s are the fastest growing age-
band, and the numbers have only just started rising
rapidly:
Population of the UK aged 85 or over
1961 - 2061

Source: Of f ice f or Nat ional St at ist ics populat ion project ions

people, t housands

6,000

5,000
4,000
3,000
2,000
1,000
0
1961 1971 1981 1991 2001 2011 2021 2031 2041 2051 2061

The pattern is the same for women:
Population projections for FEMALES aged 85 or over
1961 - 2061

3,500

3,000

2,500

2,000

1,500

1,000

500

0
1961 1971 1981 1991 2001 2011 2021 2031 2041 2051 2061

and for men:
Population projections for MALES aged 85 or over,
UK 1961 - 2061

3,000

2,500

2,000

1,500

1,000

500

0
1961 1971 1981 1991 2001 2011 2021 2031 2041 2051 2061

And it doesn’t stop at 85:
Census 2011
(preliminary results for England and Wales, July 2012)

Number of people

aged 65 or over: up 11% from the 2001 Census



Ageing - Internationally

 Across EU population growth over next 25 years:
– 81% over-60s
– 7% 18-59 year olds

 Across the world, by 2050 people over 60 will make up
– 1/3 of rich world
– 1/5 of developing world

Sources: see Age UK Later Life International Fact Sheet 2011

Longevity Revolution - Global

Global Population – Aged 80+ years

1950 – 14 million

Today – 300 million

Source: WHO 2010

The World’s ‘Oldest’ Countries (2009)
Country Aged 60+ (%)
Japan 30
Germany 26
Italy 26
Sweden 25
Bulgaria 24
Finland 24
Greece 24
Austria 23
Belgium 23
Croatia 23
Denmark 23
France 23
Portugal 23
Switzerland 23
Czech Republic 22
Estonia 22
Hungary 22
Latvia 22
Slovenia 22
Spain 22
United Kingdom 22

Source: WHO WORLD HEALTH STATISTICS, 2011

Longevity Revolution - Japan

“The number of centenarians in Japan
increased almost one-hundredfold from 154
in 1963 to more than 13,000 at the beginning
of this century and is projected to increase to
almost 1,000,000 by 2050”

Source: Ageing Horizons, 3,1 (2005)
N.B. This is assuming that records are accurate and there has not been any large scale fraudulent
reporting (some uncovered in Japan, August 2010)

Italy – population pyramid

Source: US Census Bureau 2011

China – population pyramids
(millions, by age and sex)

1950 2000 2050

Age Age
80+ 80+
75-79 75-79
Male Female 70-74 Male Female 70-74 Male Female
65-69 65-69
60-64 60-64
55-59 55-59
50-54 50-54
45-49 45-49
40-44 40-44
35-39 35-39
30-34 30-34
25-29 25-29
20-24 20-24
15-19 15-19
10-14 10-14
5-9 5-9
0-4 0-4
15 10 5 0 5 10 15 15 10 5 0 5 10 15 15 10 5 0 5 10 15

Source: World Population Prospects: The 2004 Revision
(2005).

Later life in the UK- an overview

 Over 1.3 million people are aged 85 or over. One in four children born today
will live to 100

 People aged 65 now have an average life expectancy of 82-85 years, the
last 7-9 years with a disability

 Nearly 2.5 million people aged 65+ in England have care needs

 3.7 million people aged 65+ currently live alone

 750,000 people aged 65+ currently have dementia. is This is projected to
more than double in less than 40 years

Sources available in Age UK Later Life in UK fact sheet August 2012

Later Life – internationally: an overview
 Of the current total world population of over 6.8 billion, there are
over 790 million people aged 60 and over
 Life expectancy at birth ranges from 82.6 years in Japan to 39.6
years in Swaziland
 70% of the world‟s older people (60+) live in less developed
countries
60% of people with dementia live in developing countries, and this is
expected to rise to 71% by 2040
 70% of mortality in low income countries is due to communicable
disease and 30% to chronic long term illness; this will be reversed by
2030

Sources available in Age UK International Later Life fact sheet 2011

In eight years’ time, demographic change
alone would mean that there would be:
• Nearly 2.7 million people aged 75+ with at least one limiting long term illness and
over 4.3 million people aged 65+ with LLTI
• People living an average of 7-9 years at the end of their lives with a disability
• Nearly seven million older people who cannot walk up one flight of stairs without
resting
• One-and-a-half million older people who cannot see well enough to recognise a
friend across a road
• Over 4 million with major hearing problems
• Up to a third of a million people aged 75+ with dual sensory loss
• A third of a million who have difficulty bathing
• Nearly a million with dementia
• Between 4-7 million with urinary incontinence
• One-and-a-half million suffering from depression

Demographic projections based on ONS population projections
for the UK and currently available prevalence figures (sources in
Age UK Later Life in UK fact sheet, August 2012

Why is this important?
While health is clearly an outcome in itself, it is also a key driver of
outcomes in other domains, including employment and ability to
contribute.
 ELSA (Wave 2, 2006) indicates the two-way relationship between health
and wealth: greater financial resources reduce the chances of poor
health, and good health has a positive relationship to financial wellbeing
 Services are hospital focused, prioritising cure rather than prevention or
complex case management, commissioning is in early stages of
development, question marks over value for money, realisation that
some target-driven achievements occurred at the expense of quality.
 National priorities remain but emphasis on local decision making
 Choice as a patient right and a tool to drive up quality along with
contestability between providers for contracts framed by ambition to
provide care closer to home

What do older people think?
• Mental health – older people’s preference for services include peer
support; a range of activities and opportunities of things to do; 24-
hour help in a crisis that helps you maintain everyday life; supported
housing options, technologies and skills and learning opportunities that
enable independent living. More broadly older people suggest the
following to improve mental health and wellbeing: improve public
attitudes; provision of activities for older people; befriending schemes
(esp. those aged 90+); improved access to quality public services, and
improving standard of living (mostly younger respondents).
• Community Services –priority areas for action include: improving
the range of support for carers; making services personalised and
holistic; joining up health and social care so there is one point of call;
considering the transport implications of any changes to services
• Intermediate care – help with keeping out of long term care is
important e.g. mentoring and advocacy to help them through the
health and social care system; more time from care assistants; more
availability and affordability of high quality home and telecare; help
with practical matters such as laundry, adequate refreshments and
warmth.

Long Term Health Conditions:
The Strategic Challenge
 There are over 15 million people in England with long-term health
needs.
 Long term conditions are those that cannot, at present, be cured,
but can be controlled by medication and other therapies.
 The impact on the NHS and social care for supporting people with
long term conditions is significant.
 Currently 69% of the total health and social care spend in England
is spent on the treatment and care of people with long term
conditions (DH Annual Report 2008).
 By 2025 the number of people will at least one long term condition
will rise by 3 million to 18 million (DoH 2008).
 This will be due to a rise in the ageing population and the increased
survival of pre-term babies.

unless otherwise stated

Prevalence of Long Term Conditions (1)

 Coronary Heart Disease – 2.6 million people are living with CHD in the
UK (89% of 190,000 deaths per year were in people 65 years or older)

 Stroke – 80% of 150,000 cases per year are over 65. Stroke is the
leading cause of severe adult disability

 Diabetes – 2 million people in the UK are diagnosed. Prevalence rises
with age from one in 20 people over age of 65 to one in five in people
over 85 years

 Chronic Obstructive Pulmonary (Lung) Disease – 3 million people in
the UK diagnosed. There are approximately 25,000 deaths from this
every year, with over 90% occurring in people 65 years and older


 Cancer – incidence increases with age – of the 155,000 deaths each
year, three quarters occurred in people aged 65 and over.
 Arthritis – Osteoarthritis affects over half the population by age 65, and
10% of people aged 65+ have a major disability due to OA.
 Osteoporosis – Up to 21,000 people die following osteoporotic hip
fractures each year in the UK.
 Parkinson’s Disease – The second most common neuro-degenerative
disorder (120,000 have clinical diagnosis in the UK). The incidence
increases with age.
 Sensory impairments - 1 in 5 people over 75 years old has a significant
visual impairment. Over 7 million people over 60 years are deaf or hard of
hearing.



 Depression – The commonest mental health condition in the
older population. A quarter of older people living in the
community have symptoms which warrant intervention, but it is
estimated that 85% of people over 65 do not receive any help
from the NHS.

 Dementia – Over 820,000 people are estimated to be suffering
from late onset dementia in the UK. This overall figure is forecast
to increase to 1,735,087 by 2051. Dementia affects 1 person in
6 over 80 and 1 in 3 over 95.


Disability, Age and Activities of Daily Living
%
Dependent

Older people and functional limitations
 37% of men and 40% of women aged 65 and over have at least
one functional limitation (seeing, hearing, communication, walking, or
using stairs).
 This increases to 57% and 65% respectively in those aged 85 and
over.
 More than half of men and women reporting any functional
disability were unable to walk 200 yards or more unaided without
stopping or discomfort. Both prevalence and severity increased
with age.
 The number of functional limitations also increased with age with
17% of men and 19% of women aged 85 and over with three or
more functional limitations.
 Functional limitations can result in depression and social
isolation.
Analysis of English Longitudinal Study of Ageing (ELSA) Waves 1-3

Severe Cognitive Limitation
by Age and Gender (US)

25%

20%
Males
Females
Percent

15%
Total

10%

5%

0%
51-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Age

Healthy Life Expectancy

 Life expectancy is increasing
and until recently, healthy life
expectancy has been increasing
at a slower rate
 This has meant that many older
people are living longer in poor
health
 There is little evidence of
consistent success in
compressing morbidity and
some evidence that disability
rates are declining, but an
average 65-year-old can expect
to live 7- 9 years with a disability

Age UK analysis of life expectancy and healthy life expectancies
at age 65, ONS 2011 published in Agenda for Later Life 2011

Measuring National Wellbeing (UK)
Office for National Statistics July 2012
Setting a benchmark nationally(all age)

United Kingdom Percentages
Very low Low Medium High Average
(0–4) (5–6) (7–8) (9–10) (mean)
Life satisfaction 6 .6 17.5 49.8 26.1 7.4
Worthwhile 4.9 15.1 48.6 31.4 7.7
Happy yesterday
10.9 18.0 39.3 31.8 7.3

Very high High Medium Low Average
(6–10) (4–5) (2–3) (0–1) (mean)
Anxious yesterday
21.8 18.1 23.5 36.6 3.1

General Life satisfaction: retirement is a relatively satisfying time, but the U-
shaped (smile-shaped) curve turns down again after 80

Self esteem (feeling what you do in life is worthwhile):
again, a rise in the sixties and seventies and a marked drop-off at 80+

Current happiness: how happy were you yesterday?
Retirement is a relatively happy time, even at 80+

Anxiety: How anxious did you feel yesterday?
Even in one’s eighties and nineties, later life is a time of relatively low anxiety

Some possible explanations of these trends
(only available currently for life satisfaction at all-age level):

Health and disability play a major part


Marital status (having a partner) is also important


as is unemployment

Education and age
Older workers are particularly disadvantaged by lack of educational
qualifications - employment rates are significantly lower for those with
no qualifications whatsoever.
Access to learning centres becomes more difficult with age, with FE
colleges, adult education centres and the home being main locations of
learning
Economic activity by highest qualification, 50-69 y/o
100% Employed

80% Inactive: Retired
Unemployed
60% Inactive: Other
Those 50+ with no qualifications experience Inactive: sick or disabled
employment rates over 20% lower than those with
40%
qualifications – much of the difference explained by
illness or disability Inactive: looking after
20% family/home

0%
Degree/ Higher A-Level GCSE A*- Other No Qual
equiv edu /equiv C/equiv

Source: NIACE annual surveys of learning

Continuing learning

 The number of people undertaking learning decreases
significantly with age
 But mental activity like learning can slow cognitive
decline, reduce morbidity, and facilitate healthier lives.

80% 2005 2006
70% 2005 2006
60%
50% 2005 2006
40% 2005 2006
30%
2005 2006
20%
10%
0%
16-49 50-64 65-79 80+ 50+
2005 2006

Source: NIACE annual surveys of learning. The 2011 and 2012 reports
follow this trend

Advantages of learning in later life (1)
In the community
The Benefits of lifelong learning for adults over 50 have been categorized under the following headings:

FINANCIAL
 Helps to reduce poverty through various mechanisms, including new employment and improved
knowledge (NIACE IFLL Thematic Paper 6 2010)
 Money saving (DIY savings on contractors‟ labour)

SOCIAL
• Helps to reduce isolation through improved social contacts (Age UK 2011)
 Offers an inexpensive way to try new activities
 Improved self esteem (achievement of set goal)
 New topic of conversation with family and friends (anecdotal evidence only)

MEDICAL AND PSYCHOLOGICAL
 May help to slow cognitive decline. So far, limited evidence, much of it anecdotal, about keeping your
mind sharp, improving some aspects of memory (recall)
 Self-reported reduction in symptoms of depression (Age UK 2011)
 There is no authenticated proof yet of physical benefits related directly to learning activities except where
they involve extra exercise or sport (e.g. Tai Chi classes, Morris Docker 2006)

Note: Although there is a great deal of research on the benefits of learning in general,
there is a shortage of reliable data on improvements to the health (physical and
mental/ psychological) to older learners. The best summary is Age UK summary
http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Work-and-
learning/New%20challenges%20new%20chances%20%20IACL%20(Oct%202011).p
df?dtrk=true

Advantages of learning in later life (2)

In care settings

In care settings, learning opportunities for older people can:

 reduce isolation;
 improve both physical and mental health;
 reduce dependence on medication;
 improve recovery rates; reduce dependency on others
and
 lead to a greater enjoyment of life which gives residents
something to look forward to.

Source: “Enhancing Informal Adult Learning for Older
People in Care” NIACE 2010

Barriers to learning
 Lack of interest and feeling too old are the main barriers to
learning as people get older.
 Poor information about availability of learning opportunities
and inappropriate courses may explain lack of interest.
 One survey found 43% of older people agree that there is not
enough information on what education courses are available
and 30% believe courses on offer are not appropriate for
older learners.

45
40
35
45-54
Percentage

30
25 55-64
20 65-74
15
75+
10
5
0

reste
d
ssure too ol
d
ibility learn Cost isability
t int e Time Pre Feel responts need to th/D
No
aring Feel
o Heal Source: NIACE
C

Employment trends
 7,368,000 people aged from 50 to State Pension Age (SPA, currently
60 for women and 65 for men) are in employment
 849,000 people aged 65 or over were employed in July – September
2011, a rise of 0.1 per cent over the last year; this is about 3% of
the UK labour force
 The employment rate for 50 to SPA is 65% and for SPA+ it is 8.4%
 The latest figures (Jul-Sep 2011) show the unemployment rate for
people aged 50+ in the UK is 4.7%
 In October 2011, 241,100 people aged 50 or over claimed
Jobseekers Allowance.
 Median hourly pay for workers in their 50s is £12.00 and £10.00 for
workers aged 60+, as opposed to £13.03 for workers in their 30s
 There has been a trend of people leaving the workforce (presumably
for retirement) later. For men, the estimate of average age of
withdrawal increased from 63.8 years in 2004 to 64.5 in 2009. For
women, it increased from 61.2 years in 2004 to 62.0 years in 2009

Sources: Labour Market Statistics, ONS 2009 - 2011

More people enjoy work:
• The majority of those aged 55 and over would prefer to be
working full time than not working at all, and it is common for
older people to view working as the ‘ideal’ situation for them
… and want to keep working:
 A 2003 survey found over two-thirds of respondents aged
between 50-70 who were in, or looking for, a job planned to
work in some capacity during retirement or never retire
• The average age at which workers over 50 retired reached its
highest level for men (64.6 years) since 1984. For women
comparable figures showed an increase from 60.7 in 1984 to
61.9 in 2008.

Sources in Age UK Later Life in UK fact sheet, August 2012


• Employment supports an individual’s ability to contribute in
addition to their material wellbeing (ELSA Wave 3
presentation, Banks and Tetlow 2008).
• All those who want to work need to be in work – and work
needs to be promoted as a mechanism for achieving wellbeing
and independence in later life
• The impact of projected pension shortfalls on the timing of
retirement is not yet clear, but concern about financial security
is likely to bring about a further rise in working past SPA.

Trends
• Increasing reliance on private sector, complexity in products on offer
• More individuals are directly exposed to risk: a significant percentage
of 50-65 year olds are in danger of having replacement rates below
benchmarks of adequacy
• Increase in need for info and advice to access entitlements and make
appropriate decisions about finances
• Increasing use by organisations of websites as the main channel rather
than (more expensive) face to face (although Pension Service home
visits)
• Digital exclusion now leading to increase in financial exclusion, not just
in banking, but increasingly public services and private care funding
(poor risks?)
• Greater exposure to financial abuse
• Gaps in support for frail vulnerable older people, especially around
money management.

• Confusion regarding choices of pensions, savings and
care
• Lack of interest in accessing products online
• Concern about pensions (55-65 year-olds currently
finding out that their pensions will not be adequate):
50%

40%

30%

Final report
1st report
20%

10%
Source: Turner
final report,
2005
0%
Pension Pension + All non- + Half of + All
participation income pension housing anticipated
financial wealth inheritances
wealth liquidated liquidated
liquidated

• An individual’s income clearly supports their material wellbeing. It also
enables independent living and appropriate housing
• ELSA (2006 and 2008) provides strong evidence of a positive
correlation between higher income/ wealth and reduced risk of
developing most of the age-related chronic conditions, including type 2
diabetes, high blood pressure, raised cholesterol, disability (reduced
strength and mobility)

Health and financial status
 1.8 million pensioners live in poverty. Nearly two-thirds of
these are women.
 Older people on higher incomes are more likely to report their
health as ‘good’ or ‘very good’.
 People on lower incomes are more likely to report asthma,
chronic lung disease and diabetes. High blood pressure is
more common among poorer older people.

Sources: Households below Average Income and Pensioner Income
Series, DWP 2011

Wealth and health:
Odds of poor health increase with poverty

Net Worth by Health of Husband and Wife

450
(in Thousands)
400
350
Net Worth

300
250
200 Excellent
150
V Good
100
50 Good
0 Fair Husband's
Poor Health
t
n

d
le
oo

d
l
ce

ir
oo
G

Fa

or
Ex

G
V

Po

Wife's Health

Pension coverage in UK

Occupational pension Both Personal pension No private pension
100

80
Percentage

60

40

20

0
gs

t

2

3

4

5

6

7

8

9

st
es

he
in

or
rn

ric
po
ea

Earnings
ro
Ze

For the latest figures on pensions and pension coverage, see Age UK
Later Life in UK fact sheet, August 2012

Forecast change in public pension spending 2000–2040 (%)
-5 0 5 10 15

Greece 11.2
Spain 6.6
Netherlands 6.2
Germany 4.8
Finland 4.7
Ireland 4.4
Portugal 4.0
Austria 3.8
France 3.7
Belgium 3.7
Denmark 3.5
Sweden 2.4
Luxembourg 1.9
Italy 1.9
UK -0.5

EU 3.2

Do Pension Incentives Matter?
Survival probabilities, by pension status
1 UK men
Survival probability

0.75
No Occupational
Pension
0.5 With
Occupational
Pension
0.25

0
50 55 60 65 70
Age

Do Pension Incentives Matter?
Survival probabilities, by pension status
1
UK women
Survival probability

0.75
No Occupational
0.5 Pension

0.25 With
Occupational
Pension
0
50 55 60 65 70
Age

Housing
 Decent and appropriate housing is a key element in
quality of life and good health in older age
 Demographic changes, combined with changes in policy
on care provision and home ownership have meant - and
will continue to mean - an increasing number of the
oldest old living longer, and often alone, in their own
homes
 Older people (especially single people aged 75+) are
more likely than younger people to live in older, non-
decent homes)
Source: Older People, Decent Homes and Fuel Poverty. An
Analysis of the English House Condition Survey, Help the Aged
and BRE, 2006

Policy context
 Government encouraging institutional investment more in private
rented sector to make up the shortfall in social housing.
 Growing debate around reconciling housing related support, social
care and health services to deliver independence at home (role of
common assessment framework)
 Cuts in preventative services - housing related support - more funding
diverted to social care Further decline in retirement housing in the
social sector - increased focus on the most vulnerable
 Reforms to security of tenure (see Hills report) possibly less security
for both private and social residents – issue around offering settled
accommodation to older people
 Calls for improved coordination - partnership with LAs and PCTs
increasing focus on the role of retirement communities - some growth
 Increasing push towards assistive technology to replace or reduce
 housing support workers - increased pressure to cut labour costs
through assistive technology but likely to remain marginal for next 5-10
years (except top end of market)

What older people think
 92% of adults say they envisage living in a home they have for life, but
23% said their current home was unsuitable to live in in old age (B&Q
survey, 2008)
 More older people refusing to purchase preventative services to save
money as the result of increased 'choice' and rising charges
 Opinions sharply divided between those who benefit from Assistive
Technology and those who see reduced contact with 'human' support
 Concern about inheritance tax is not necessarily exclusive to the very rich.
ELSA (Wave 3, Emmerson Muriel 2008) found that 1 in 8 of their
representative 50+ sample have assets above the IHT threshold
 Whatever the merits of residential in comparison with living in the
community, over 70% of adults surveyed view it negatively: 48% of
homeowners 18+ say they can‟t think of anything worse than moving into
a care home.
 A further 14% say they would be nervous and 9% frightened (B&Q survey
2008)
 5% of people aged 65+ in the UK need but do not receive help with
everyday jobs such as hoovering or changing a light bulb

Trends
 Continued push on homeownership - experience of Right to Buy
generation unable to maintain housing should provide lessons
 Growth in need for local housing advice and advocacy – opportunities for
one-stop shop services
 Growing inequality of retirement provision between private and public
sectors
 Growing regional and local inequality in regard to poor housing Expansion
in private rented sector - more older people living in insecure tenancies
 Increasingly difficult to obtain additional resources from PCTs
 Housing support and service charges - growing divide between those
receiving benefits and those paying for themselves - likely to increase
friction within retirement housing
 Likely increase in numbers of older homeless people resettled in poor
temporary accommodation
 Public sector will focus on the most vulnerable
 Possible further decline in specialist housing. Growing debate around
mobility (moving to be nearer friends and relatives offering support) and
flexibility within social rented sector

Health and Home
 The majority of older people live within the
community.
 26% of households with someone aged over 75 live
in social housing and 68% are home owners.
 6% of older households live in sheltered housing
 4% of older people live in a care home.
 Poor housing has a detrimental impact on both
physical and mental health.
 2.7 million households with at least one person aged
over 60 are living in a non-decent home.
 Older people are more likely to be living in non-
decent homes in the private sector if they are over
75, or aged 60 or more and living alone.
 1.5 million women aged 75 and over live alone
compared to 0.5 million men of the same age.

Sources: see Age UK Later Life in UK fact sheet, August 2012

Care and support at home
 There are 6 million carers in the UK.
 2.8 million people aged 50 and over provide unpaid
care; nearly 1 million of these are aged 65+ and nearly
50,000 are aged 85+.
 There are 8,000 carers aged 90+ (4000 providing 50+
hours of care per week.
 Unpaid carers currently provide 65% of care compared
to 25% paid for by the state (10% is privately
purchased).
 73% of English local authorities have plans to limit
care to people with substantial and critical needs only.
 The growing number of older people means that the
need for support from unpaid carers could rise by 30%
over the next 35 years (9.1 million).

Sources: see Age UK Later Life in UK fact sheet, August 2012

Supported self-care

 Older people and their carers want services that will:
– improve their quality of life, health and well-being and enable them
to be more independent.
– Be supported and enable them to self care and have active
involvement in decisions about their care and support.
– To have choice and control – services built around the needs of
individuals and carers.
 The 2006 White Paper Our health, our care, our say, promoted telecare
and assistive technology in helping people retain their independence
and improve their quality of life.
 The use of the internet by older people, particularly over 75s is
increasing steadily but over half of all older people continue to be
excluded from the benefits of new technologies.

Source: Internet Access Quarterly Update Q3 2011, ONS 2011

Why is this important? (1)

• 3.7 million people aged 65+ live alone and 600,000 older
people leave their homes once a week or less and 17% of have
less than weekly contact with family, friends and neighbours

• Over one million older people experience (poor social relations
and) social exclusion.

• Older people who live alone spend a lot of time with friends
and acquaintances, but on average, they can also spend eleven
hours alone on a week day and ten and a half hours alone at
weekends (excluding sleep).

Source: ESRC/NATCEN research (Dec 11) and Age UK Later Life
in UK fact sheet, August 2012

Why is this important? (2)

 Social isolation prevents ability to contribute. It also is a risk
factor for health.

 Inactivity and isolation accelerate physical and psychological
declines, creating a negative spiral towards premature,
preventable ill health and dependency. A recent ELSA study
revealed that social detachment reduces quality of life.

 Depression is associated with lack of social support (36% of
men and 54% of women with severe lack of social support
have high depressive symptoms)

Source: ELSA waves 1-3 and Age UK Later Life in UK fact sheet,
August 2012

Social Inclusion impacts negatively on older
people’s quality of life
Mean Quality of Life Score

50
40 Pleasure
30 Self-realisation
20 Autonomy
Control
10

0
No social exclusion Temporary social Persistent social
exclusion exclusion

Source: ELSA waves 1-3

Policy context
•Social isolation is a cross-cutting issue and the responsibility for
alleviating it lies with several Government departments.
•Policies which may directly impact on social isolation are fragmented
but include:

•Linkage Plus aimed to improve outcomes for older people
through better joining-up between services and linking older
people to services.
•Developments in transport policy including making the freedom
pass available, amending community transport regulations and
•Investment of £5.5 million into intergenerational volunteering
•Individual budgets for those that access social care
•Positive duty as applied to culture and leisure opportunities
•Lifetime neighbourhoods
•Neighbourhood warden schemes
•Informal learning white paper

•29% of respondents to an Age Concern survey saw friends and
36% saw family a few times and month or less
•However many people at mid- to later life may not consider they
need to expand their social networks
•44% state they do not need lots of friends
•45% disagreed that they feel lonely from time to time

•Analysis of ELSA wave 3 has found that life satisfaction
significantly decreases after certain life events, with many
underlying factors clustering around themes of social isolation and
lack of support.

•Satisfaction with current levels of social interaction could be a
barrier to individuals building up social networks

Source: Own surveys and analysis of ELSA wave 3

Trends
One person households are projected to overtake married couple households by
2030
2,359,000
75 and over 1,659,000

1,559,000
65 - 74 1,061,000

1,792,000
55 - 64
947,000

1,415,000
45 - 54
834,000

1,460,000
2026
35 - 44 923,000
2003
1,048,000
25 - 34 797,000

254,000
Under 25
226,000

0 500,000 1,000,000 1,500,000 2,000,000 2,500,000

As people age, the risk of being lonely increases.
For details of trends in volunteering and digital inclusion, see Appendix

Source: DCLG household estimates, 2006

Long term challenges
 A decade of spending cuts – doing more with less?
 Demographic change – a manageable transition (working
longer; pensions reform) but we must now prepare our
public services
 Income – pensioner poverty stuck around 20% for the next
decade despite pension reform
 Healthy life expectancy - remains an elusive goal, avoid
longer periods of disability
 Social and technological change – changes in family life,
communities and the digital divide – what next?

2011/12: Uncertainty and Opportunity
UNCERTAINTY OPPORTUNITY
 Older people not immune from  A new ageing strategy
the recession  Social care reform - 2011 is
– Job losses hitting older ‘make or break’ for the long
workers term
– Rising costs of living  The Equality Bill – new rights
– Impact on savings and outside work; end forced
annuities retirement?
 Now - a focus on employment  Pensioner poverty – Child
and skills; an end to forced poverty Bill focuses minds on
retirement ending pensioner poverty
 The aftermath – public service  Coalition pressing older
cuts must not disproportionately people’s priorities
harm older people

Equal citizens, equal rights
PRIORITY: Outlaw mandatory retirement ages (2010 priority)

PROPOSALS INDICATORS
1. Use Equality Bill to outlaw age  68% say politicians see older
discrimination in goods and people as a low priority
services, rapidly and with minimal
 60% say age discrimination
exemptions
exists in older people‟s lives
2. Support EU directive on
 60% say age discrimination
discrimination beyond the workplace
exists in the workplace
3. Robust enforcement and promotion
 53% say people in very old age
of existing age discrimination law
are treated like children
4. Extend Human Rights Act to private
 52% say those planning services
providers of public services
don‟t pay enough attention to
older people

Enough Money
PRIORITY: Roll out automatic payment of benefits

1. Government commitment  16% (AHC) of pensioners
to end pensioner poverty in poverty
2. Public services work  59-67% of those eligible
together to push take-up receive Pension Credit
of benefits
 56% of employees covered
3. Index State Pension to by a non-state pension
earnings now and
 36% of over-60s avoid
improve pensions for
heating rooms to save
women who retired
money
before 2010
 7% of 85+ households don‟t
4. Urgent review of Fuel
have a bank account
Poverty Strategy

My life, my care
PRIORITY: Spend an extra £1-2bn on older people‟s care

1. Increase investment in  410,000 people over 65 with unmet
preventative support and need for help around the home
information, advice and advocacy
 67,000 households receiving low-
2. A fair national system for level home care
assessing need and allocating
 347,000 people receiving home
resources
care
3. A radical new long-term settlement
 £60 gap between average weekly
for care and support, which
fees for a care home and the
increases access and quality, and
standard council payment
is fair and affordable for all
 27,000 people over 65 receiving
Direct Payments

Staying well and feeling good
PRIORITY: Re-direct the NHS to prevent and manage common
conditions of ageing

1. All public services to work to  24% of over-65s say quality of life
promote lifetime good health has worsened in the last year
2. NHS reform to reflect older 7.3 years for men and 9.4 years for
people’s needs and women of future disability at age of
preferences 65
3. Improve access to primary 19% of 65-74s and 7% of over-75s
care for carers and care home do recommended levels of exercise
residents  149,000 75+ emergency
4. All health providers to adopt readmissions within 1 month of
person-centred measures of discharge
dignity  64% say health and care staff don‟t
5. Age-aware workforce always treat older people with dignity
development strategies

Places to age in
PRIORITY: a national „offer‟ and brand for local older people‟s services

1. Local public agencies to  11% of over -65s say they are
commit to ‘lifetime lonely
neighbourhoods’  35% of 60+ households live in
principles poor housing conditions
2. Rapid adoption of Lifetime  26,000 65+ excess winter
Homes planning standard deaths
3. Review policy and funding  9-10% of over 75s find it very
for supported housing difficult to access doctor, post
4. During recession, anti- office, supermarket
crime initiatives for and  6% of over-65s leave home
with older people once a week or less

Opportunities and contributions
PRIORITY: „age proof‟ employment and skills support during recession

1. Employers to adopt flexible  76% say the country fails to
working and ‘age make good use of older
management’ policies, with people‟s skills and talents
a right to request flexible  312,000 over-50s unemployed
work.
 168,000 over-60s participating
2. All local public services to in state-funded learning
facilitate lifelong learning
 60% of over-65s have never
3. IT industry to embrace used the internet
accessibility and inclusive
design  39% of 65-74s and 24% of
over 75s participate in formal
4. Public bodies to involve volunteering at least once a
diverse groups of older month
people in decisions
affecting them

Public Policy at Age UK
NATIONAL LOCAL
 COMMUNITY AND SOCIETY  Supporting Age Concerns and other
– Income and inequality partners influence effectively

– Housing  National programmes where the key
decisions are local
– Communities and transport
 PUBLIC SERVICES
– Health and healthcare REGIONAL

– Independence and support  Regional teams working with
partners
– Equality and human rights
 PRIVATE SECTOR
INTERNATIONAL
– Employment and
opportunities  EU and international institutions

– Consumer markets  Partnership with HelpAge
International
– Financial services

A large and growing older population

'000s
70000

60000 0-15

50000 16-29

40000 30-49

30000 50-59

20000 60-74

10000 75+

0
Source: National
2002 2006 2026 2036 Statistics 2004

Spending, income and wealth
SPENDING
 Over £100 billion spent by 65+ households every year
 Rich people spend same amount, whatever their age. Poor people in
later life spend less than younger groups with the same income
INCOME
 Lower incomes on average, but similar poverty rate
WEALTH
 2.2 million with no savings; 3 million with over £20,000
 Huge inequalities in wealth, but richer than younger age groups on
average (housing)

Sources: see Age UK Later Life in the UK fact sheet, August 2012

Distribution of wealth within and between cohorts

85+

75-84

65-74
Total Wealth

55-64

45-54

35-44

25-34

16-24

0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000

Real spending power
 Over 50‟s account for 80% of UK financial wealth

 On average, higher disposable income than under 50‟s

 But huge variation in terms of who accounts for it……..

 Wealth concentrated among current 50 - 64‟s:
– 80% home ownership
– spend more per week than any other age group

 65 – 75‟s already have similar spending power to under 50‟s versus…

 40% of retired who rely on state pension: 60% home ownership over 75‟s


Assumptions about older consumers
 Often misrepresented, neglected, ignored
 55% of over 55s agree „business and retailers have little
interest in the consumer needs of older consumers‟
 Ageism – stereotyping of a whole age group as
– Homogenous „others‟
– Warm, friendly
– Incompetent and incapable
 Neglected even for products mainly for older age
groups… reinforcing and responding to internalised
ageism

Facts about older consumers (1)

People get more diverse as they get older…

 Full-time, part-time, retired, caring, grand-parenting,
volunteering etc
 8% of people over 65 are from BME backgrounds
 5-7% over over-60s are LGB
 A third of over-65s are disabled, rising to 2/3 of over-85s
 A quarter have symptoms of depression



 Driving – half of over-70s don‟t have a driving licence
 Valuing home – over-65s spend more time at home
(80% of the week) and like them more. But some feel
trapped at home.
 Living alone – half of 75+ households live alone. 7-9%
over over-65s are often or always lonely
 Not exercising enough – 17% of women aged 65-74
and 20% of men meet recommended guidelines
 Having cognitive difficulties – especially over 80s


 Late adopters, but get there…
– 77% of 65-74 year olds use a mobile
– 40% aged over 65 have used the internet, including a
million almost every day
– 1 in 10 60-69 year olds own an MP3 player
 Spend higher share on essentials (food, energy, housing
etc)
 A little less susceptible to switching products, advertising
etc
 Hate stigmatising products… eg ugly adaptations
 But mainstream products don‟t always serve their needs


Impact of ageing on activities of daily living

 Impacts on hearing, sight,  Small print harder to read
touch, dexterity, muscular  Call centres more difficult
strength, mobility etc to navigate
 28% of over-65s have  Bending and stretching to
significant sight loss reach shelves
 55% of over 60s have  Fiddly buttons on clothes
hearing problems
 Sending text messages on
 One third of over-65s have mobile phones
a fall each year
 Shopping harder to carry
 9 million people have
arthritis  Packaging harder to open


An attitude problem
 As a society, we have failed to come to terms with the dramatic increase
in the number of older people, both in absolute terms and proportionate to
the population

 Denial; the difficulty we all have in coming to terms with getting older, our
own ageing process

 Older people feel they are marginalised, ignored, stereotyped

 Products, marketing and communications still addressed to the younger
generation

"I feel my opinion is taken less note of nowadays"

60%

50%
50%
44%

40% 36%
31%
30%
25%

20%

10%

0%
45-49 50-59 60-69 70-79 80+

ACRS Lifestage Survey 2007 (R)
Weighted base: 2372 adults aged 50+
Agree = Strongly Agree + Tend to Agree

Age discrimination in the UK is still pervasive
and widespread

 60% of older people in the UK agree that age discrimination exists in the
daily lives of older people
 53% of adults agree that once you reach very old age, people tend to treat
you as a child
 52 per cent of older people agree that those who plan services do not pay
enough attention to the needs of older people
 68% of older people agree that politicians see older people as a low
priority
 76% of older people believe the country fails to make good use of the
skills and talents of older people
 97% of annual travel insurance policies impose an upper age limit for new
customers
 In a study of patients at a stroke unit (2004-06), 4 per cent of patients age
75 and above were given an MRI scan, compared to 26 per cent of those
under 75


Ageist attitudes are considered a serious problem in
Europe, especially in the UK and France

Source: Ageism in Europe. Findings
from the European Social
Survey, Age UK 2011

Even amongst the old themselves….

Source: Ageism in Britain, Age Concern 2006

Society does not place a high value on old age
 Sheer numbers mean there is no status or achievement in having defied
the odds

 As a revered minority, older people used to carry the wisdom of their tribe
and family. But now:
– no longer natural leaders
– diminishing role in extended family

 In a secular / Western society, there is no sense of the development of
spiritual wisdom that comes with age

 Experience used to be a basis for respect. But with the impact of
technological change the experience of age is increasingly replaced by
the expertise of youth

Longer life seen as a burden, not a benefit

Society is dominated by youth culture

 Huge pressure to remain looking and feeling young:
– role models are young and beautiful
– men worry about loss of potency, power and success
– women about a decline in their attractiveness

 Business still tends to innovate and grow by focusing on
the young

 The majority of people working in marketing,
communication and design are under 40 (including Age
UK)

Society is bound by cultural conditioning and
stereotyping of what old age means and looks like
 Deterioration and decay, no sex, no fun

 Traditional and conservative, not innovative, lacking in
discernment, not interested in style, fashion, technology

 Stereotyped prejudice written into the language: „grumpy old‟,
„silly old‟, „boring old‟, „dirty old man‟

 Indeed, society tends to shut old age away, rather than living
with it

The idea and fact of ageing can be traumatic
 Coping with „retirement‟

 Coming to terms with loss of youth

 Fear of physical and mental decay

 Fear of being alone, isolated, abandoned, helpless

 Of being poor

 Many live in denial: suppressing and denying our own fears we
do not put ourselves into the shoes of being an older person…….

Summary: the business case

 Design inclusively and older consumers will buy

 Recognise that business opportunities come with change

 Recognise the complexity of the market

 Think beyond age

The ‘Third Age’ should present rich opportunities

 The changing lifestyle of „retirement‟

 Different priorities and needs

 More time, and different uses

 New interests and opportunities

 More disposable income

Potentially a different life and opportunities
Family woman Empty Nester

 Focus on the family  Focus on me (us)
 Spending on them  Spending on me
 Family food and toiletry products:  My food and beauty preferences;
– value packs to suit all – premium toiletry products
– chips and pizza – salad bags and fish
 No time for me  More time for me
 Family holiday  Tour of China, cruise
 Swim with the kids  Swim and Yoga
 DIY face pack  Weekly professional manicure
 Family wagon  Sporty car
 Take away  Meals at nice restaurants
 Old TV and video  New DVD system

Lifestages survey cluster analysis, ACRS

Thinking beyond age
 Not helpful to think of age per se.

 Ageing is an individual experience; people age in different ways

 The accumulation of „damage‟ is dramatically different from one
person to another

 People‟s response to and ability to cope with the ageing
process, differs dramatically

 Basic differences in attitudes towards life become magnified

Attitudes are much more defining
 Potentially a more complex segmentation than for younger
markets:
– less vulnerable to peer group pressure
– less need to conform, more individualistic

 Most helpful segmentation based on understanding a
range of feelings about ageing

 Overlaid by attitude towards life per se

 Whilst spending power is clearly a critical marketing
variable

The way forward...
 Question the notion of ageing; in society, in ourselves
 Ignore the calendar; chronological age is
progressively less relevant
 Develop services and products which are appropriate
to the „third‟ and fourth ages‟
 Think about how we can
– enable life and living
– enhance the quality of life
– simplify life

Later life in over 100 slides (August 2012)

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