Can we talk about ageing populations?

[Kendodd]

Birth rates around the world are collapsing. South Korea has the lowest birth rate at about 0.7. That means for every 100 people, 35 children will be born. There are predicted to be more people over 65 than under very soon. Many countries are predicted to see their populations half be 2100. While I think this is great for the planet and wouldn't want to change things, it will present problems.

What to do?

There's already a crisis of recruitment in care. Throwing more money at it won't work, we need people to do other jobs as well. Limiting care/health care to the elderly, I can't see how that would work either. Also, most of these countries are democracies, the elderly would be the most powerful voting block.

Anyone any ideas?

I keep mentioning Land Value Tax for a reason.

This has absolutely nothing to do with the thread.

Unfortunately not all people with dementia are happy. My DF has been increasingly unhappy and distressed over the past 10 years. He has spasms, which may be referred pain, but we don't know because he can't tell us. He cannot understand what is happening to him - attempts to bite carers, cannot communicate in any meaningful way, and doesn't understand what food is. It is an entirely and unremittingly miserable existence. Your parents were very lucky!

I wholeheartedly agree with everything you’ve said including the assisted dying.

view new children as new polluters rather than as human beings who will contribute to society

New children are new polluters and at the same time also human beings, new citizens, and future contributors to society.

What is it with people holding this stupid "either or" fallacy?

In my experience doctors do allow people to die in some circumstances. When DF 93 was in CCU with heart failure and aspiration pneumonia and the antibiotics were not working and therefore there was no hope, the doctors spoke to us and asked what we wanted them to do. We agreed that he should have no more antibiotics (that weren't working anyway) and should be allowed to eat and drink what he wanted (despite aspiration risk) and just be kept comfortable until nature took it's course. He had capacity so they talked to him too, but our views were taken into account. It was all very peaceful and the care he received was excellent (local NHS hospital).

Bed-bound dementia patients being given endless courses of antibiotics to postpone their deaths from pneumonia aren't volunteering for the National Trust.

Yes. I'm not entirely convinced that the existence of homo sapiens is actually beneficial to the planet.

Indeed but there are significantly more of the NT volunteer variety. That’s why age is a shit way to determine who should or shouldn’t get medical care.

This absolutely could be done, if a system was set up. The most important element would be the will of the patient, if mentally competent. Then the view of the family, comfort level, pain, ability to communicate, quality of life, use of the senses etc. If the criteria was very narrow and heavily regulated then it would be possible for a team to decide when to withdraw medication. Much as a diagnostic team decide what amounts to a disability, for comparison.

Humans aren't that important. There was life on this planet before us and there is likely to be life after us. We just need accept that and stop thinking that we need to populate the planet/country. We don't. It is fine to not have kids and it should be seen as normal as having them.

Perhaps we also need to go back to more communal living so we can support each other rather be expecting care in old age.

What needs to be done;

• better preparation for old age by individuals
• increased (subsidised?) immigration to the UK from sub-saharan Africa in to care roles
• redistribution of young population
• allow euthanasia
• decrease life preserving measures

Do you know what the straw man fallacy is? Because you've just committed it by fabricating an intention to kill you and ascribing it to PPs.

There's loads of commenters who have made it clear that they are talking about withdrawal of medical care from, or assisted suicide for, people who do not have long to live and have very poor quality of life. Not forcibly administering pentobarbital to someone who is capable of posting on Mumsnet.

The trainwreck in Canada hasn't been reproduced in Switzerland, has it? It's almost as though Canada's problem is the lack of safeguards rather than the legalisation of assisted dying per se.

It's awful to see an elderly person suffering in pain everyday due to incurable illnesses or suffering from dementia. I fully believe in euthanasia in these kinds of circumstances and I am sure quite of few elderly people would agree.

Age is strongly correlated to probability of imminent natural death. We expect a 90 year old to die of natural causes in the next ten years but we'd be horrified if a nine year old did the same.

So "is elderly" is a fairly reasonable proxy for "does not have many high-quality life years to protect through medical treatment".

Remember, we all die. There's no such thing as "saving" a life, only prolonging it by delaying death. The question is how many years more the doctors can give you and how good those years will be.

In my experience that's an unusual view. What would be your main reasons?

But the post which prompted this particular aspect of the discussion, and which is at the start of your quoted post doesn't suggest that decisions be made on age.

Here's that post again and I've bolded the part which is relevant. It is about quality of life, not length of life.

"People need to become more realistic about old age and Drs need to stop prescribing medication and treating conditions that are part and parcel of old age and allow people to actually die instead of fighting to keep them alive in disgusting cruel circumstances for an extra few years of life. Or in pain and confusion. Just because we CAN medicate and treat doesn’t mean we SHOULD."

I had a great aunt who laid a patio in her 90s. No one is suggesting that someone like her shouldn't receive medical care, but I am actively suggesting that my almost 90 year old DF who will never stand up again, far less walk, never mind lay a patio!, should not be receiving antibiotics for a cough. There are worse things than death.

I agree. The elephant in that room is women being expected to do double duty when they have a family, while men saunter along almost unimpeded. Things are changing, but slowly. For now, a woman considering starting a family faces a heavy financial hit, damaged career prospects and the lion's share of childcare & domestic work. Can't blame her for opting out.

If we start considering euthanasia for the elderly it won't be long before any child born that is not perfect should be left to die.
We are not God.

We already do play God by keeping people alive with medical treatments. With regard children, in the UK a pregnancy is considered viable at 24 weeks, minimal care is given to babies born before this. I believe some other countries set this level differently.

Medical care is pretty much all about "playing God" one way or another. Extending the lives of the young and those who are likely to recover and have a life to live after treatment is one thing. Extending the lives of those who are already well on the downward slope of incapacity towards death is quite another. But both are about "playing God".

I've had an extra 45 or so years of life because of surgery and treatment I received when I was a child. That's great, but I do not want any treatment if I have dementia or a similar disease associated with old-age and from which there is no prospect of recovery or real improvement.

But we already play God through medical intervention to prolong life.

500 years ago then aside from a few leeches if you got seriously ill then you died.

The question now is what level of medical intervention is appropriate, humane or affordable - otherwise you could technically keep everybody alive on life support machines.

In your opinion. My opinion differs.

Personal experience. Close relatives who were living with conditions that from the outside looking in, were impossible situations. Family were imposing their own perceptions onto those 'suffering' because they were feeling uncomfortable with it all. Those living with the conditions were still vital and content human beings, at peace with the quality of their lives.

Do you have a point at which you would prefer that medical treatment was withheld or restricted? At which point do you feel that a human being is no longer vital or content?

I have yet to meet anyone who will say out loud that they would like to spend the final months or years of their life completely dependent on others, doubly incontinent, unable to move themselves, unable to eat or drink without assistance, unable to speak or communicate in any meaningful way, etc. But I have met people who insist that doctors ensure that someone else continues to exist in that condition.

Edited to add - I am genuinely interested in your thoughts. Given my DF's current situation, and his DF's before him, I have given a lot of thought to what I would consider tolerable, and am in the process of drafting an advance directive, setting out in some detail what my own preferences would be at different stages of physical and mental health and capacity.