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?

There really isn't enough money for everyone who needs specialised treatment to get it
I think this bears repeating, we do not have unlimited resources! Health needs and caring needs tend to be bottomless pits, presenting us with endless dilemmas.

We are trying to have an adult conversation about the harsh realities of trying to care for an aging population fairly when faced with resource scarcity and you are talking about turning working age people, who logically would be doing some of the care work, into pies. No, it's not relevant. It's one of flippant or hyperbole, possibly both, but it's not relevant.

We do already make decisions on a case by case basis.I've faced palliative care only three times. Once tbf was Covid where it was done equally to the able bodied. The other two times I have survived but been left further disabled.
I try not to dwell on if I might be less disabled if I'd received pro active treatmen as that way madness and bitterness lie, but a rehab place at least should have given once it was clear I was still here. As it is I've had to spend years getting myself from prone and useless (including a year taking up a hospital bed before I self discharged.) to a wheelchair user with abilities as well as disabilities.
I've just come back from work and hurt like hell and my body is seizing.
In a few hours I hopefully will have slept for three hours, and my carer will come in and I will be a rigid fetus shaped ball in a great deal of pain that has to be straightened out and attached to equipment to be turned into something resembling partial normal movement to start another day. When there is no one to do this I'm left useless and bedridden, but I struggle to give up as much as I struggle not to. Sometimes that's for long periods and then I have to start over again trying to rebuild muscle and independence. Really easy to look at me one end of the day, or after a period of no assistance and say no point. But I still exist, in what shape and for how long is in the hands of carers and Dr's and more and more shaped by the worlds opinions about the value of people like me living lives others wouldn't want to have to.

I don't think it's as bad as everybody says. Yes, the population's changing due to reducing birth rate - but not that fast, and there's plenty of time to readjust.

Thank you for your honesty, @Elleherd

I am sorry you haven’t always received the quality of care you need. I’m glad you are able to advocate for yourself, though I’m sure it’s exhausting.

Separately- my family are excessively rational, perhaps due to unusual family circumstances. I stand no chance should I lose capacity 🤣. Funeral likely to be direct cremation, a cardboard box, and ‘everyone mark the event as suits them best’-ie, none!

With regard rationing of healthcare, sometimes it's not even money, it's resources. Organ transplantation for example. I think during covid, decisions on who gets a ventilator were made on clinical grounds and so people who wouldn't benefit weren't considered. Had it been much worse and decisions had been made by having to choose between patients I think the more moral choice would be to choose the youngest. If presented with a 55 year old women and a 18 year old girl, both of whom would likely recover well but die without ventilation, for me, its a no brained, you choose the kid. And I'm a 55 year old women with dependents.

To me it’s also a no brainer given that you have dependents. It would be you. It would be a different story without those dependents.

Some cultures won’t opt to preserve the wisdom of the older person too!

The pre eminence of youth is relatively modern and not universal!

That should say ‘would opt’, sorry.

Or it’s a political choice. Like it is in the U.K. just now.

The most wealthy can afford healthcare, they dint need to die. It’s ok because they have money.
But those with no money? Scroungers!! They should be at work doing something worthy instead of lazily sit at home.

Does it reminds you anything?

This. Once my mother was past a certain stage of dementia (and was over 90 anyway) we agreed with her care home that except in the case of e.g. a 2nd broken hip, there should be no hospital*, and no ‘striving to keep alive’. IMO it would have been verging on cruelty.
They agreed 100%, but you do have to make these things clear, otherwise the default action is to keep them going.

*Hospital is in any case a terrible place for anyone with dementia, when they can’t understand what is going on, or why, and keep pulling cannulas etc. out.

It's still illegal to buy an organ in the UK though and as far as I know, near impossible (but not impossible) to do so, no matter how much money you have.

The powers that be might be right that there are too many people considered economically inactive….

I don’t know if I would classify as disabled enough to have an opinion for you (MS - its impacts fluctuate) - but I will also age, almost certainly less gracefully + comfortably than some. I don’t think that I have a right to a limitless bucket of therapies to extend my life indefinitely - when public resources are finite.

I wouldn’t want life prolonging therapies for me in my later years to be prioritised above early years intervention + education in budget allocation.

When I was (of necessity) a regular visitor to a forum for carers of people with dementia, I read of someone of over 90, with at least moderate stage dementia, who was found to have a heart problem.
A pacemaker was one option, and the family asked what would happen if their relative didn’t have it.

Answer, most likely their heart would quietly give up while they were asleep.

The family insisted on the pacemaker anyway.
Given that dementia is only ever going to get worse, to me this was a prime case of misguided ‘striving to keep alive’, rather than letting Nature take its course.

Letting nature take its course is one thing. Active inducement of death is quite another.

It is the powers that be whose opinion matters on if you are considered disabled enough, or economically active enough, not mine.

Precisely because it is understood it fluctuates, I doubt people with MS would be pushed towards voluntary euthanasia while they considered their quality of life worth having, but who knows.

I also don't think I "have a right to a limitless bucket of therapies to extend my life indefinitely."

But, I do want a life for as long as I am cognitively able to get on with it as best I can.
I've been disabled since birth and have always accepted that I will have a shorter more difficult life. I'd just rather it wasn't made unnecessarily shorter because others felt they had the right to decide if I should be taking up resources or not.

I hear that - and in an ideal world no one would live a life that was in anyway limited by resource availability.

I don’t mean to suggest that people living with disabilities are in anyway less deserving.

I do feel deeply frustrated by all the idealising about what should be available to everyone. In this ideal world everyone should have access to gene therapy, cutting edge oncology, universal credit, psychological care in prisons, free drug and alcohol rehabilitation care, housing benefit, free university, free late life care etc etc etc. but there aren’t unlimited resources. More than 50% of people in this country are net beneficiaries of the tax system. There aren’t many more places to take money from. There has to be some prioritisation somewhere 🤷🏼‍♀️

I would argue that it makes sense to prioritise education + early years intervention because that is literally the future of humanity.

I don’t know what the answer is to late life care. But I agree with PPs that it can’t be our current children paying an ever higher tax burden to fund extended pensions + care bills for people who haven’t paid into the system. That’s a scheme that’s going to collapse really quickly when it hits a tipping point.

in an ideal world no one would live a life that was in anyway limited by resource availability
this will never happen, humans would want more however much they have, our appetites are limitless