Advances in medicine over the past 100 years mean that in general, most people are living longer - even in countries where the life expectancy figures are lower. On the whole, lifespans are rising, and countries across the globe have a higher proportion of older people to consider in their policies and planning.
Dr John Beard, director of the Department of Ageing and Life Course at the World Health Organisation (WHO), says when that happens - when 30% to 40% of the population in a country is older - it demands a very different way of thinking, particularly when it comes to healthcare.
Beard and Prof Nathan Vytialingam, president of the Malaysian Healthy Ageing Society, were in South Africa, to speak at the launch of the Longevity Association of South Africa.
"Older people have a central role in society, and they have a right to good healthcare," says Beard. "When they get sick, often the whole family carries the burden," he says.
However, the bulk of that burden is usually carried by women, Beard says, with repercussions that are far-reaching.
Vytialingam endorses these sentiments.
"In Malaysia, for example, the retirement age changed from 55 to 58 and now it's 60," he says.
"Women live on to 78 and men to 76. People are living longer, so we have to look at sustainability," Vytialingam added.
Beard says countries need to be prepared to manage longer life expectancy.
"If we can keep older people healthy, and break down the barriers to their participation in society, they are a wonderful human resource, and we can draw on that," he says.
"The costs of keeping people healthy are often over-estimated, but it's more cost effective to prevent disease rather than cure it. Remember, older people often support younger people financially, and in other ways, so we must see them as a resource," says Beard
He believes the most important thing is to control hypertension because it's the biggest underlying cause for stroke and heart attacks and in South Africa hypertension rates are alarming.
"A longitudinal study of older people in South Africa shows that 80% have hypertension, yet less than 8% of them receive treatment," he says.
"Older people need access to primary care. We need to focus on those basic building blocks, and provide primary healthcare wherever possible."
"When it comes to healthy ageing, we have to take a holistic approach - it's not just about old age," Vytialingam says.
"It's a life course. It's about a healthy mind, body and spirit," he says.
When people remain healthy, they will have fewer hospital bills to tax their finances, he says.
Older people also need to remain mentally occupied.
"When you retire, you don't retire from your life. You still feel young, even if your body is ageing," says Vytialingam
It's vital to educate young and old alike that savings and medical insurance are important, he says. Then there's the problem of women living longer than men. Even in this day and age, they simply don't have enough money to see them through their retirement years.
"We also see in Malaysia that where in the past there was a strong extended multiracial and multicultural family structure, the youngsters of today are caught up in the rat race, and are more interested in (material things)," Vytialingam says.
"They don't have time for the elderly. In our national newspapers we see stories all the time of old people who've been abandoned by their families. So there are social and financial factors to consider."
One financial factor is medical funding: South Africa is planning a national health insurance scheme and the needs of the elderly are an important consideration. Moreover, national health insurance does not equate to universal access to healthcare, says Beard.
He goes on to say governments have to ensure that what they provide is of a good quality and affordable.
"Ultimately, we need to develop the way we manage chronic diseases and provide social support," Beard says. "As the number of older people increases there will be fewer people available to provide the necessary and vital care to the elderly."
And as the demand for care increases, the burden on carers will increase, he says.
"We need to look at ways to support those carers. They will need advice, care and access to rehabilitation. Older people need palliative care and social support so they can die with dignity," he adds.
Beard says trends in ageing will change everything. In the past, he says, people worked until they were 60, and died at about 72.
"Today, you can expect an extra 10 to 15 years of old age, which means that realistically, you could retrain and change careers at 45, and still have a good 20 to 25 years left as part of the workforce. And at 60, you might decide to do something like having more flexible working hours, Beard says.
The way society accommodates older people also has to change fundamentally, says Vytialingam.
"Asia has the fastest growing elderly population and in Japan there are already more old people than young people and these people could be contributing to the economy. However, they are not being employed, because people think they've retired and are no longer part of the work force.
"But they have a lot of valuable experience, so it's silly not to make use of them," says Vytialingam. "Most elderly people want to contribute to society and not just gain financially gain."
Beard and Vytialingam say that barriers to employment need to go because if older people can sustain themselves they won't be a burden on the government.
"We need to raise the retirement age because it's unsustainable to have so many people dependent on welfare schemes and we must have an environment where older people can participate socially.
"One of the ways we're doing this is through developing a global network of age-friendly cities, which we hope will continue in both developed and developing countries," Beard says.
"Abuse of elderly people is a big issue across the world - and it's not just sexual or physical abuse, it's often financial too," says Vytialingam.
"Very often, the older generation provides for the younger members of their families. They may end up funding the lifestyles and education of the young, which leaves them financially drained. That has to be resolved."
The most important thing anyone can do when it comes to living longer, however, is to make sure to age healthily.
"It's never too late to change," says Beard."Stop smoking and drinking, eat well and exercise. If you make those changes, they will make a difference. And if you keep yourself healthy, you will enjoy life more," he adds.
Vytialingam cautions, though, that there is no point in waking up one day and deciding to change everything at once. Build up slowly, and get guidance from healthcare professionals," he says.
Healthy ageing is about having a healthy mind, body and spirit.
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