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Older people

A manifesto for successful ageing

Victoria Tischler on the need for a Commissioner for Older people and Ageing in England.

18 May 2023

There are recent calls to appoint a Commissioner for Older people and Ageing in England. This person would act as an ambassador for a growing demographic; with more than 11 million people aged 65 and over in England, representing 19% of the population and numbers of those aged 65 and over predicted to grow to around a quarter of the UK population by 2043. As a chartered psychologist and a passionate advocate for working with older people, I am heartened by this development and hope it will have a positive impact on the representation of older people as well as encouraging more psychologists into this rewarding sector. Here, I outline why the commissioner role is urgently needed and provide an ambitious guide to what the new commissioner's manifesto could contain.

Ageism and disadvantage

Pernicious ageism is common, characterised by stereotyped negative reporting of older people in the media illustrated with images of wrinkly hands and depictions of 'bed blockers' dominating scarce NHS resources. Ageism has been associated with poor psychological wellbeing in older people in a recent systematic review and high levels of loneliness are reported.  Ageism also pervades psychology training, and this has been picked up by APA colleagues in the USA who published a Resolution on Ageism in 2020. The issue has been highlighted in the UK but more can be done.

Some older people face multiple disadvantages. Those from Black and racialised communities experience health inequalities as evidenced by higher levels of mortality during the Covid-19 pandemic, and poverty rates almost double that of their White counterparts. Those in care homes fare even worse as most live with dementia in a sector characterised by regular reports of poor conditions, ageism, neglectful and sometimes abusive behaviour towards residents, and a workforce crisis with 165 000 vacancies currently. This situation is scandalous and unconscionable given that older people have spent their lives raising families, contributing to the economy, and supporting relatives and their communities, e.g., via volunteering.

10 factors

I propose a manifesto for successful ageing that a new Commissioner for Ageing and Older People might adopt. My top ten factors address individual, societal and wider structural issues that safeguard and optimise mental and physical health and quality of life for older people.

  1. A secure income. The European Trade Union Institute has proposed minimum income levels that ensure a life of dignity for older people according to the European Pillar of Social Rights (EPSR).
  2. Safe, affordable and warm housing. We all need basic levels of shelter that support us to live comfortably, as part of a community, and to prevent ill health. An All Party Parliamentary Group for Ageing and Older People (2019) recommended a range of measures to ensure decent housing including accessibility standards, integration with health and social care provision, and energy efficiency. Interaction with neighbours and friends is important to building and maintaining social capital, a crucial factor that is protective at times of crisis.
  3. Free and accessible green spaces, gyms and pools to encourage exercise and socialising. There is increasing evidence on the benefits of well-designed outdoor space and nature to the health and wellbeing of older people.
  4. Provision of healthy, locally sourced food. Healthy eating prevents illness and maintains good health including in older age. Meals can also represent social events that bring people together thus providing socialisation and alleviating isolation. This is the focus of my project The Imagination Café that has visited market squares, art galleries, and football stadiums across the country.
  5. Wrap around health and social care, that adapts as needs change. This must be integrated and responsive, and affordable, ideally free at point of access. This has been addressed somewhat via the introduction of Integrated Care Systems (ICS) in 2022 but still faces major challenges due to pressure on services and workforce shortages.
  6. Make working with older people a valued and attractive career. Better education and remuneration are needed to attract skilled candidates into work with older people that is rewarding, has career progression and offers training opportunities.
  7. Free access to high quality arts, culture and heritage. As Article 27 of the UNESCO Declaration of Human Rights attests: "Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts..." . This is a core focus of my research, and it builds on a growing body of evidence that attests to the health and wellbeing benefits of creative activities for older people, including those living with dementia. This cultural capital is being further recognised via social prescribing initiatives. Civic spaces including art galleries, museums and libraries are often centrally located, free to enter, and aesthetically pleasing, thus offering many types of individual and social benefit to older people.
  8. Role models that promote healthy ageing and positive imagery and reporting of older people. The Centre for Ageing Better lead an excellent campaign, providing positive images of older people, including those from diverse communities. This should be picked up by the media and mandated, so that such imagery becomes normalised.
  9. Intergenerational programmes as standard. Children and young people can develop negative attitudes to older people, including aversion to working with this population. This may be reinforced through exposure to ageist imagery and discourse and lack of positive interactions.  Intergenerational programmes benefit children, young people, and older people by fostering reciprocal learning and friendship, and by helping to counteract ageism and negative stereotypes.
  10. Lifelong Learning. Learning new skills is one of the pillars of the Five Ways to Wellbeing. Excellent initiatives such as U3A ensure that such opportunities are open to all.

In April 2023, a new Global Initiative on Ageing Centre of Excellence on Ageing was launched at the University of Surrey. This will provide a fertile environment to develop, test and showcase interdisciplinary research that aims to improve the lives of older people. During the event, the Chair of the United Nations Institute for Training and Research, Ambassador Luis Gallegos noted that all older people should enjoy a life of dignity. I wholeheartedly agree and would add that they should also experience a life filled with joy. This is why an ambassador for older people is vitally needed; to champion this diverse and growing group, to raise awareness of current inequities, and to campaign for better lives for ageing citizens. This will not only benefit older people, but all of us as we age.

Victoria Tischler PhD CPsychol AFBPsS
Professor of Behavioural Science, University of Surrey