October 23, 2014
Prolonging life will only make death the least of our worries in an ageing societyPosted in Irish Independent · 51 comments ·
My father passed away five years ago at the decent age of 79. With the passing of time, it becomes easier for me to consider the last years of his life.
Like many people, he was healthy up to a number of years before he died, but overnight his quality of life plummeted dreadfully.
At seventy-five, this fit man who was a daily walker (of 5 to 10 miles), suffered a heart attack and underwent an emergency triple bypass, which we hoped would lead to a reasonably rapid recovery. I looked forward to being able to walk with him again on Killiney Hill or the nearby beach, which were our favourite walks in South Dublin.
It didn’t work out that way.
Complications associated with an acute disease, diabetes, ensured his final years were not years of joy, surrounded by family and grandchildren – the type of old age we all imagine we will enjoy.
His were years of ill-health, faltering recoveries, incapacity and ultimately pain, due to poor blood circulation induced by diabetes.
As getting old is inevitable and happens quicker than we think, looking back at the end of my own Dad’s life has prompted me to look forward to the end of mine.
What will it be like? What sort of society will we live in by the time I reach my ripe old age?
How many other oldies like myself will be knocking around? Will I be in slippers, beside the fire, chatting to grandchildren, surrounded by loving family or will I be alone?
Will I be rotund, corpulent and content or will I be raging against time, trying to run marathons, looking like a hyperactive raisin in Lycra cycling like a demon up the Sally Gap in Co Wicklow, trying to prove something?
These are considerations which all of us will face in our own way at some stage in our lives.
In the past, the need to reflect on these issues was not so acute because lots of us more or less ‘dropped dead’. My grandfather dropped dead at 50-odd, when my father was 15. That was the way it was.
But this is no longer so likely as the demographics of our society change dramatically in the 21st century.
The medical difference between my father’s time and his father’s was that in my grandfather’s lifetime – the 50 years from 1900 to 1950 – life expectancy increased dramatically.
Vaccines, antibiotics and better medical care saved children from premature death and effectively treated infections. This was the case all over the western world. Once cured, people who had been sick largely returned to their normal, healthy lives without disabilities.
In my father’s adult lifetime, since the mid 1950s, increases in longevity have been achieved mainly by extending the lives of people over 60.
In 1961, there were 315,000 people aged 65 or over in the Republic of Ireland. At the 2011 census, there were 535,393, an increase of 70pc. This trend of an ever-ageing population continues today.
While the young population (0-14 years) was higher than the old population in 2011 – with 976,600 compared with 531,600 – this trend is set to change drastically in the decades ahead.
The switch-over from young to old is expected to start in 2036. This gap will move ever wider by 2046 when there could be 561,000 more older people than younger people in Ireland.
Even by 2021 (which is only seven years away) the number of elderly people in Ireland will have grown by 200,000 from the 2011 figure.
According to the Central Statistics Office (CSO) projections, based on estimates of fertility and mortality rates, the population could reach 6.4 million by 2046.
The numbers over 65 will reach 1.4 million by 2046. This older group will make up 22pc of the total population, compared with 11.6pc of the population today. I will be one of them.
While the number of children at primary school age will rise by up to 100,300 by 2021, the over-80s population will rise from 128,000 in 2011 to between 470,000 and 484,000 in 2046. In Ireland, by 2046 there could be up to more than half a million older people than younger people.
Male life expectancy has increased from 57.4 years in 1926 to 77.9 years in 2010, a gain of 20.5 years over the 84-year period; while females have seen a gain of 24.8 years – from 57.9 to 82.7.
This stretching out of life will continue as so much of modern medicine is focused on prolonging our time here.
There are all sorts of new genetic advances that will come on the market in the next few years, all of which are aimed at retarding the ageing process.
However, what if we aren’t really slowing the ageing process so much as slowing down the dying process?
And what will be the purpose of that? And at what stage do we say stop?
Typically, economics columns, when discussing the elderly, refer to the financial costs of an ageing population, about pensions and whether enough money has been set aside to provide for the old.
Economics conferences on demography host discussions about whether we should encourage emigration to supplement our falling population.
Yet over the coming years, we will realise that these concerns are the least of our worries.
The consequences of slowing down the dying process will lead to some of the most pressing moral dilemmas faced by our society – where the right to die will become as contentious as the right to life.