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Paul Kendall: Making a virtue of age-old problem

Last year, the world reached an incredible milestone. In the Philippines, on Monday, October 31 -- Hallowe'en, no less -- the planet's seven billionth inhabitant was born.

But "Seven Billion Day", and its attendant hype, disguised a contradictory trend that threatens the wellbeing not of the poorest nations in the world, but the richest. For, far from exploding, the populations in the developed world, particularly Europe and east Asia, are rapidly ageing. In Japan, the ratio of people under 20 years old to those over 65 has plummeted from 9.3 in 1950 to a predicted 0.59 in 2025. In Italy, which has seen its birth rate crash in recent years, there are now only 1.3 taxpayers to every pensioner. By 2028, demographers predict a quarter of the nation's adult population will be over 65.

There's nothing wrong with people living longer, of course; it's what we all want, provided we can remain healthy. But the way countries treat their elderly populations varies enormously.

Less conspicuously, ageist attitudes -- completely alien to some cultures -- permeate day-to-day life.

Advertisers carry on as if nobody above the age of 30 watches television or reads a magazine.

Some progress has been made. But there is still a long way to go.

What do other countries do? Francesca Colombo is a senior policy analyst at the Organisation for Economic Co-operation and Development (OECD) and the lead researcher on a paper published last year which compared care provision across European and other developed countries. For her, any discussion of care has to start with the family. "Family carers remain the backbone of any long-term care system," she says from her office in Paris. "Even in countries which have a very developed, formal arrangement. We should never forget about them.

"We want them to continue to provide care because, if they don't, it would simply be financially unsustainable."

Anyone who has had to look after an elderly parent knows what hard work it can be. There's an endless round of shopping, cooking and cleaning to do, as well as helping them to dress and undress, take a bath or go to the lavatory. If you are trying to hold down a full-time job at the same time, the pressure can be intolerable.

Other countries have recognised this situation as a serious problem and introduced new laws to make it easier for carers to take time off. In Australia, there is a statutory entitlement to "carers' leave" which applies whenever an employee needs to care for a member of their immediate family. And in the United States, the 1993 Family and Medical Leave Act entitles employees to take up to 12 weeks of unpaid, job-protected leave per year for "specified" family reasons.

Other countries in Europe have even passed laws stipulating what a son or daughter is obliged to do for their parents. When 15,000 mostly elderly people died in a heatwave in 2003 in France, many were not discovered by their families for weeks. People were so shocked by the news that new legislation was drawn up soon afterward, holding children "legally responsible" for their parents' care.

To find real models of filial devotion. you have to go to Japan. The longest-lived race in the world, Japan holds its elderly citizens in extremely high esteem . Respect for the elderly is drummed into children from a young age. Families stick close together and older members of the family come to live with their children in their later years. It's just the done thing.

That makes care cheaper, of course, but Japan was also one of the first countries in the world to introduce a universal system of funding, by which the entire population contributes to a pool of money that is ring-fenced for long-term care. Statistically, there are plenty of people who pay into this pool who will never need to draw out from it, but nobody would ever dream of complaining, such is the value placed on old age.

And the result? A well-trained phalanx of professionals who administer high-quality care both in a person's own home and in well-resourced nursing homes.

Dr John Beard, the director of the Department of Ageing and Life Course at the World Health Organisation, believes these are the signs of a nation that truly values its older citizens. "Populations around the world are rapidly ageing, but when people talk about that they often talk about it as if it was a problem," he says.

"We accept that there are challenges with ageing, but we also see many opportunities. Older people are a very big resource for society, their families and the voluntary sector and the things we need to do, to liberate that resource is, first, ensure good health in old age and, second, make sure people live in a society that allows older citizens to contribute." In other words, putting an end to age discrimination.

In Bolivia the elderly are also cherished and made to feel involved. The same values apply in many other countries. In Scandinavian countries, too, a high priority is placed on providing care for people in the last years of their life. Sweden, where one in six citizens are 65 or over, is widely regarded to have the best long-term care in the world, funded by general taxation. Those with a pension make a contribution but it's not that high; the most anyone pays is around £90 a month. There is no question that tax payers feel it in their pocket. Sweden spends around 3.5 per cent of GDP on public collective solutions but it is a cost the people are happy to shoulder.

(© The Daily Telegraph, London)

Irish Independent