Ageing and Society

This BBC Podcast is supported by ads outside the UK. Fall flavors are waiting for you at Whole Foods Market. Cozy picks all through the store, like maple leaf cookies from 365 brand. Swing by the bakery for pumpkin cheesecake, here for a limited time, and pumpkin turmeric bread freshly baked every single day. Sip the season with 365 brand cinnamon spice coffee and pumpkin spice creamer, while you still can spice up fall at Whole Foods Market. Why does the world want American surrogates? I'm Asma Khalid and I host the Global Story Podcast from the BBC. Paying someone to carry a pregnancy is banned in most of Europe and large parts of Asia as well. But here in the US, business is booming, though as the popularity has grown, so too has the public debate around the ethics of it all. For more, listen to the Global Story on BBC.com or wherever you get your podcasts. This is a thinking-allowed podcast from the BBC and for more details and much, much more about thinking-allowed, go to our website, thebbc.co.uk. Hello, when I was teaching sociology to first-year university students, I from began by trying not always successfully to extend their awareness, their sensibility towards others. Look, try to imagine what it feels like, I'd say, to be someone of your own age who's less fortunate than yourself, who's been brought up in a broken home, become addicted to drugs, being locked away in the young offenders' jail. It wasn't always an easy task, but I was helped in my endeavors by the well, the numerous ethnographic studies of such young people by sociologists about their ways of coping with their circumstances, their possible roots out of misfortune. Well, in today's programme, I will, however, not be revisiting this relatively well-reserved area, but attending to what my first guest today has described as a less well-documented, less visible, less dramatic feature of life in the UK, the quiet fear of poverty amongst older people. That guest who now joins me in the studio is Kingsley Perdom, who is reader in social statistics at the University of Manchester, and a leading consultant on civic society, citizen involvement and policymaking. Now, Kingsley, I've cited a phrase which appears in the sight of one of your research papers, the quiet fear of poverty among older people. Tell me what you're trying to capture to encompass with that phrase. Well, I think the common perception is that older people are living the life of luxury, and this oversimplifies the high levels of poverty amongst older people. When we say older people, we might think of people over a time and age in the UK, although age varies by context, and so there's around two million older people who live in relative income poverty, and there's a number of measures that can be used to check the accuracy of that. There's deprivation measures, there's quality of life measures, but the common perception is that older people aren't struggling, and so we decided to look at this population through survey data and qualitative research, and we came across older people who were really struggling with their weekly budgets, and some of the interviews were we conducted, and the focus groups were very moving, and so older people, one interview we talked about how she felt like it's older people don't exist, and another interview we talked about how when you're older, no one wants to know you. I can imagine that people can begin to have these feelings, but are they, in all cases, rational ones, or is it just an emotional perception? There's not necessarily accurate. Well, there's some stark inequalities as we age, Laurie, and they reflect the inequalities in society more widely, so these are robust estimates of older people who are struggling financially, and so what motivated this research was back in the mid 2010s, we were doing some research on children using food banks, and we came across older people in those cues, and that was really shocking for us, so we decided to look at some of the evidence and also conduct our own research into the everyday lives of older people in the UK, and there's some striking stories of how older people might not be protesting, and also might not be applying for the welfare benefits fits their entitled to, so they're living a quiet life of struggle. We're not just talking about income here, are we? No, it cuts across different aspects of life, so issues around affordability of things in your daily life, but there's a huge unmet care need amongst older people in the UK, so whilst we have debates about the cost of the triple lock, we also have something called a triple threat to older people, of course there's a limit to public spending, but it's about how that public spending is targeted, because a lot of the benefits available to older people, such as pension credit, which there's been debates about in the news, I think only about 63% of eligible people claim pension credit, and so they're missing out on those benefits, and also pass-bought benefits such as help with other aspects of health care and other housing costs. When you look at this, you talk about the way in which people describe their circumstances, it's very interesting, I found, to see the number of people who express concern about others, who are really items of our people, are concerned themselves, but they talk about needing to do something else for other people, because I can manage that type of vocabulary. Yeah, this is an aspect of self-sacrificing, or not recognising being in need, and we might know that from your own family networks, where you ask your grandparents if they eat, and then they would say yes, and perhaps they haven't eaten as well as they tell you they have, so there's lots of hidden aspects older people in our research, didn't really want to reach out for extra help, but they also didn't know where to go to for that help. There was also a lack of trust in public services and welfare support due to issues, say for example, someone in their network might have been a victim of fraud, so there's some graphic examples of an older person being tested on the telephone for, I think it was around £7,000 to fix their washer, or this person on the phone was going to call the police, and this creates a barrier between older people and the services that are there to help them. There's a bit of a paradox here, isn't there, because if we say, well, we could rectify the situation by increasing the benefits, it's not necessarily a solution, because in many cases, people, these people don't claim the benefits they're entitled to. Well, if we go back to beverage, Laurie, and I'm sure you remember the founding of the welfare state, he was very concerned about the unintended consequences of mean-tested benefits, but the issue here is getting the right benefits to the right people, so we know there's around two million older people relative income poverty, large numbers of older people living in deprivation, so it's about using their more up-to-date data and evidence to try and target those people, so as beverage identified, there can be some unintended consequences to mean-tested benefits, and quite often the most vulnerable people face the most barriers to claiming, so in our research, there was evidence that people did not want to risk losing what they had, they didn't want to answer lots of personal questions, the forms were too complicated, they felt like they didn't want to ask their families for help, because a lot of older people don't want to let their families know that they're in financial difficulty. I mean, I speak from someone who's always had difficulty navigating my own way around some of the stuff that's online now, but is there any particular part that's particularly tricky to navigate for these people that they refer to, we might do something to make it easier for them? Well, the research on means-tested benefits and take-up goes back to the 1980s, and different experiments have been tried, but in summary, it's face-to-face support that really helps older people claim the benefits they really need in our entitled to, and we need to remember that older people have paid into this welfare system through their work-in-lives, and this is a challenge to the debate where some people think that their support for older people is too expensive, but forms for such things as pension credit are quite complicated, they're long, there's more than 100 questions, there is telephone support, but there isn't so much face-to-face support, and I think this is what older people are asking for. And there are some concerns that your paper makes clear by these people that they might, if they apply for benefits, that might have adverse effects upon them. Well, I think it's that's a aspect of human behavior, and this also links to not recognising being in need. It's almost a make-do with what you've got to approach, but unfortunately, as we know, there's a strong correlation between low-income and poor health. And so there's follow-on effects for those older people who are trying to manage their health perhaps not saying to their doctor they feel and well or not saying to their doctor they're not eating as well as they could or not telling the families they have serious concerns about their financial circumstances. Let me ask you about wider consequences. You've been talking about the gaps in provision for older people, some of them self-informed. What happens if these gaps aren't addressed? Well, we've got stark inequalities in the UK if we look not only at life expectancy between areas. So those people who are living retirement in poverty are living perhaps a decade less. But there's also a huge gap in healthy life expectancy, how long you expect to live healthily. So that has a follow-on cost to the welfare state to the NHS. If older people aren't eating well and they become unwell then went on arrival in hospital. Their condition are more complicated and they spend more time in hospital. You've done a great deal of work on this, a great deal of important work. So I have to ask you the question, what does all that work suggest to you about the ways we should rethink our approaches to aging and welfare in the UK? Well firstly I think societies should view aging more positively. Imagine if we looked around and there were no older people, how do we feel about society? But we've also got to target those vulnerable older people. And when we think about the costs such as a triple lock, that needs to be targeted at vulnerable older people. Those two million people who were estimated to live in relative income poverty and particularly older women. As we know older women outlive men and it's older women living on their own, struggling financially with the health that should be really targeted with support. As part of this much more positive approach to aging, whether it's how old people live, where they live, what sort of communities they live in, what sort of housing they live in, are they supported housing? Much more positive approach to aging because as we know, aging population continues to grow. Thank you for the moment. You may remember that after a recent discussion about suicide on this program, I had to apologize for using the phrase "committed suicide", recognizing this was a quite inappropriate phrase to use at a time when suicide was no longer a criminal offense. And I'm also grateful to another listener, Richard Pryor, for correcting the impression that the reasons for suicide were necessarily complex and long term. And to make his point, Richard said me this, "I found it rather wonderful quotation from Anthony and Arto's study of Van Gogh. There are some temperaments who, on certain days, would kill themselves for a simple contradiction. And for such a thing to happen, there's no need to be a marked and listed madman. All the contrary, it is enough to be in good health and have right on one side." Fall flavors are waiting for you at Whole Foods Market, cozy picks all through the store, like Maple Leaf Cookies from 365 Brand. Swing by the bakery for pumpkin cheesecake, here for a limited time, and pumpkin tumeric bread freshly baked every single day. Sip the season with 365 Brands Cinnamon Spice Coffee and Pumpkin Spice Creamer, while you still can, spice up fall at Whole Foods Market. I'm Asma Khalid, and I host the Global Story Podcast from the BBC. Paying someone to carry a pregnancy is banned in most of Europe, and large parts of Asia as well. But here in the US, business is booming, though as the popularity has grown so too has the public debate around the ethics of it all. But I must now turn to those who may still love life, have no thought of ending it, but because of their age find it increasingly difficult to manage. But as I'm now about to learn, an even more pertinent question might be how exactly is society in general going to supplement such self-help? How might people remain active, productive, independent, and socially connected for as long as possible as they age? Well, for answers to such questions, I turn to my next guest. She's Judith Phillips, Emeritus Professor of Aging and Dementia at the University of Sterling, and she led the UKRI Social Behavioral and Design Research Program under the Healthy Aging Challenge. What was that project? What was that challenge? What was it set out to do? Well, Healthy Aging Challenge was designed to address some of the inequalities that you've just been talking about, and particularly in healthy life expectancy. The fact that over the last century we've been living longer is really to be celebrated, but not all those extra years are spending good health. I mean, if we look at the research, the average life expectancy has risen to 81 years of age, but healthy life expectancy is lower at 62 years. And life expectancy and healthy life expectancy varies starkly across the UK, different areas, with many people in deprived areas spending more of their time in poorer health. The Healthy Aging Challenge was really looking at these things and was aiming to add life to years rather than years to life. Was it in one area you were looking at specifically yourself? Yes, this was a 98 million pound investment from government, and it was a huge programme of work to stimulate innovation and research. And the main aim was to stimulate a nascent age in market with the aim of incentivising business, bringing business and social enterprise on board to develop product services and processes to enable people to actually be independent, socially connected and engaged. And research, the research programme that you mentioned, social behaviour and design research programme, was one of many initiatives in the Healthy Aging Challenge, which aimed to do this, to bring together business, other sectors, a variety of disciplines, to really look at stimulating this aging market. I imagine rather similar schemes have been set up in the past. Did this differ? Was there something new about this approach? Yes, well there's been very long established programmes of aging research funded through UK research and innovation primarily, but also charitable bodies. But this was actually quite a different research programme under the challenge. Twelve projects were actually funded and ranged quite widely from things like maintaining health at work, designing age-friendly homes, creating active places, supporting social connections, living well with cognitive impairment. And I guess the difference between this and previous programmes was that there were particular elements such as co-production with older people, which was central to all the projects. And all the projects were mission-driven, so this is research that brings together multiple disciplines and stakeholders to address clearly defined problems with measurable outcomes. Let's get down to specifics. Let's look at the housing sector for example. What was the research looking at? The housing was a big part of the challenge and we had several projects involved in housing. And to look at the importance of this I think it's worth saying the home is very much the centre of gravity as we age. So as our radius of movement can shrink the home is really important. So how it's designed is really important and design was also another key aspect of this programme. So we needed design homes that support the physical cognitive and sensory changes associated with aging because the home is, as I said, very central and it needs to encompass us as we age. So we had a project led out of the University of Stirling and this was looking at a house design in relation to older people and how they navigated around the home. So we were looking at, for example, if I take the kitchen as one area, it was looking at design principles of how the kitchen was laid out, the use of drawers rather than cabbards, the importance of high levels of light, the importance of colour in the kitchen, which sometimes can be less important in contrast. We used a VR headset with a number of people and bear in mind this was done during Covid so we couldn't be with many people using the headset. 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For more, listen to the Global Story on BBC.com or wherever you get your podcasts.