Chapter 5
You Are as Young as You Feel — Part 3
Many European countries still have mandatory retirement for workers in the public sector despite a large share of workers wanting greater retirement flexibility. In Japan, 43 per cent of workers aspire to continue working past retirement age, whereas in France, only 15 per cent consider this. Two thirds of EU citizens prefer to combine a part-time job and partial pension than to fully retire. In part, disparities in preferences for flexibility across countries are likely driven by various designs of pension systems. The level of pensions available at different ages and the gains from working longer play an important role in shaping workers’ attitudes towards flexibility. For example, limits to the amount that can be earned before pension benefits are cut reduce the incentive to work beyond the official retirement age. Yet individuals are not motivated to work longer solely by financial gain – doing so can improve life satisfaction. Surveys from several European countries and the United States have shown that workers over the age of 45 experience less stress and greater life satisfaction, on average, than younger workers. This holds for full-time workers, voluntary part-time workers and the self-employed. Being able to choose when to stop working is important and affects both life satisfaction and ageing perceptions. I have witnessed the sadness of colleagues, whose enjoyable work was thriving, suddenly forced to retire. Not only was this miserable for the individuals involved but also a great loss to their institutions and to society. In my view, mandatory retirement is ageist and discriminatory and flexible working choice is a more equitable policy. Unfortunately, mandatory retirement chimes with other negative societal attitudes towards ageing. Reported age-related stereotypes, commonly found in literature and in the media, depict older adults as physically weak, forgetful, stubborn and selfish, with a widespread consensus about these attributes occurring across different cultures and generations. And yet, according to the World Health Organization, there is little objective medical or psychological evidence to support these commonly accepted ‘truths’ about ageing. Only a small minority of older adults are physically, cognitively or mentally impaired. The majority are independent and enjoy a good quality of life, which continues to get better after 50. Moreover, negative attitudes about ageing result in social inequalities. ‘He told me I was too old for that’; ‘She assumed I couldn’t understand because of my age’ and ‘I was denied employment because of my age’ are just some of the examples of everyday ageism that 77 per cent of older adults surveyed in the UK reported experiencing. These negative attitudes extend to our social contacts. A 2018 review by the European Social Survey, taking into account the attitudes of 55,000 people across 28 countries, showed that the UK is riven by intergenerational splits, with half of young and middle-aged adults surveyed admitting they do not have a single friend over 70.
Chapter 1: You Are as Young as You Feel
Only a third of Portuguese, Swiss and Germans said that they have older friends. In ageist societies, older adults are consequently more likely to be excluded from social situations and have poorer employment prospects than younger counterparts, making it difficult for individuals to perceive themselves as youthful in this cloud of negative attitudes. Worryingly, in some medical situations, older adults are less likely to receive the same treatment simply because of age. This was graphically demonstrated during the Covid-19 pandemic when, in anticipation of an overwhelming need for intensive care beds and ventilation, some countries introduced a policy whereby patients over a certain age (in most this was 70 years) would not receive intensive care whereas other countries correctly based these decisions on the likelihood of survival and ‘biological health’, which is a reasonable approach. In the UK, the approach was ambiguous. Under the Equality Act, it is illegal to deny an older person access to healthcare on the basis of age. But a ‘frailty’ screening test was used across the NHS to determine who should be offered more aggressive treatment, with age making up 50 per cent of the frailty score and thereby biasing the assessment against older patients. Dave Archard, emeritus professor at Queen’s University, Belfast, argued that an ‘overburdened service is no excuse for discrimination that would result in a cull of older people’. He continued: ‘To discriminate between patients in the provision of care on the grounds of age is to send a message about the value of people. Such discrimination publicly expresses the view that older people are of lesser worth or importance than young people. It stigmatises them as second-class citizens.’ Catherine Foot, director of evidence at the Centre for Ageing Better agreed. ‘Chronological age must never be the principal factor that determines a person’s right to care. Medically speaking, it is a poor proxy for a person’s capacity to respond well to intensive care and to recover.’ The way we think about, talk about and write about ageing has direct effects on health. Ask yourself: are you ageist? Do any of the stereotypes we have discussed resonate with you? We will all grow older and if negative attitudes towards ageing are carried throughout life they will have measurable, detrimental effects on how people age, on how we age. If we want a more equitable society now and in the future it is incumbent on all of us to ensure that we do not hold ageist attitudes either towards our own ageing or that of others. All areas of society need to be aware of the danger of subscribing to negative attitudes. The media makers can take steps to avoid biased language when referring to age. Practitioners should check themselves for bias in treatment strategies. Researchers and policy makers should work together to encourage novel ways to reinforce positive attitudes. The good news is that change is coming because of the sheer number of people who are ‘coming of age’ and will demand societal equality. Enter the baby boomers, whose attitude towards ageing is different from their predecessors.
Chapter 1: You Are as Young as You Feel
Baby boomer is a term used to describe a person born between 1946 and 1964. The baby boomer generation makes up a substantial portion of the world’s population, especially in developed countries. After the end of the Second World War, birth rates across the world spiked and the explosion of new infants became known as the baby boom. During the boom, almost 77 million babies were born in the United States alone. Early baby boomers lived to 63 on average whereas later baby boomers can expect to live to 79. Thus, the high numbers coupled with the natural extension in lifespan means that baby boomers represent an influential growing ageing cohort. A large percentage of baby boomers will live up to 25 years longer than their parents did. Those retiring in their sixties can expect to live another 25 years, at least. This is the generation of Woodstock, flower power, hippies, greater access to education, liberal movements and new music genres. Their voices will be heard. Baby boomers have high expectations. With more wealth, better health and more energy, and their children now adults, boomers are more likely to be able to afford to spend their retirement fulfilling travel dreams and other bucket-list items. When they reach retirement age, boomers are increasingly likely to be healthy enough to run marathons, build houses and even start new businesses. When it comes to examining how different countries and cultures address ageing, we need look no further than Denmark. As a society, it behoves us to be aware that ageist attitudes infiltrate our very biology and that childhood circumstances feed into adult health and well-being and thus can have long lasting influences. Therefore, to achieve a more egalitarian society, childhood and old age are a priority and Denmark exemplifies such a society.
Chapter 1: You Are as Young as You Feel
The Social Progress Index evaluates the capacity of a society to meet the basic human needs of its citizens. It is based on an index of social and environmental indicators that determine the quality of life for that country. In short, the index calculates overall human well-being. It includes data from 128 countries on 50 indicators and, extraordinarily, Denmark has most consistently topped Europe’s happiness rankings for the past 40 years. Danish society makes it easy to live an interesting, fulfilled life, where age is respected.
Danes spend more money per capita than almost any other nation on children and on older people. Young people get an excellent education and healthcare. Equipped with a strong liberal arts education, Danes make productive employees. Adults spend little time worrying about retirement and focus more on pursuing the jobs they love and can enjoy their final years with the knowledge that the necessities will be covered. It’s a virtuous circle.
Danes employ an ‘ageing in place’ policy. Over 30 years ago, they started to close down nursing homes and to redeploy funds and human resources to enable people to stay in their own homes with support for health needs as necessary. The number of nursing home residents is therefore less than one tenth of that in Ireland, although the population differences are 5.3 versus 4.4 million respectively. For the small number of people who are in nursing homes, the care is delivered in houses with four or five ‘apartments’ and a central nursing pod. Couples can be together and if one dies, their partner can remain in the nursing home apartment – it is ‘home’.