Old age, but not as we know it

It was good to read about the dementia debate in Parliament last week, called by the former Health Minister Paul Burstow MP.

Although there will be differences of emphasis and sometimes policy between the parties, I take heart from the evidence that all three main parties recognise that “doing something about dementia” is a priority. Dementia is past being the darkness that dare not speak its name, and past being the clichéd elephant in the room. It is now being talked about in many forums, including Parliament, and there are people like Mr Burstow who are prepared to make others return to the subject time and again.

The debate was closely followed by the Government’s announcement this week of reforms to the state pension. Their close proximity was coincidental, but they have a common cause. Because we are generally living longer, old age needs to be reinterpreted and planned in a new way.

When 65 was first set as the retirement date for men (60 for women), the numbers of people living deep into retirement would have been relatively low. Changes to pensions policy have been inevitable for some time because we now expect to live to 80 or more, and that is expected to increase.

This is the same increase in life expectancy that means that there are far more people in the age groups that are at high risk of dementia. There are therefore far more people with dementia.

Just as we can’t expect pensions provision from another era to work in the 21^st century, neither can we expect the NHS, social services and everyone else to cope with the rising number of dementia patients on the basis of out of date thinking and statistics. For example, with more dementia sufferers overall, there are inevitably greater numbers of them in our hospitals, admitted for reasons other than dementia.

While dementia has always caused suffering to individual patients and those close to them, rising numbers make it a problem that society is struggling to manage. It seems callous to reduce suffering to numbers, but these numbers matter. One new case every seven seconds is a lot of people, as is 36 million current cases worldwide. £23 billion cost to the UK every year is a huge blow to our public services.

We should not hesitate to provide the best possible care for everyone with dementia, treating them as every bit as important as other patients and dependent people. However, part of the purpose of dementia research is to reduce the numbers, with and without currency signs, so that fewer individuals suffer and our public services can cope more easily.

This is a changing world and woe betide us if we don’t prepare for it, even at this late stage.