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Who
are the “older people”? In this article,
older people are those aged 65 or over. In 1998, it
was estimated that in Northern Ireland 219 500 people
or 13% of the population were within this age range.
(Northern Ireland Research and Statistics Agency,
1999) Ageing is truly a global phenomenon.
There
are currently about 580 million older people (aged
60 years and above) in the world, with 355 million
in developing countries. By 2025 the corresponding
figures will reach over 1.2 billion and over 700 million
respectively. The sharp increases in life expectancy
have been followed by substantial falls in fertility
worldwide in both developed and developing countries.
By 2020 one in four European Union citizens will be
aged 60 or more. In Northern Ireland between 1900
- 1995 life expectancy for men rose from 47.1 years
to 72.7 years and for women from 46.7 years to 78.3
years.
It
is estimated that in the 1996-2036 period, the percentage
of the population in Northern Ireland aged 65 or over
will almost double from 13% to 24%. This increase
in the older population together with lower fertility
levels means fewer people will be working to generate
resources to meet the needs of an ageing population.
This has caused panic and scare-mongering in some
quarters concerning society's ability to cope with
the change. On the positive side it has assisted in
moving issues about ageing from the periphery to the
centre of political debate. What are the central issues
affecting the social and economic conditions of elderly
citizens?
The
UK is the world’s fourth richest country, yet
more than two million pensioners live below the poverty
line. A third of pensioner households lived in poverty
in 2000. The majority of those aged 65 or over are
in receipt of a state pension. The basic pension is
£77.45 a week and £128.80 for a couple.
The value of the pension has decreased by some 25
pounds since the linkage of pensions to average earnings
was broken in 1979, and is now seen as not sufficient
to live on, so a ‘minimum income guarantee’
for older people has been introduced. Accordingly,
if an older person passes a means test then they are
entitled to an income support top-up or ‘minimum
income guarantee’ from the state. In 2000/2001
the minimum guarantee is £78.45 per week for
a single person and £121.95 for a couple. Those
aged 75 or over, or disabled will receive a higher
amount. Another interesting fact is that in Northern
Ireland, one in four people aged 60 years or more
is in receipt of income support, whilst the percentage
of older people entitled to Income Support but who
do not claim it is 33 percent. The number entitled
to Housing Benefit but who do not claim is 18 percent.
In
Northern Ireland, the material depravation of older
people is very marked in terms of fuel poverty. Problems
of fuel poverty in Northern Ireland are more severe
than in other parts of the UK. A common definition
of a fuel poor household is one in which the occupants
need to spend in excess of 10% of their income on
fuel to maintain a satisfactory level of heating.
The Department for Social Development has noted that
the over 60s have the worst health risks, are least
likely to move out of fuel poverty through increased
income and are the most likely to live in dwellings
with the lowest energy efficiency. Some of the most
unfit properties are in the section of the private
rented sector which is subject to rent control. For
poorer older people, this is a particularly difficult
situation as the landlord is receiving very little
rent and may not feel it worthwhile improving the
property.
Older
people face also problems in the health system. A
big issue is waiting lists. There are a higher proportion
of people on waiting lists for hospital treatment
for more than twelve months in Northern Ireland compared
to Britain. But more worrying perhaps is the differential
treatment they have to face. Older people comment
that they sometimes feel that they are treated less
seriously in relation to the treatment offered to
them because of their age. This can range from the
types of medication offered to the ‘do not resuscitate’
notes which have been found on medical files. Older
people face age barriers to screening programmes and
treatment options in the NHS which are not supported
by clinical evidence. Examples include screening for
breast cancer, operations for cataracts and hip or
knee replacements, access to specialist care for stroke,
coronary care and treatment for depression or addiction.
Over
half of the personal social services expenditure per
annum in Northern Ireland is spent on older people
(over 65 age group), and a lot of it is spent on social
care services (services such as assistance with cleaning
and laundry and personal care services such as assistance
with bathing and taking medication community nursing,
therapy input and aids and adaptations to the home
etc) . The problem is that vulnerable people are not
being sufficiently supported in their own homes and
that there has been a reduction in home-based care
packages for the elderly since 1995. Local authorities
impose upper limits ("ceilings") on what
they are willing to pay for an older person to be
supported at home or in residential or nursing home
care, which are lower than those for younger adults.
Charging for care impacts most heavily on older people
because they are the major users. One of the consequences
of the charging system is that people who are being
given financial assistance from social services are
required to pay over the majority of their weekly
income towards the fees, leaving them with a personal
allowance of £15.45 per week to cover toiletries,
clothing and other personal expenditure such as birthday
presents, magazines or cigarettes. A report by Age
Concern Northern Ireland found that many older people
feel that community care, while welcome, has been
undermined in practice by a lack of funding.
While
there are several international instruments protecting
and promoting the rights of older people, the Northern
Ireland Human Rights Commission found in its 2001
report (“Enhancing the Rights of Older People”)
that laws, policies and practices in Northern Ireland
still discriminate directly and indirectly against
older people in the enjoyment of their human rights.
The extent of discrimination tends to be hidden because
of an absence of research especially in relation to
the health care system. The fact that by 2036 over
24 percent of the population of Northern Ireland will
be over 65 years of age calls for urgent action.
Quantitative
information taken from the websites of:
Help
the aged NI
Age
Concern NI
NIHRC,
"Enhancing the Rights of Older People"
(Word document)
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