Most people will probably be aware of phrases like the ‘demographic timebomb’, and ‘aging population’. Across the globe, there will soon be many more older people than younger, and it’s not only in terms of paying for retirement that this matters. Orange Healthcare has produced a nice little infographic to show the problem.
So what are the actual numbers? In the US, the ratio of older people to those of working age is thought likely to rise from 19.5% in 2010 to about 37% by 2060. The EU already had a higher ratio of older people to those of working age in 2010, at nearly 26%, and this ratio is projected to rise to over 50% by 2060. In both China and South Korea, the proportion of older people to those of working age is also expected to be more than 50% by 2060.
Orange Healthcare estimates that 66% of older people have two or more chronic healthcare conditions. Since 75% of all healthcare costs are related to chronic conditions, that means we all need to pay attention. Increasing numbers of older people will lead to increasing healthcare costs. EU age-related spending on healthcare is projected to increase from 25% of GDP in 2010 to 29.1% by 2060, and it is estimated that spending on long-term care could triple by 2050. And in a world where resources are increasingly tight, this means we need to find new ways to manage chronic conditions.
But there is good news
Providing care through hospitals is the expensive option. Orange Healthcare’s infographic includes evidence that ehealth can improve outcomes, cut hospital admissions by 50% and also shorten hospital stays by 50%. And 85% of patients said that they were satisfied with the ehealth services provided.
What’s more, over 80% of older people say that they would rather stay in their own home as they get older. There are already success stories about supporting people at home by using mobile and telehealth technology. For example, in France, home monitoring of kidney failure patients delays the need for dialysis by up to three months. 73% of older people in Europe say that they feel safer with an electronic alarm that can detect falls and call for help. And electronic prescription reminders have improved compliance with medication regimes from 48% to a massive 81%.
As more older people live further from their families, they can no longer rely on family care, but need the support of health services. And non-family carers need more information to ensure that they are able to provide the right support and medication. Use of technology also helps health service managers to plan services, including visits to vulnerable people, more efficiently. Family carers can benefit from the use of alarms and remote monitoring to allow them to run their lives while still keeping an eye on their vulnerable relatives.
But increasing the use of ICT also has a social benefit. There is evidence that improving use of ICT among older people (so-called ‘silver surfers’) reduces loneliness and isolation. The number of older people saying that they never felt lonely rose from 40% among non-internet users to 60% of internet users. Maintaining contact with family and friends, and feeling part of a community both reduce isolation. This is an important contributor to improving well-being, and therefore psychological health. And it’s generally agreed that this also contributes to improved physical health.
There are, of course, real barriers to use of technology to support older people. In the first place, many older people are not familiar with technology and prefer not to use it. The proportion of homes with access to a computer drops from 65% among those aged 55-64 to just 21% of those aged over 75. There are unresolved questions about the capacity of the network to cope with the increasing traffic likely to arise from use of ehealth devices, and also about the priority that should be given to medical use of the internet. And this is not as easy as it might sound, since social use to reduce isolation may be as crucial to good health as the streaming of monitoring information. Finally, the provision of high-speed internet services is good in urban areas, but may not be as reliable in rural areas, where many older people live. None of these are insurmountable problems, of course, but they do require co-ordinated action from governments, telecoms providers, and healthcare services to ensure that services are planned and delivered in a way that maximises the potential of technology to support improvements to health.