Speech to Age Concern
Thank you for
the opportunity to speak with you today about the topic you've
given for me: "How can we move beyond the perception that older
people are a burden on the health system?"
speech I will describe the challenge of health policy not being the
over 65s but the over 80s, and then touch on the significant
challenge that dementia, will present the public health
I would like to acknowledge Liz Baxendine,
National President of Age Concern NZ, Chief Executive Anne Martin
and Managers and all delegates who have travelled here to attend
In the New Zealand Herald this week was a
report about the United States' oldest federal judge who is still
delivering justice at the age of 103.
Judge Wesley Brown has presided over his
Wichita court room for nearly fifty years.
He arrives at court in a van that collects
him from his assisted living home and
steers his electric chair into the
Next to him, behind the bench, among the
court documents is his oxygen tank.
At 103, Judge Brown is the oldest federal
judge in America by only six years. There are another eight in
their nineties and more in their eighties.
Judge Brown values his job because he says
it gives him a reason to live.
As long as you perform a public service he
says you have a reason to live.
Living proof that older - even very much
older - people, do make a valuable and active
getting away from the reality our population is ageing.
Zealand in 1950 children under the age of five made up ten per cent
of The population, and people over eighty were just one per
the number of 80 year olds has quadrupled to 153,000 in
number will double again by 2030 to 300,000.
twenty years' time, it is predicted the two generational groups
will be neck and neck - one adult over eighty for every child under
five. The so-called population pyramid is becoming a
old are not so old anymore
conventional wisdom is the older we get the more likely we are to
suffer aged related illness or disability. And that coupled with
more of us ageing will crash public health systems around the
But there is
increasing evidence that the so-called burden of an ageing
population may not be as dramatic as people fear.
published in Science magazine late last year argues that
rising life expectancy and improved health means while there will
be increasing numbers of older people, physically, they will age
The American and Austrian authors say that
the current methods of predicting the impact of an ageing
population are wrong because they are based on chronological age...
and consider people as being "old" when they are 65.
say people are living longer healthier lives and, basically, "the
old are not so old anymore".
People are fitter, healthier and more
As a cyclist
I can vouch for the speed of some of the more senior members of the
And how many
65 or seventy year olds do we meet these days who we'd describe as
In 2006, one
in six New Zealanders aged 65 and over was in paid
That's a big
jump up from less than one in ten over 65 year olds working in
Science report is saying people can look forward to
fewer years of ill-health, much later in life and possibly for a
the expected tidal wave of older people dependent on expensive
health and welfare services may actually be more of a ripple - for
some time to come.
effects of getting older and healthier for longer offset one
This suggests that there may not be
unmanageable pressure due to ageing or end of life expenditure in
the medium term.
But we must still plan for the future to
meet the increasing needs of older New Zealanders.
Much of the
official analysis of ageing defines older people in terms of those
over age 65. Clearly this doesn't reflect the realities of ageing
today. In fact, more and more commentators suggest the age band of
focus should be considered at 80+.
One in four
people over 65 are aged over 80.
Yet, if you
look at the budget spent on those over 65, half the money spent on
health services for that population is spent on over 80 year
Over 80 year
olds use 76% of aged residential care, 70% of home based support
hours for over 65s, 63% of respite related care and 32% of all
elective surgery carried out on older New Zealanders.
50% of over
80 year olds are living independently - and two out of three of
them are women.
there is no need to panic about an imminent tidal wave of older New
Zealanders, we do need to prepare for shifting resources to support
the needs of our growing group of much older New
Zealanders…sometimes referred to as "the frail elderly".
are clear: we have a window of opportunity to plan and to get
ready, as demand remains relatively stable over the next few
With more of us living over the age of 85,
many more people are now living with dementia.
Dementia is a
severe and devastating disorder for both sufferers and their
families - and it is increasingly making itself felt amongst
Ensuring the health service supports people
with dementia will be very important into the future.
The number of people with dementia (of any
age) is expected to increase
considerably. Estimates show that the
numbers of New Zealanders who are living with dementia is
approximately 41,000; this is expected to increase to 77,000 by
The rates of
growth may be affected by various risk factors associated with
· A study
of more than 10,000 people showed that obesity was associated with
a 74 per cent increased risk of dementia 25-30 years later, while
overweight people had a 35 per cent greater risk.
· Previous work
has linked high blood pressure and high cholesterol with increased
risk of Alzheimer's disease.
factors may include physical activity:
· A study at
Johns Hopkins in the US found that people who engaged in four or
more physical activities, from gardening to biking, had about half
the risk of dementia compared with those who engaged in one or
· Time spent in
full-time education also appears to be negatively associated with
· Some research
has suggested a possible link between a reduced risk of Alzheimer's
disease and people with mentally demanding jobs
But as you know, there is no cure and the
best science can do is slow down progression. An Australian study
suggests that if the onset of dementia can be delayed 5 years, then
by 2050 there would be 50% fewer people with dementia than
PHARMAC's decision last year to fund its
first first-ever dementia drug enables thousands of people
diagnosed with Alzheimers or related types of dementia to have a
better quality of life for longer.
We also need to concentrate on making sure
people suffering from dementia receive quality services and live as
good a life possible- whether they live at home or in residential
Earlier diagnosis and earlier provision of
support will mean people will be able to stay longer in their homes
in comfort and safety.
One important way to achieve that is to
better support those who care for their older people with dementia
We need to be mindful of funding
limitations on the Government at this time of economic
We recognise, however, that to address the
upcoming demographic changes, Health of Older People will become an
area of investment for governments into the future.
The Government acknowledges dementia as a
key issue that for our country into the future we are committed to
working to ensure people suffering from dementia receive quality
services and live as good a life as possible - whether they live at
home or in residential care.
government is committed to protecting and growing public health
services - we have invested an extra $1.2 billion into health while
we've been in office.
funding more services and more operations for older New
We now have
over five hundred extra doctors and over a thousand extra nurses in
our public health service than we did two years ago.
Health Boards have been delivering more services to older people,
with record numbers of people receiving home support.
In the past
two years, we have increased the amount of home support being
provided by more than 12 per cent to around 9,200,000
delivering more hours to the people who need it most, and we will
be spending more money this year than we did last year.
the Government's work to help people stay in their own homes for
longer. That also means helping people to manage their own health
I look forward to hearing more from you
about the challenges you are facing and the opportunities you are
taking to improve the lives of the older people in your
Thank you for what you do.
I wish you well for the rest of your
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