From an Ageing Society to a Longevity Economy

Old age is a natural fact that has its own characteristics like youth and maturity. What is happening today is that old age is being created, whether as a result of technology, medical progress, changes in the labour market or, in short, contemporary social changes. With the creation of old age, and the lengthening of the years between the cessation of work and death, an expansion that has inaugurated old ageism due to the awareness of the social defeat of the physically able, the issue seems to be shifting from the natural of functional social qualifications, and the social system has to ask itself the question of the solution of its problems. By creating old age, dependency has been generated. It is necessary, in successive stages, to rethink this new state and its consequences in order to reintegrate human beings into the community.

1.- We have repeatedly argued that a return to antiquity in the cult of the wisdom of the elderly is a mistake in societies where culture and skills for competence are acquired by way of texts. If there is a dramatic way to see the technological and cultural disengagement of the elderly, one need only look at the situation of those over 50 who have been made redundant and cannot find employment.

The pension systems mistakenly turn to them to grant them full passivities, thus confirming their uselessness in an essentially productive society.
Of course, among the elderly as a whole, there is a variable range of ways in which they need different conditions, services and policies. But the important thing to realise is that society has destroyed structures that assimilated old age ... and when they are missing, it is essential to create new ones that perform the same or similar functions. It is well known that the family can no longer look after them because it has shrunk or broken up, with the aggravating factor that women leave the home (now it seems that "everything" is or happens outside the home: from birth and important family celebrations to wakes) to work, unfortunately less as a matter of female liberation than because of the need to have two salaries for the satisfactions induced by the consumer society.

It would seem that the replacement structures for the family would be the network of services for the elderly living alone or the institutionalisation of nursing homes. The latter include private models that operate according to the rules of the market, replacing the affective family interrelationship with the service-versus-benefit link, thus expanding the centres of conflict. For the same reason, costs are rising at an alarming rate, both for family and public-social budgets, since the market must be used to satisfy the need for services and goods.

For social security, the increase in old age acts as a kind of pull factor for all its benefits (pensions, health, services, etc.), acting as a cost multiplier. This worrying scenario is aggravated by the characteristics of the needs of the elderly, who require immediate satisfaction and for whom long-term programmes are not possible. The presentist characteristic of contemporary society (without futures) is more present in the elderly.

2.- Elderly people who need care beyond a normal level are the most in need of social security services. The nursing home can be an institution that concentrates most of the benefits with immediate effectiveness. But they should certainly be regulated in order to safeguard the care of the residents and, what has been forgotten so far, their rights, as the elderly are often the subjects of abuse by the regents.

The network of rights and obligations must be guaranteed by exercise rules appropriate to the person's new reality. If they are placed within common rules, there is a danger of leaving them helpless, even if they are left without the assistance of relatives. Furthermore, one should think of "alternatives" and not reduce the actions to only the establishment and control of nursing homes. From a certain point of view, these institutions are nothing more than communities of old people where the ailments of old age are fed by accumulation. Although today's family is not in a position to assimilate the elderly when they have a high degree of dependency, it is no less true that there are intermediate states. There are legal or other families who are able to care for semi-dependent elderly people. This fact should motivate social policy-makers to implement forms of assistance (as in Austria and France, for example) to make it easier for them.

"A life is made with the future, just as bodies are made in a vacuum". (J.P. Sartre: "The Age of Reason", p. 22).

3.- On the other hand, preventive action should not be forgotten, which may come as a surprise in this area but is nonetheless real. There is a sufficiently widespread problem of old age which highlights the feeling of uselessness and lack of future of the elderly person, which ends up placing them in a situation of risk to their autonomy. When this situation worsens, the destiny is to be placed in a nursing home which, due to the current characteristics and modalities of these facilities, increases dependency.

Consequently, there is a sector in continuous growth that needs a different type of policy. Today it is being thought that after having obtained retirement for the tasks performed by the individual since his or her youth, a second profession should be started(1) . This new profession would eliminate the feelings of uselessness and lack of future. Perhaps this is the thorny issue of the shaping of the identity of the elderly person, but it will be necessary to confront it, however difficult it may be. We should not work on what we have lost but on what we are and what we can be.
In any case, we believe that contemporary society is bringing about changes that will facilitate this new vision of old age. Today there is greater mobility of professions and it is estimated that people will change occupations or specialities three or four times in their lives. Couldn't social policies concentrate their efforts on these trends by designing plans for non-dependent older people? Couldn't intensive action in this field even put an end to certain hospitalisations? As we are optimistic, we think so, but public support will be necessary to balance the market interest that has entered geriatric institutions.

It is perhaps too harsh to disqualify the activities currently favoured by senior citizens' groups, although we do not know whether they are induced by those who are not. They are generally reduced to tasks of superficial pleasures, generating a certain against-the-grain activism that ultimately smuggles life. Doing for the sake of doing, or just distraction, ends up boring and, what is worse, making us aware of the so often repeated uselessness, which is a way of dying, or of defeat in the face of the life offered to others.

4.- We intend to get involved in the conception of Social Policy for the elderly by configuring a new working hypothesis: on the basis of the physical extension of the prolongation of existence, to break the limits of this mere natural consideration in order to find the meaning of people over a certain age, placing the emphasis on social integration and functionality.

The situation of the so-called elderly is not determined by the simple fact that they are a certain number of years old. What happens is that from a certain age onwards, people usually give up their usual and normal tasks, family functions are reduced due to the independence of children and they often lose the partner who has accompanied them for many years. This means economic, social and emotional consequences. However, today's society seems to have the same characteristics for most adults since, as we know, children bring forward the abandonment of the parental home, jobs are not so stable, the acceleration of scientific findings that are transferred to technology makes individuals quickly become functionally obsolete and couples have a significantly shorter duration, making temporary unions habituating. Hence, the individual constitutes his or her relationships with peers in a plurality of opportunities and spaces and not only in a geographical or working environment. Lifelong friends and partners are no longer the norm.

5.- If old age is often associated with negative values, such as poverty, dependency and segregation, it is necessary to analyse the factors that led to this and whether they will be the same in the years to come.

Our current social context may soften some factors of old age, as the loss of friends, partners and children does not seem to be as shocking as in the past. But the idea of this stage of life in which many important things have come to an end and for which the individual has been preparing since his or her youth is absent. But why even talk about completion? In this absence of identity, the cost of social protection for the elderly has increased and will most likely continue to increase. This "population trap" is a paradox of rising welfare and quality of life that at the same time leads to more accidents, disabilities, degradation and human obsolescence. Within this social development with negative consequences, perhaps now is the time to act on the causes and their redefinition in societies changed by welfare itself, and not only on the effects valued according to outdated structures. "In a world in which policies used to compensate some groups to accept the costs necessary for the progress of others, in short, to cure symptoms rather than prevent problems, the continued growth of social spending should be much less of a surprise than it generally is. Consequently, as long as policies continue to be inspired by principles of reaction rather than prevention (i.e. tackling problems that have already arisen), the 'welfare stopper' is likely to continue to exist and the 'war' on destitution and inequality is destined to fail" (2).

Within this possible framework, the approach to old people's homes or institutions for the elderly will have to have other perspectives. If social policy tackles the problem with preventive attitudes, institutionalisation will be an extreme matter of last resort, but with rehabilitative functions, both social and productive. This is the hypothesis on which we have placed ourselves in order to follow the path we have started today.

1. To raise awareness among governments so that they promote preventive public policies that guarantee healthy longevity.
2. Public authorities should guarantee integrated health and social care when a person's intrinsic capacity begins to diminish in order to prevent/delay as long as possible the appearance of situations of disability and dependence.
3. To also raise awareness in the business sector to keep older persons in their jobs as much as possible, which not only benefits the person's state of health, but will also contribute to delaying situations of dependency and minimising the costs of social and health care.
4. Encourage the participation of older people in the formulation of policies that affect them, while drawing on their knowledge and experience for the benefit of younger generations and society as a whole.

1. Education for the financial coverage of a long period, difficult to cover by the public pension system, through actions to promote savings from a young age, both in the public and private sectors. (See the contributions of Thaler-Sunstein and the aforementioned Professor Valero.

2. Adaptation of the labour system (not only legislative, but also functional) to allow the design of "jobs" suitable for professional collaborations beyond the legal retirement age. There is, in my opinion, an undeniable win-win (society-individual) in the contribution of experience.

3.Creation of social organisations oriented towards the study of these formulas and towards the reception and promotion of people who can/want to join this model of "active retirement".

¿Saben cuántos odontólogos geriatras tienen en cada país? ¿Cuántos oftalmólogos geriatras, traumatólogos, rehabilitadores físicos, terapistas, enfermeras geriátricas, auxiliares de enfermería, camilleros especializados en cargar y desplegar ancianos? ¿Cuántas bancas de parques están preparadas para no herir el cuerpo de una persona de 75, 80 0 90 años? ¿Existen parantes, coderas, barandas de apoyo en las esquinas para que se sostenga en un brazo con el bastón y en otro, en ese punto de descanso un anciano que camina sin ayuda y se cansa al caminar? ¿Existen botones de emergencia en las calles o plazas, en las puertas de bancos tal vez -no sé, digan ustedes dónde- para transeúntes ancianos que requieren ayuda porque les viene un infarto? ¿Saben si en las estaciones del Metro tienen ascensores para cuatro o más sillas de rueda en simultáneo?

Me perdonan y por eso les hago la reflexión un poco injusta, pero la pregunta es para Lima, Quito, Bogotá, Caracas, Sao Paulo, Boston o New York. No sabemos las respuestas porque no hemos pensado en el futuro, sino en el bolsillo inmediato, el de corto plazo, como si la jubilación o la longevidad fuera, contradicoriamnete, para un corto tiempo, y no es así, no va a ser así.

La respuesta es #InfraestructuraParaLaLongevidad y eso es lo que estamos trabajando en el Instituto del Ahorro: un horizonte con esperanza para la longevidad. Por eso, aplaudo su artículo, porque sienta bases y obliga a reflexiones, a ser complementarios en cada paloabra y acción, por todos.