Ours is an ageing land. A quarter of Scots today are 60 or older. Children under 14 account for a scant 16 per cent of the population. The tax base, our population still in employment, contracts annually.
And yet care for our ageing parents is something many of us do not want to do, a conversation most families studiously avoid, and an economic, demographic and social time bomb that must inevitably go off.
Even as an increasingly confident lobby pushes for – bluntly – legalised euthanasia, amidst a welfare state established over a century ago and on rather old maths.
In 1909, the Liberal government of the day sensationally introduced the old age pension: five shillings a week, once you turned 70.
But it was a happily hedged bet: back then, our typical life-expectancy was 52. By 1948, when the National Health Service was created, it was 66 for men and 77 for women.
Scotland has a growing elderly population which is storing up problems for the future
Today, it’s 77.8 and 82.8. But many of us live far longer. Late in the Great War, King George V started sending congratulatory telegrams to subjects celebrating their 100th birthday.
In 1917, he needed to wire only 24. In 1952, when his late granddaughter assumed the throne, there were 273. By 2014 – the relevant office in the Palace had to hire extra staff – some 7,500 cards were sent: today, it is more than 10,000.
‘The first person to live to 150,’ crowed biologist David Sinclair in 2015, ‘has already been born…’
Some 6.5million people in Britain are ‘informal carers’ for one or more relatives. Usually, parents. Experts joke of this ‘sandwich generation’ one in five of those between 50 and 64, coping with their old folk even as they raise their own sprogs.
One in three informal carers is over 65 and not a few, incredibly, are over 75 – a 35 per cent increase since 2001.
There is also marked, bricked-in gender discrimination – 59 per cent of carers are women, according to 2021 Census data collated by Carers UK – and there is still lazy expectation that care for mum and dad is the immediate responsibility of your sister, especially if she is unmarried.
No one who has never done it has the least idea what minding, round the clock, an elderly parent is like – especially if they are failing, increasingly confused, and dying.
My late father was not the easiest of personalities: I am emphatically no angel.
And, in hindsight, the last months of his life have a nightmarish hue: the constant arousal from bed to spoon out morphine, the building dread that filled the house, the sustained retreat from life – from New Year 2023 he refused to sit at the dining table – and a host of dark, strained memories best kept to myself.
One Saturday, shaken by the latest pointless psychodrama, I left my mobile on the sideboard, nipped to a distant supermarket, and roamed its grounds for two or three hours just to be beyond his reach.
Not four weeks later – and it was as much a surprise to him as it was to us – he was dead.
Carers are twice as likely to suffer from mental health problems than the rest of us, according to the 2011 Census.
In a 2021 GP Patient Survey, 60 per cent reported a long-term health condition or disability compared with 50 per cent non-carers.
Over 29 per cent feel lonely often or always, say Carers UK, and Public Health England now calls for caring to be made a social determinant of health.
They are especially vulnerable to fatigue and breakdown, and real discrimination in the workplace, especially when – and for the best of reasons – they have stepped back for a year or three to look after mum and dad.
One woman, Chrys Stevenson, tended her mother for 12 years after a diagnosis of Alzheimer’s.
Through her caring years she dealt with panic attacks, hypervigilance and exhaustion. ‘After she died I went to bed for six months,’ Chrys recalled. ‘It’s been four years now and I’ve only just recovered.’
Six hundred people a day leave work to tend their elderly, asserts Care UK. And, in time, struggle to return.
Ming Ho, 58, was an Oxford contemporary of David Cameron and Michael Gove. ‘Back then, my future looked as bright as theirs,’ she recalls.
By the 1990s Ho was a script executive working on multiple primetime TV dramas.
But as an only child of a widow, Ho had to shoulder full responsibility for her mother’s care.
‘After a decade of missed opportunities and life chances while attending to mum’s needs, I have found myself single, childless and with virtually no savings. I am having to start again,’ she remarked in 2017.
But one in five people over 50 have no children, and a million have no adult offspring in the UK – a figure expected to double by 2030.
There is still another complication. As our parents live longer and longer, our generation is marrying later and later. In 1972, the typical bridegroom was 27; the bride was 25. By 2020, these ages were respectively 40 and 37.
That has two implications – much smaller families, and that our parents start forgetting things and falling down stairs just as our offspring hit door-slamming adolescence or leave for university.
A major driver in this is the ever more distorted housing market. It has had another consequence: of necessity, both man and wife are now in full-time employment.
There are very, very few surviving full-time housewives in a position to mind granny.
Which is hardly auspicious for that difficult conversation: one we often tried to have with my late father, especially after his 2010 retirement.
He was then a vigorous 70 and we had high hopes he and my mother would quit their Edinburgh townhouse, complete with Esheresque stairs and abundant trip hazards, for a pleasant Lewis bungalow.
But the trouble with the difficult conversation is that when parents are spry and well they seldom want to have it.
According to a 2021 Home Instead UK survey, 17 per cent are unwilling to discuss their inevitable frailty, 25 per cent become upset, and 24 per cent become defensive and cross.
With the result that when our elders finally move in with us, or wilt into a care home, it is usually in the wake of widowhood or medical emergency, the decision is of necessity rushed and the chosen establishment often turns out to be unhappy.
Care homes are a recent development. The poorest looked after their elderly themselves and their lives tended anyway to be short.
The prosperous had servants – in 1914, if you had £200 a year, you could afford a maid; few then saw their 70s and, in the pre-antibiotic age, were usually borne to eternity by such infections as pneumonia.
Eventide homes are largely the creation of the Great War: not merely, half a century later, all those widowed and childless women, but women whose potential spouses had fallen on Flanders field.
Most my age can remember all those dainty, fluttering old maids: in my Edinburgh church alone, the Misses Anderson, the Misses MacAskill and the Misses Niven, in their hats and gloves and calf-length skirts.
They were delightful, gracious ladies, but of necessity they all fetched up in this Shady Pines or that and thus normalised institutional care as an option.
For old folk, 40 years ago, it still had terrifying connotations of the poorhouse, and when I moved to Harris in 1993 there was much local pride that none of the residents in Tarbert’s eventide home had a first-degree relative on the island. It is still thought shameful in some of our ethnic communities.
But further Home Instead UK polling shows 28 per cent of us worry that our ageing parents are not currently safe living on their own, and most of us feel the sapping tension of trying to eliminate all risk – which is impossible – while still allowing mum the ‘agency’ vital for her self-respect.
I allowed my father, for instance, to carry on driving, months after it was obvious he was past it: that would have been an appalling conversation and would have poleaxed his dignity.
But 40 per cent of us in 2021 told Home Instead UK they would not countenance letting an elderly parent move in – though 73 per cent would feel guilty about putting them into care.
There is not enough space, say 60 per cent and 28 per cent plead that they and their partners are too busy with work. And 15 per cent say flatly that their partners forbid it.
If this sounds heartless, in reality elderly parents are not always easy personalities. And this in the context of parents still continent, in full possession of their wits and able to dress themselves.
Once you are dealing with dementia – and especially if it comes with terrifying personality changes or determined bids to escape – it is no wonder 27 per cent of us, three years ago, confessed to Home Instead UK they did not feel qualified to give the level of care their parents need.
Along with the fear you may end up as the exhausted primary carer, the odd sibling dropping by now and then to patronise you all.
As of March last year, there were 30,129 people in care homes, according to Scottish Government data, most of which are in the private sector.
That was a 2 per cent increase on 2013. Of this grey brigade, 18,931 had dementia – not an illness, but a condition born of assorted morbidities, from Alzheimer’s through Lewy-Body to arteriosclerosis and Parkinson’s.
Care homes meanwhile have struggled. A fifth of Scotland’s facilities have closed in the past decade, even as admissions went up.
Energy costs, in the wake of the war in Ukraine and the disastrous Truss administration, increased eight to tenfold.
And – admittedly, hardly anyone moves into Green Pastures in the whole of their health – the outcome is always sub-optimal. Women in their 60s can expect seven more years; past 90, only 2.7. Men have rather less than that.
Weighing increasingly on elderly minds is the thought not just that they are a resource no longer valued in society – granny keeping an eye on the crib as she clacks on with the knitting – but the dread, especially with the recent change of government, of legalised ‘assisted dying.’ As one infamous Guardian columnist crowed on July 26, ‘Tories swept away mainly by Labour and Liberal Democrat MPs is a good augury for all liberal causes. The campaign group Dignity in Dying counts the removal of at least 183 MPs who blocked it in the past…’
People have been thinking the unthinkable for years. In 2017 a childless Cumbria couple, John and Lindsay Allen, 65, who spent years caring for both sets of parents and were still caring for John’s mother – pondered their own staged exit.
What prompted our interest in euthanasia is that we don’t have children,’ said John flatly. ‘We’re having to look at all the options because we don’t have anyone to put us first.’
An explosive, profoundly disturbing response to a demographic crisis. Live-in care may be one solution.
‘This is a tailored option for those who still want to live independently, but need ongoing support from care professionals,’ argues the IvyPalmer concern.
‘Live-in carers can be on hand on a regular basis or as relief for friends or relatives who normally carry out everyday care duties, and this flexibility can often keep expenses down for families who are worried about escalating costs.
It may sit slightly outside of the traditional concept of care but it’s proven to be a lifeline for many thousands of families.’
Some countries, such as the Netherlands, have found success in pairing the elderly in residential care with student accommodation.
Young Willem has somewhere to live; old Mr van Klopp has morning and evening company.
Nor is it beyond the wit of our rulers to deliver powerful financial incentives for us to care for our own – for instance, the adjustment of inheritance tax and, as is done pretty well in the Western Isles, some morning and evening support by professionals and regular ‘respite care’ to allow sagging offspring a few days’ break.
Some evenings ago I stood outside my house, watching bats flit about, guided by their own high-pitch sonar. At 19, I could actually hear it, but by 30 that altitude in my ear-drums had gone.
We all age. Forty is pushing it for a professional footballer, the oldest player to have lifted a Wimbledon singles title in the Open era was 35 and, given the vital fast reflexes, the average age for a Battle of Britain fighter-pilot was a mere 20.
Meanwhile – not that there was any hint of it in the Labour manifesto – the new Government (followed in quick time by the Scottish Government) has stripped the winter fuel allowance from ten million pensioners, despite charities warning of a ‘public health emergency’, or many in genteel poverty forced to choose between heating and eating.
Foster children in Scotland and, if you pass the vetting, ‘you’ll receive a fostering allowance that’s between £24,104 and £29,778 per child, per year. The fostering allowance is generally tax free for most foster parents and does not affect any benefits you receive.’
The Carer Support Payment in Scotland, if you’re minding mam and dad? £81.90 a week.
