When policy-makers, council leaders, or even the media hear the phrases ‘older people’ or ‘the elderly’, they dive straight into a particular narrative.

It’s all about the problems of an ageing society, the costs of adult care, the expense of bed-blocking… It assumes there will be shrinking numbers of younger people of working age due to falling fertility in the recent past, and that this trend imposes an unprecedented economic burden on health and social services, and pensions.

Even when it’s a bit more nuts and bolts, the discourse seems to be about the vexed issue of the bus pass, and whether it ought to still go to all the elderly when many are rich – and the same goes for the TV licence.

And its also about seeing if we can’t get the old to work a bit longer for their suppers – with images of teachers in their late 60s or early 70s trying to control classes of stroppy 15-year-olds conjured up and causing horror to many parents.

It’s not only policy-makers who are on this kick. Many charities and independent funders also think along these lines, delivering services in the ways they have for years, eking out funding for lunch clubs and meals on wheels, and funding community centres for the old as though the 21st century had never arrived.

There are elements of enduring truth in all this. Of course, there are. We are ageing as a society and this does pose problems. But, as an over-arching narrative, it is misleading us all and it creates a sense of pessimism, of a fatalistic and unavoidable future which is grim, and suggests that all we can do is cope.

As research professor at King’s College, London, and professor emerita of the University of London, Pat Thane, argued in a recent policy paper for the British Academy, this is a carefully-designed narrative, and there are alternative ones which have as much if not more validity.

So, instead, Prof Thane says there is a story that ‘stresses the great diversity within an ‘age group’ said to extend from around age 60 to past 100, in terms of health, income, capacity for independent living, culture and experience’.

This story frames older people as a varied bunch, with differing wants, let alone needs. They are not only concerned with zimmer frames and loss of hearing, but want high streets and evening life which work for them, ways of engaging with their fellow citizens – young and old, and support to live independent lives, not having people boss them around in faceless institutions.

Many will be working – perhaps down-timing as they get older, but supplementing this by doing more charity and community work. In addition, the costs of the change in the age dependency ratio are less about the old being a burden but about our inability, so far, to improve productivity in the health system, not least by switching resources from acute to primary care.

In this second narrative, the real challenges are more complex than in the earlier, simpler version of ageing, but also more rewarding. But if we are to meet all these challenges with needs growing and resources tight, we must do things differently all over the place.

So, we will need to focus on the outcomes that older people really value, not on the ones we think would be good for them. And we must become more certain of how to get some measurement handle on them and meet them cost effectively.

This area has not always been subject to the same intensity of thought as areas such as early intervention for children or offenders, and that is why we’re keen at NPC to continue to build on our research on ageing in the 21st century and nail down some of the issues which need to be addressed. Approaching the challenges of ageing will undoubtedly involve charities working together, and dropping the emphasis on competition for funding.

This throws up its own challenges, but it is encouraging that at a recent AgeUK conference where I spoke, an event dedicated to this sort of discussion, people were certainly on board in principle for the kind of changes needed. They know we need to do more than tinkering and incremental change. The next step is for action.

A version of this blog first appeared in the MJ (paywall).

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