According to a 2012 UN report, ‘older persons are the world’s fastest growing population group, amidst rapidly changing family structures and the possibility of declining family support systems.’ The fact that more people are living longer than previous generations has often been hailed as the successful consequence of improvements in medicine and health care systems as well as the improved economic and social standings of many people, both in the developed and the developing world. However, these positive developments have become causes for concern as governments have begun to debate the potential social and economic consequences of an aged population.
In Britain, whilst the debate has been taking shape since the late 1990’s, it has gained increased prominence in the wake of numerous scandals pertaining to the mistreatment of the elderly in care and in hospitals, and even in their own homes in the form of the home care system. The extent of the problem came to the attention of the public after numerous investigations including the five-month long police investigation into the Hilcroft nursing home in Lancaster and the BBC panorama investigation into Ashcroft care home in North London. Both investigations uncovered physical and verbal abuse that was no less than the wilful neglect of vulnerable elderly patients. It then transpired that the abuse of the elderly was not just taking place in care homes but that the elderly were vulnerable even in their own homes. A year long inquiry by the Equality and Human Rights Commission which begun in November 2011, published in November 2012 expressed concern that the human rights of the elderly were not being protected.
The general discourse then came to be centred on legislation, regulation and quality control; essentially, the demands came for better care homes and better practices. What was and still is missing in this very important debate is the social question – rather than demanding better institutions where the elderly are effectively out of sight and out of mind, what an Islamic morality necessitates is a debate on the possibility of a social solution to the reality of an aged population.
The mood of the nation regarding this issue can be gleaned in part from a YouGov opinion poll which posed the question, ‘Who should be responsible for caring for the elderly?’ The overwhelming response was that the NHS should take the responsibility; this is in line with the reasons often given as to why the care of the elderly will increasingly fall to the State. The main reason is what the UN report described as the ‘rapidly changing family structures and the possibility of declining family support systems.’ Whilst this has been clearly acknowledged, what has not followed is the questioning of this status quo. To a great extent, the reason is that whilst it is viable to document and analyse social change, it has become politically unfashionable to challenge the consequences of such social changes. Where some politicians have tried to do just that such as in 2012 when the care minister Norman Lamb claimed that ‘Britain has become a neglectful society,’ it has failed to result in a deeper debate about the general health of our society of which care for the elderly is but one facet.’
In an attempt to address the increased reliance on the state, the Joseph Roundtree Foundation published some innovative ways of caring for the elderly. These included care insurance, in which residents moved into care homes whilst they were still fit and healthy financially contributing to a communal pot which would then sustain them for when they needed care. Anther solution they suggested was home share, where an NHS carer would move in permanently and stay in the home of the elderly person rent free in exchange for spending a few hours a week assisting the individual with shopping, cleaning, and general household chores. What was lacking in all of these suggestions is the possible role of traditional mechanism such as the extended family in providing care for the elderly. Until recently, families were the main providers of elderly care, a tradition that Britain shared with most Muslim societies.
It is often said that the moral test of a society is how it treats its vulnerable, be they children, the disabled, the poor, the weak or the elderly. The possible consequences of the trend towards putting our elderly into care homes and institutions with inadequate care provisions should not be underestimated. It is a stain on our society if men and women who have paid their dues to society are then subjected to isolation, neglect and abuse. This does not mean passing judgment on the lives of individuals, many of whom have a myriad of issues to contend with, but merely to highlight some of the problems in the current debate and to inject some alternatives to the discourse.
In the first case, we have to change the way we think about age and the aging process. There is a tendency to put an expiration date on individuals once they reach a certain age, where they are thought to no longer be of any use to society, particularly from an economic perspective. The elderly still have an important role to play in our societies as they have done in previous centuries; they remain important sources of knowledge, experience and wisdom. Another problem with our general discourse is the widely held assumption that the best form of care is professional care which can only be given in care homes by trained staff. What the care home scandals have taught us is that this is not necessarily true, in times of austerity and cuts there are legitimate fears that this could in fact undermine the quality of residential care. Further, the debate on the elderly can often be one that distinctly lacks empathy and compassion. There is far too much discussion on the effects of aged populations and what this means for the state and its resources, but less discussion of the possible solutions that could relieve some of those pressures on the state.
Rather than centring the debate on state institutions, it is time that our government and society consider social solutions to the question of what to do with an aged populace. The reality is that the traditional family network has broken down; the only way this can be reversed is if society is willing to ask the big questions. Where real change can take place is in the instances where family members who have wanted to look after their elderly relatives have found it increasingly difficult to manage work and finances whilst caring for their elderly relatives. There is currently very little support for these individuals with many of them having to make the difficult decision to place their relative in a care home.
In recent years, facilitating the care of the elderly in the community has received more attention, but enabling that care to be undertaken by relatives is something seldom discussed with any real meaning. It would be to the ultimate benefit of all of society if politicians and all interested parties and groups start moving the debate forward in this direction. The issue then is not what the state can do, but rather what we can all do to ensure that the elderly members of our society are treated with dignity, empathy and compassion.