Wherever you look, at residential aged care institutions, at retirement village life, at the home support package scheme, or talk to the people over 65 — called “the old” — living at home making no claim on the system, just coping by whatever means they can, this stage of life means grappling with overwhelming challenges.

Kathy Eagar gives a comprehensive account of the state we are in. We have, through medical science and technology, been successful in extending life expectancy by 30 years across my lifetime. At 88, I am a pioneer as one of a rapidly growing demographic group who have never lived so long in such numbers in history. But alongside this remarkable scientific achievement, no one has given commensurate thought to what these added years are for, or how to live them with purpose and dignity. We need to draw on the experience of those who are working out how to live their long lives, despite our chaotic system.

In Australia today, 16.5% or 4.2 million people are over the age of 65 and deemed “old”. Most of the over-65s are well-educated, live in a private dwelling (only 6% are in aged care accommodation), and want to live independently. An increasing number of men and women are still in the workforce into their seventies, by choice not just by necessity. Research also shows that people over 65 are overwhelmingly positive about their lives and contribute significantly to the national economy, not only through paid work, but also childcare and voluntary work, contributions not well recognised by policy makers.

Prevailing social attitudes and economic policy discussion take a negative view of the aged as a social cost, a burden on society, a problem that will grow and the major issue addressed is care; where do we put them, how do we feed them, not how can they live a productive life, with self-respect. Current policy leads to social isolation and a lack of purpose for the old, which is a major cause of their ill health and premature death. No attention is given to a science of social interaction in extended old age.

No age policymakers are yet old.  One does not have to live in poverty to understand the poor, to know real pain if you haven’t borne a child, to understand parenting if you have no children, but, if you have had the experience, you have a flying start in understanding. No one knows what it feels like to be old until you get there.

When I turned 70, I wanted to know why some people lived actively and apparently happily into their 90s and others gave up and withdrew, their life effectively over. I interviewed 90-year-olds who were still active, studied the available research and published my book In Praise of Ageing.

The answer was evident: good health and genes are obviously important to healthy ageing but the way we deal with life experiences — the grief, the trauma, the hardships, setbacks with health, the disappointments — make all the difference. Those with resilience, a positive attitude, the ability to reinvent themselves as circumstances change, have ongoing engagement with and interest in people of all ages, follow what is going on in the world, have loving relationships with partners, family and friends and find a purpose they regard as worthwhile are all critical factors in leading a long rewarding life.

I went on a speaking campaign to try to help change attitudes to ageing. I thought there was some progress. The language about ageing was changing, the scornful jokes were less public, employer attitudes were shifting, job applications from those over 50 weren’t going straight in the bin, more women were going back to work as their children grew and flexibility in work hours was a consideration. We were recognising that middle age was 50-60 not 40-50.

That change was seen as a marketing opportunity and ageing was commodified as a for-profit business selling financial advice, insurance, home-support packages and self-funded retirement in villages — that looked like The Truman Show and called a name like Happy Valley — were established in the 1980s. The eligible entry age was 55. Images were of golf, travel, cruises, cocktails and sunsets.

People were enticed from jobs to a life of leisure. In the 90s, governments, wanting to shed teachers and public servants, offered retirement options at age 55. Tax-payers are still paying the bills for those people who live on those superannuation salaries more than 30 years later, wondering what they did with those years and looking for purpose. There are approximately 300,000 (over 55) living in retirement villages, around 7.5 % of the aged. Reports suggest some love the life, others tolerate it, and others, realizing they made a mistake, get out with difficulty.

In 2019, the Royal Commission exposed the disgraceful, obscene conditions in aged care. The worst findings of the Australian Royal Commission into Aged Care Quality and Safety were detailed in its  interim report, tabled in October 2019, which described a “ shocking tale of neglect” and a “sad and shocking” system. The findings highlighted systemic issues including mistreatment, physical and chemical restraints, poor hygiene, and inadequate funding, which diminished the dignity of elderly Australians.  Attempts to redress these abuses are slow in coming.

Two months after those findings, COVID-19 hit and attitudes to the aged — not just those in care — slid downhill like an avalanche. We were “the other”. Our QUALY’s were debated – quality of life years left. Who should get the emergency bed? We were blamed for lockdowns and distancing. Society and families were divided in arguments which remain today.

The government wants to help us stay at home and most of us want to do just that. But how? As Kathy Eagar describes, the hurdles are challenging for home support packages. Once accepted into the system, providers and case managers do not explain clearly enough how the home package system works.  It’s not in their interest to do so. A cashless credit card in a competitive market is a difficult concept and open to rorting.

Regulation of the sector needs to be vigilant. Staff are hard to find, especially in the western suburbs. When a carer comes to a house, they have a list of things they may and may not do. One friend says her carer can’t do the things she most needs, won’t use certain equipment or certain products, won’t lift her arms above her head, or stand on anything. Ceiling cobwebs remain, light bulbs don’t get changed, there will be no scrubbing or moving of anything deemed heavy. My friend tidies up before the carer arrives, so she won’t trip on the kitty litter box or other potential hazards; “she’s as useful as a chocolate saucepan but she is someone to talk to”.

On the other side the carers need to minimise risk to protect themselves and need training in handling desperately lonely, isolated men. Many women carers will not attend to men. They get lewd comments, “Want some jiggy-jiggy?” A friend was offered $20 for the perk. She knew how to look after herself, but others flee. We don’t speak about the sexual needs of the old (see Glenda Gartrell, Getting on with it, 2024), but they too need to be acknowledged.

At the end of the iconic detective series (1958–1963) the narrator says: “There are eight million stories in the Naked City. This has been one of them.” We could say the same about home aged care packages.

But support for staying in our home in our later years is a system to be nurtured and managed more effectively, for there is a burgeoning number of aged in the human pipeline who want to remain where they have lived. Fewer will be able to work when AI sweeps through the system. More people will live 100 years, most working out how to do this on their own, as the options now available to them, to help them succeed, are as fragile as a house of cards ready to topple.

PART 2

How we can develop a system to live with purpose and stay longer at home

Year by year the numbers of the aged increase. By 2050, 25 % of Australians will be 65 and older with the proportion of young people declining.

Whichever way the figures are structured, there are at least 3.5 million Australians over the age of 65 today, who do not access age care services and do not live in retirement villages; they live in their homes. What are their secrets? How could they be assisted in their determination to stay at home?

The large majority of the over-65s are managing in ways not yet known in any systematic study of “older” people. We need to know their living conditions, how they feed themselves, what are their health issues, how they use their time; do they work, volunteer, babysit? Who are their social contacts?  Do they live in an age-friendly community? How do they move around? Do they feel safe? What is their life satisfaction? What help do they need? What are their concerns? Could they share their homes with a young person in exchange for practical help with cooking, shopping and getting to appointments? Would they tolerate an unfamiliar “carer” coming into their homes or being segregated in aged care accommodation?

Importantly, is there a dark world to be discovered where people are not managing at all?

From available relevant data we know the following. Forty-two percent still have face-to-face contact with family or friends and 93% say they can expect support in times of crisis. Many have children and grandchildren, and the lucky ones have daughters, but this is changing. Fewer children are being born; Australia’s replacement rate is now 1.5. Twenty six percent of households today are people living alone. The problem of isolation, feelings of loneliness and despair reported by the old and the young is growing and is a cause of social instability. This is the number one issue yet to be resolved in ageing policy.

Not much of the data available paints a picture of “dependency” or cause for alarm, but we need to break down the so-called “old” age group and look at those over 75 years and over 80 years separately to refine any sensible policy on ageing in Australia.

In an ideal world, we would structure lively intergenerational communities where the young and the old live alongside one another, where the experience of one generation can meet the needs of another through activities of mutual benefit, reducing the separation and isolation of older generations from youth, and changing community attitudes towards the whole process of ageing.

One model is home-sharing, an international movement which goes under the name of HANZA in Australia.  This is an arrangement where two or more people share a living space. Typically, a householder offers accommodation at a low cost in exchange for companionship and support. This support may include assistance with chores, some cooking, social interaction, or simply providing a presence and company.

Don and I had our own private home share arrangement for two years. Piet was a final year engineering student and our grand-daughter’s boyfriend who lived with us at no cost to him. He would cook 3-4 times a week, do odd jobs and sometimes drive us to appointments. During those years, Piet completed his degree and applied successfully to a university in Belgium to do a PhD. We were able to help mentor him and refine his applications. He was good company, and we shared many thoughts about changes in society. If the right match can be found it is an ideal solution for some who have the space and the means.

Most of the aged, as well as needing social interaction, need help with technology to open up their world and help them take charge of their lives. We were middle-aged at the time tech boomed, and many have never learnt how to use a computer, email, order groceries online, do banking online, deal with all services — water, gas, electricity (finding the best rate) — deal with taxes, telephone, even hospital admission online.

Almost everything that needs to be done is now online with no friendly voice to be found there to help. It’s an alien world for many older people who are disadvantaged and hopelessly frustrated without the skills needed to live. Grandchildren are the go-to experts, if you have them, but they will be fewer in future as well.

The young are digital natives. They could be the mentors. If they would help an older person to master technology it would build competence, instil independence, reduce their isolation and give them control of their lives. As mentors, the young volunteers would derive great personal satisfaction as well. Idealistic? Maybe. But I have seen challenging things done when there is a will.

It would not be difficult to implement a national service-learning program or community-based education scheme involving hands-on community work with academic learning and reflection, through the school system, fostering civic responsibility in students – a program to bring the generations together in the interest of the old and the young.

Technical competence for the older group would facilitate their social interaction, help keep them in touch with friends and family, motivate activity and provide access to the range of entertainment and information now available.

We know from Time Use surveys that older people spend more time watching TV and less time using digital devices. That will, of course, change as digital natives join the elderly. Meanwhile, the viewing and listening options for this older audience are limited. This group could be taught how to use the remote, their mobile phones, how to access music and podcasts and take advantage of the wealth of material available that they don’t know about, but now have the time to listen to.

The older group averages the same 1.4 hours per day as younger people on exercise, sports and walking, but close to 70% do little or no outdoor activity, a vital contributor to health and well-being. This inactive lifestyle could be addressed through digital access to appropriate exercise programs already available, and cross-generational friendships could motivate activity for both groups.

There are already some programs addressing intergenerational and friendship connections. The program “I Wish I’d Asked” is a story-telling project aimed at preserving history, which also helped combat loneliness and depression by fostering conversations and skill-sharing between older residents in aged care facilities and secondary school students. It was set up in November 2017 by Eva Gruen and Danny Finley in Shepparton, Victoria, assisted by Rotary.

One of the interesting things which came out of this project was some boys finding the experience of making friends with an older person satisfying to the point where they thought they would consider working in age care. If we could bring young men into the caring services, it would be a bonus all round and fill a gap in the employment sector.

We know boys are falling behind in education. More girls are completing schooling at a higher level, getting more places in universities than boys, and going after the highly paid professional jobs. They are also dominating in the care sector which is the biggest driver of employment growth because it is labour-intensive. Men face no formal barriers to working in care, and many do, but deep-seated gender norms and social factors have slowed such a change. We need to correct the balance.

What if the tech companies, as part of their responsibility to the people they now exploit, decided to provide the internet, a computer and smartphone or watch, to all those over 70? They would learn a lot about this demographic and their needs of value for marketing purposes.

There is a program underway called Healthy@Home, developed by the NSW Smart Sensing Network, aimed at keeping ageing citizens healthy at home, out of hospital and aged care facilities by integrating sensor technology, alerts, telehealth and care models. They plan to help people and their carers take advantage of technology, checking on their well-being and looking into robotic solutions, such as robotic pets to help counter loneliness. AI will undoubtedly be employed.

Facilitating friendships, social contact and support systems is the single most important intervention needed now to live our post-working years productively. Potential solutions could assist the old and the young with their problems of isolation and loneliness. The government has an essential role to play here and should be bringing together thinkers and innovators across the disciplines, with technology companies, to rethink ageing for modern community life. Australia could be a leader in this field.

P.S. I would take a bet that the many experienced retirees who are writing for Pearls and Irritations and sharing their thinking, will likely live longer because of this engaging process.

The views expressed in this article may or may not reflect those of Pearls and Irritations.