Cherishing Our Old People

on Thursday, 31 July 2003. Posted in Issue 36 Cherishing our Old Folk, 1999

Bill Toner, SJ

December 1999

Introduction

Like many other blunt Anglo-Saxon words used to describe people, \'old\' is no longer politically correct. The literature on old age restricts itself to gentler terms and expressions, - \'Elderly\', \'Ageing\', \'Senior Citizens\', \'Older Persons\', \'Active Retired\'. The term \'Old Folk\', with its cheerier and more affectionate connotation, still survives in the names of a few community associations for the elderly. The reluctance to use the world \'old\' may well be a resistance to being \'labelled\' and pigeon-holed. Or it may contain an element of denial in a secular world that increasingly sees the seventy-odd years of life as all that we have or will have.

 

Whatever terminology we use, most of us can expect to grow old. Having reached the age of 21, an Irish female can expect to live to 78.7 on average, and a male 73.4. 1 How well do we as a people prepare for this period of our lives, which is almost as inevitable as dying? The value we place on our senior citizens now will very much determine how well our society will cherish us in turn when we near the end of our productive lives and perhaps move from the \'income\' to the \'expenditure\' side of the national balance sheet.

In Europe generally, the increasing proportion of older people is seen as a growing problem, as a shrinking active population has to cope with the care and support of older citizens. However, in Ireland there is still some time to go before this trend takes hold. The proportion of over-65s in the general population has remained remarkably static in Ireland from 1946 to the present day, never moving lower than 10.6% or higher than 11.4%. It will be around the year 2015 before this figure begins to rise significantly, but it is expected to climb to 18% by the year 2030.2 Young immigrant families may slow the trend towards ageing considerably.

There are many indications that Irish people have positive attitudes towards their older people. This can be seen by comparison with attitudes in Europe as a whole (though this is itself a little worrying, as European attitudes tend to become established here in time). For instance, 44% of older Irish people say they have been treated with more respect as they have grown older, compared with 30% in the EU as a whole. And 82% of older Irish people considered that younger people are helpful towards older people, compared with 58% in the EU. More than half the Irish older people surveyed believed that older people are admired and respected by younger people, the opposite of the result in the EU where 63% of older people thought the contrary.

At the same time the majority of older Irish people (52%) considered that families were less willing to care for older relatives than they used to. However in the EU the figure was even higher, at 67%.

The generally positive attitudes expressed above did not always seem to have been translated into concrete actions by governments. 60% of all Irish citizens stated that the government should do more to meet the needs of older people. This is not as high a figure as the 75% recorded across Europe as a whole.

Older Peoples\' Income

We take it for granted that people will not be as well off when they are older as they were in their more active years. The \'widow\'s mite\' is an enduring image from the past. But logic would suggest that this is not the best way of arranging our affairs. Most of us would say, that ideally we should be roughly as well off in older age as when young, so that we can enjoy the autumn of our lives to the full. But it is a human failing not to give sufficient thought to the future, even leaving aside the misfortunes of life and struggle to exist that force many of us to live from day to day.

The ability of the state to make up for income shortfalls in later life is limited. However, successive governments have gauged the public mood correctly on this issue and have shown relative generosity to a group who have little bargaining power compared with the main social partners. The recent budget has been relatively kind to older people, at least compared with its miserly treatment of other categories of social welfare dependents.

In 1995, the average person over sixty five had an income of £95.30. If the average income of older people has kept pace with average household income over the past four years on, and taking into account the most recent increase in pensions, this figure can be estimated to have risen to about £122 a week. Between 1977 and 1995 the average income of old age pensioners increased in real terms by only about 9% (one half per cent per annum), but has increased much more rapidly in the past four years.

The average income of over-65s in 1995 was made up of a number of components, and obviously varied from individual to individual. 55% of the total income of the group came from state pensions or allowances, 23% from pensions from previous employers, and more than 8% from farming. There can be assumed to be large disparities within this group. Many of the elderly living in cities and large towns would be totally dependent on a means-tested state pension and would have no pension from employers or no farm income.

Those who are totally dependent on means-tested state pensions have been the focus of most attention in assessing the levels of poverty among the elderly. At the end of 1998, 64,311 (67%) recipients of non-contributory pensions were paid at the full rate, meaning that their means other than the pension were negligible . The non-contributory pension has generally hovered at or just below the 50% poverty line i.e. half the average income in the state. In the years before the 1998 budget the situation had worsened because social welfare pensions increased at a slower rate than average household income. For instance between 1994 and 1997 the increase in pensions was about 11%, as against a 20% increase in household income. In the last three budgets pension increases have been more generous. There have been proposals by some lobby groups to index-link the non-contributory old age pension so that it remains at about one third the average industrial wage. This would mean increasing it to about £115, as against the figure of £85.50 reached in this month\'s budget in respect of a non-contributory pension (under 80). Some categories of pension have now reached the figure of £100 which has been sought by many lobby groups, but the rates for non-contributory pensions are still too low.

The expenditure of nearly £9m. in the recent budget to increase tax allowances and exemption levels for the elderly is very welcome, and will take about 50,000 people out of the tax net altogether. However it is of no benefit to the poorest pensioners.

Means-testing for non-contributory pensions is strict. In the case of income from savings and investments the rules were, until the last budget, not just strict, but unfair. There appeared to be a lack of awareness among those who make the rules that with current rates of interest, income from ordinary savings is close to zero. Before this month\'s budget if a 66 year-old woman (or man) on a non-contributory pension inherited a sum of £40,000, unless she spent it all at once her pension of £4000 per annum was cut to zero. It was assumed that she would be able to get a return of almost 10% on the £40,000, a totally unrealistic assumption. A pensioner in this position also loses most of her entitlements such as free electricity allowance.

Under the new arrangements an individual non-contributory pensioner can have capital of £10,000 (as against £2000) without it affecting his/her pension (the home, if owned, is not taken into account). In the case of a couple the figure is now £20,000. Above these figures the pension reduction is tapered, and while the rate of tapering remains the same, the higher initial disregard means, for instance, that a single non-contributory pensioner with capital of £40,000 over 66 is now entitled to a pension of £21.50, as against £9.50 before the budget, an improvement of £12 a week.

There is still some room for improvement in this regard, as £10,000 is still not a great deal of money. The pensioner with £40,000 described above would still need to get a return of 8.3% (or live partly off capital) to avoid a reduction in income.

One of the fears expressed is that if the rules were changed to allow pensioners to retain large sums of money along with a full pension, this money might pass on their death to sons and daughters who are quite well off, rather than to the taxpayers who supported the pensioners while they were alive. One solution suggested is a system whereby older people could have the option of lodging windfalls or part of them, in a special savings account from which they could use money as they wished, without it affecting their non-contributory pension, on condition that on their death the balance of the account passed to the state.

The budget change in regard to capital will make it less likely that pensioners will conceal cash in the house rather than declare their savings, a practice that, since it was well known, made them easy prey to criminals. In recent years there have been about 100 attacks each year on old people living alone in remote areas. Public agencies tried to improve security while the underlying issue was not addressed.

Many older people have a number of non-cash benefits such as free travel at certain times, medical cards, and allowances for electricity (occasionally gas), solid fuel, telephone and TV. The current monetary value to the elderly of the free schemes (apart from the medical card) amounts to several hundred pounds a year on average, but is impossible to calculate exactly. The total cost of the free schemes in 1997 was £148m. but they are paid to a variety of claimants, not just the elderly. A change in this month\'s budget is that free schemes are to be extended to all people over 75 \'regardless of income or household composition\'. However this already applies to most of the free schemes, with the important exception of the fuel allowance. The recent budget brought in the second phase of the doubling over three years of the medical card income guidelines for people over 70 years. The application process for free schemes is not very user-friendly, with multiple forms to be filled in, and many older people missing out on entitlements.

In 1993 more than half of older people interviewed stated that they could make ends meet \'fairly easily\', \'easily\', or \'very easily\', with only 46% expressing varying degrees of difficulty . However, this may be as much an indication of the way older people have been conditioned to expect very little, as a measure of the adequacy of pensions. While the pension may be sufficient for basic needs such as food and clothing it restricts most pensioners to a rather frugal existence, and can turn any non-routine expenditure into a crisis. One older person in ten lives in seriously sub-standard housing, but there is no possibility of getting any substantial repair done on a pension alone. Many older people have owned a car, and many badly need one still, but it is nearly impossible to keep a car on the road on a cash income of £85.50 a week. It is also a fact of life that many older people smoke (1 in 4 in 1993), and nothing will induce most of them to stop. For the thousands of 20-a-day smokers among the elderly, the Budget increase in duty on cigarettes will halve the benefit of the pension increase given in the same Budget.

Although the increases in benefits directed to individuals, such as pensions, tax allowances and free scheme items, are important, older people are also dependent on a lot of \'public\' goods that their own personal money cannot buy. For instance they may need support services from social workers, home helps, paramedics and others. Personal income is only one component of their well-being.

Why Services are Under-Funded

In 1997 the Department of Health spent £1.8 billion building and running hospitals and special homes, but only £99m. on home-based services i.e. 5.5% of the amount spent on hospitals and homes.

This illustrates a characteristic of government expenditure on a range of social needs. Governments have the option of directing money:

· to individual people, such as unemployed people. 
· to institutions that care for people, such as hospitals. 
· to services that cater for a particular group.

In Ireland the government tends to be better at spending money in the first two categories than in the third. For instance on the individual level, the old age pensions has risen by £18 in the past three years, at a cost of about £160m. But far less new money has been allocated to home services for the elderly.

Or to take a different example relating to institutions: in 1998 the budget allocation to prisons was £166m. but to the Probation and Welfare Service £16m. This is in spite of the fact that the weekly number in prison is 2,500, while the weekly number under probation supervision is 4,500. The cost of prison per year per person is £46,500, while the cost of maintaining a probation order is £3,000.

One could speculate at the reasons why governments tend to direct money at institutions rather than services. The main one is that politically it is easier to get money allocated for capital than for non-capital expenditure because the capital element is non-recurring i.e. a hospital has only to be built once. Also, overruns in capital expenditure are tolerated in a way that overruns in current expenditure would never be, because once a building or structure is started it has to be finished. Once the institutions are up and running, it is usually possible to secure allocations of running costs because otherwise it is clear that the investment will be wasted.

It is in the nature of services, however, that they involve little capital expenditure, but can involve considerable staff costs. Governments are always nervous about increasing current expenditure directly in this way because it is seen as recurring and in particular they do not want to increase the public sector wage bill.

There are probably other reasons why governments are slower to spend money on home-based services. Large capital expenditure items have more visibility and have an electioneering and image value. Elections are often preceded by promises to build bridges, by-passes, prisons, regional colleges, community halls and so on. Services are often hidden and do not make the same impact as a physical structure.

There may also be an element of control involved. It is easier to install systems in institutions to supervise and monitor staff performance than it is with home-based services and there are always concerns about travel time and travel expenses where clients are not based in one location. However there is no evidence that home-based services are less efficient than those carried out in institutions.

The Health Boards, and groups representing older people, would like to see much more money directed at home-based services. They see the government as more concerned with providing for the relatively few people who need long-stay homes, than with financing the kind of services that would keep older people out of long-stay homes. Where the proper supports are in place, most older people prefer independent living to institutional living. Of course it is also much cheaper for the state if older people stay at home instead of going into nursing homes, so it is very short-sighted not to spend money on the services that would make this possible. The Department of Health\'s own stated aim is to maintain at least 90% of people aged 75 or more in their own homes. In fact only about 5% of this group are currently in long-stay care.

The Eastern Health Board has come up with a very ambitious 10-year action plan, which is well-balanced between services and institutions. During this period they hope to spend £101 million on current expenditure, and £157 million on capital expenditure and equipment. There is no guarantee that they will secure this level of funding from the State. The recent budget allocated an extra £16.8m. to home health services for older people. The main item is an increase to £4.40 of the minimum hourly rate for home helps. Again, the amount devoted to services is small compared with the amount distributed to individuals in pension increases and tax breaks.

Transport

"Transport is a huge problem", stated a senior official in one of the Health Boards. The availability (or absence) of, and access to, transport can make a big difference to an older person\'s life. Apart from the day to day matters, it is essential if older people are to access services provided by Health Boards and other agencies.

In a recent survey , 34% of over-65s expressed difficulty with shopping. This is closely linked to the fact that 27% had difficulty in walking half a mile, and 23% getting on a bus.

There is no doubt that the Free Travel Pass was a generous innovation which is the envy of pensioners in Northern Ireland and Britain. However, it is not a complete solution to the travel needs of older people as the hours of use are restricted (often affecting travel to clinics, for instance) and much of the population do not live on bus or train routes. Public transport for those in rural areas is inadequate, with bus services either absent or infrequent. In the 1986 survey 70% said they never used their Free Travel Pass. Similar results were reported in Co. Waterford in a more recent survey. In general, older people\'s use of public transport in rural areas has declined sharply in recent decades, for reasons that are not completely clear.

In the more remote rural areas of Ireland a car is generally regarded as a necessity. There are no completely up-to-date figures on car ownership among older people. In a 1986 survey in rural Galway it was found that only 4 older people from a sample of 150 owned a car, while 14% lived in households with cars. General ownership of cars has gone up by about 50% since then, but figures for older people must still be small.

The 1986 report found that hackney cabs and unlicensed private carriers were often used by those in rural areas to gain access to the bus stop or train station. Some respondents were spending as much as £23 a week on transport (at 1986 prices, - about £32 at current prices). Some rural respondents cannot use public transport to attend out-patient clinics as the public bus service would not get them to the hospital on time. The 1986 report instances people spending as much as £50 on a hackney to get to a clinic. Obviously older people also rely on neighbours, friends and relatives to bring them to services and to obtain goods but such arrangements can have their own problems.

The lack of transport has become a greater problem in rural areas as services that were formerly mobile have declined. Rural areas were once served by mobile banks, shops and libraries, but these now have declined as car ownership among the general public has increased.

In spite of the obvious lack of transport for older people, there have been surprisingly few initiatives by the state in this area. About a third of voluntary groups working with older people are involved in some kind of transport provision and some of these groups are in receipt of state aid. Other options which remain undeveloped in Ireland are the school bus and post-bus options, community bus and social car schemes, the development of the hackney service, the issuing of vouchers, and facilitating greater car ownership among older people by giving help with tax, insurance, M.O.T charges or in other ways. Although the recent budget provided a good opportunity for some imaginative initiative, the only explicit mention of the elderly in regard to transport is in relation to the abolition of travel tax.

Most disturbing of all are the statistics on pedestrian road deaths among older people. These are inevitable if older people are forced to go on foot when some form of transport would be more sensible. In 1998, 111 pedestrians were killed on the roads. If pedestrian deaths among older people were in proportion to their numbers, one might expect 15 of those killed to be older people. In fact, 41 of the pedestrians killed were over 60 years . Such deaths and injuries will not be surprising to any regular pedestrian, given the increased volume of traffic and the few facilities to cross roads on foot except at road junctions.

Housing

Contrary to a popular view, the vast majority of older people - about 95% - live in ordinary houses or flats rather than nursing homes or other institutions. It is general public policy "to maintain older people in dignity and independence at home in accordance with the wishes of older people as expressed in many research studies" . Towards this end the Eastern Health Board\'s 10-year plan envisages an expenditure of no less than £107 million over ten years on new or improved services in the community, including substantial expenditure on home help. Other Health Boards have developed similar strategies.

But if older people are to be able to live comfortably at home, the quality of housing is of paramount importance. This is, however, a matter for concern. Research carried out in the mid-seventies found that 60% of those admitted to three county homes were admitted for social reasons, such as poor housing, rather than medical ones. Older people tend to live in the oldest houses. In 1991 a third of older people, a total of 119,000, lived in houses built before 1919. About one in ten of elderly people in Ireland report having damp walls or floors, inadequate heating or rotting windows. In the majority of cases the people cannot afford to have the necessary repairs done. A startling statistic is that in Ireland the incidence of deaths and reported illness among old people rises in winter by about 25% , whereas in Norway and Iceland, where winters are more severe, the percentage increases are close to zero. Most of the difference is due simply to good central heating and double glazing. Older people are particularly vulnerable at night, as they move from a warm room to an unheated one. The Health Boards would say that the current fuel allowance would need to be doubled if older people are to stay warm in the winter. The government has all this information available to it, and it is inexplicable in a year of such plenty that the government could not increase the fuel allowance, which has remained at about £5 a week for ten years. It is also inexcusable that only 115,000 from 300,000 of those with medical cards receive fuel allowance, because of strict eligibility criteria.

Sub-standard housing can also lead to accidental falls, fire, and vulnerability to crime. And while older people are most likely to have structural faults in their houses, they are the least well equipped to get something done about it. The recent budget increased to £8m. the provision in the year 2000 for the Task Force for the Elderly, a scheme to make dwellings of older people habitable and comfortable. This scheme is run by Health Boards and the work is often done by FAS trainees. It is free of charge but there is a waiting list.

The budget also increased from £4,500 to £6,000 the Essential Repairs Grant (in 1995 it was only £900). This scheme, which is operated by local authorities, gives assistance for the carrying out of minimal repairs to prolong the life of the house for the lifetime of the occupants.

Adaptation of housing is another issue. In the survey mentioned above, 31% of females over 75 expressed difficulty in getting up and down stairs. Part of the problem here can be solved by a downstairs toilet, which in some cases could be installed for about £1000, or perhaps even better a mechanical chair-lift on the stairway for as little as £3000. The responsibility for this area rests with the Department of Environment who fund the housing adaptation grants from the local authorities. Under the Disabled Persons Housing Grants Scheme, up to £12,000 or three quarters of the cost (which ever is the lesser) are given, and the scheme is not means-tested. Each local council has a budget for work of this kind but it is not always adequate. The application process is sometimes slowed up by the requirement that an assessment be made by an occupational therapist. This delay can be circumvented by those who can afford to pay £60-100 to get an assessment privately. The scheme does not appear to be weighted in favour of the less well-off.

Carers and Long Stay Care

As our population begins to age, and more elderly people need looking after, those who bear the greatest burden will not be the taxpayers but the carers. For instance, family care accounts for 50% of the overall resources used in dementia care. About 30,000 people in Ireland suffer from dementia (often caused by Alzheimer\'s disease). In all about 20% of older people living in the community need some physical care, and this figure rises to 40% of those over 80. A 1993 study found that 88% of carers were relatives, 9% neighbours, and 3% paid Home Helps . It is difficult to estimate the total number of carers because much care is informal and figures usually include care for all categories, not just the old. The Carers\' Association estimates a figure of 55,000 full-time carers and about 60% of these care for older people . But in fact only about 30% of these are in receipt of the carers allowance, and only about 75% of carers get the allowance at the full rate. It is estimated that part-time carers number about 55,000 and these are not eligible for a carer\'s allowance.

Most objective analyses of the carers\' allowance scheme conclude that it is inadequate and miserly. Some measure of this can be seen in the fact that the state pays a total of £1.6 billion per annum to older and disabled people who cannot support themselves, but only £36m. to the people who look after those in need of care (1997 figures). The recent budget decision to include carers under 66 among the \'undeserving poor\', and give them an increase of only £4, as against £7 to the \'deserving\' pensioners, is indefensible. The Carers Allowance is means-tested and is subject to reduction once a spouse or partner has weekly income over £150 per week. The Report of the Commission on the Status of People with Disabilities (chaired by Justice Feargus Flood) concluded that:

The carers\' allowance, however, needs major overhaul. A large majority of carers are women but the restrictive nature of the present criteria means that many carers do not qualify for the allowance. This results in exploitation of many carers and is a major issue which needs to be addressed by the state immediately. The definition of "carer" is too restrictive and should be reviewed.

The recent budget introduced a new insurance-based Carer\'s Benefit for people who leave employment temporarily to look after persons in need of full-time care and attention. In its 10-year plan the Eastern Health Board has allocated £160,000 per annum for carer support groups, which is some recognition of the role played by carers. Only 6% of voluntary bodies providing services to older people also provide support services for carers . One of the biggest needs is respite facilities for carers whereby, for example, those in need of care can have a place in a residential home for a couple of weeks each year so that the carer can go on a holiday. The last budget increased the annual allowance for respite care by 50%, from £200 to £300. Some of the Health Boards and other organisations actively facilitate respite care, with application usually being made through a public health nurse. Given that carers perform a service which in their absence the state would often have to provide, there is a strong case for increasing the carer allowance to levels recommended by various advocacy groups (perhaps £110 a week) and to abolish means-testing altogether. The vast majority of carers themselves would like to be paid properly, both as recognition for the work they do and to enable them to purchase more respite and relief care.

Additional home help would be a great help to full-time carers, but it is received by very few of them. Health Boards report that the biggest difficulty is recruiting and training suitable people for home help, particularly people who are prepared to be multi-functional and to look after physical needs such as bathing as well as cleaning and cooking. The budget increase to £4.40 per hour in the minimum rate for home help workers should bring some improvement here.

One of the biggest problems faced by carers, especially family members, is that sooner or later they are unable to look after an older person in the home, and are faced with the problem of finding a nursing home or a hospital where the person can be looked after properly. Older bed-ridden people do not generally constitute an \'emergency\' and are often looked after at home with great difficulty when they should be in hospital. For this reason it is difficult to calculate how many bed-places are needed for long-stay care, since the estimates of \'need\' by the Health Boards and by the family may be widely different. However, discussions with any family affected by the issue would suggest that in Ireland there is not a single bed too many. In this respect Ireland is not too different from many other countries, though there are a few countries where more people live in institutions, especially where families are small. In Denmark, 15% of older people are in residential homes as against about 5% in Ireland and Britain. In Ireland families can often be made to feel guilty when they make enquiries about long-stay care for older family members.

Among the public there is almost universal criticism of either the standard or the cost (or sometimes both) of long-stay care. There is a Code of Practice for Nursing Homes but it is not legally binding. It covers such issues as the standard of care and treatment, accommodation and facilities, nutrition and privacy and respect. There is anecdotal evidence that it is constantly breached.

The allocation in the Budget of £5.3m. for nursing home subventions is to be welcomed, as is the £1m. to improve staffing ratios in geriatric units. But these amounts are small considering the scale of the issue. An allocation of additional resources for the inspection of nursing homes, and the publication of an annual report on them, would have been of equal importance

Work or Retirement?

Recently it was reported that a man in Dublin had secured employment as a security guard at the age of 75 and is reportedly delighted with his lot. While many people look forward to retirement, others find it a time of demoralisation and loss of identity. In an ideal world people would have a choice between retirement and continued employment, and happily the economic situation in Ireland is such that many have that choice.

Data on the number of people over 60 still in employment in Ireland are not readily available. In the U.S. only half of the men aged between 60 and 64 are still in the labour force; in Germany the figure is one third, and in France one fifth. In general retirement begins so early nowadays that men spend only half their lives in work.

As fertility rates fall, and life expectancy increases, a big change is occurring in population structure in most European countries. Between now and 2020 the number of people aged between 25 and 50 will fall sharply in many developed countries, by as much as 19% in Italy. However in Ireland this trend will be very much slower and the proportion of 25-55s in the population is projected to be slightly higher in 2021 compared with 1996, 40% as against 39% . The current concern of the government to build up a large nest egg to cope with future pension costs may be somewhat premature.

There are good reasons in modern developed economies for encouraging older people to stay in the workforce longer, but these reasons vary considerably as between Ireland and most OECD countries. In the OECD at large, the cumulative effect of low fertility and greater live expectancy will create two problems: one will be the affordability of pensions, and the other will be the resultant shrinkage of the economy. Changing demography could cut Japan\'s living standards by as much as 23% by the middle of the next century.

In Ireland, on the other hand, the main factor that would make it desirable to have more older people in employment is not shrinkage of the economy, but its possible failure to grow to its full potential as a result of manpower shortages.

There is no biological basis for a retirement age in the 60s. Disability is not generally a barrier to activity until people reach their mid-70s, and older people are growing healthier. Clearly, when older people do heavy work, their age may affect their productivity. But other skills may increase with age, such as the ability to handle people diplomatically, or to run a meeting well. So-called "crystalline intelligence" (problem-solving ability) actually increases with age. Many statesmen and others have done some of their best work beyond normal pension age. In 1940 Winston Churchill took over the leadership of wartime Britain at the age of 66. Konrad Adenauer was 73 when he headed up Germany\'s reconstruction in 1949. Pope John XXIII was 77 when he became Pope, and 83 when he opened the Second Vatican Council.

The virtues of younger workers can be exaggerated, particularly in an age of high technology and automation when less physical effort is required. Younger workers may be more flexible, and employers consider that older workers are not worth the investment in training. But the fact is that young people tend to change jobs so frequently that they offer poor returns on training. In Japan, one in three university graduates leave their first employment within a year.

People have been retiring in their 50s and 60s on the one hand because they have been bribed to do so by governments and employers trying to cut down seniority-based wage costs or who felt that redundancy for the old was less demoralising than unemployment for the young. On the other hand, generous pension schemes have given some employees an economic incentive to leave. One U.S. study found, not surprisingly, that the ages of retirement in large companies correlated with the financial incentives in their pension plans. In general, though, most Irish workers face substantial reductions in their living standards on retirement; a 1995 survey found that fewer than half of retirees had ever contributed to a pension scheme.

There is a common belief that retirement is compulsory at 65 years. In fact, there is no set legal age at which an Irish person must retire unless it is specified in the contract of employment.

It may well be possible for governments, employers and unions to design policies that would change the present \'culture of retirement\' so that it is no longer unattractive for older people to stay in employment, perhaps part-time, for as long as they want to. IBM in Belgium have come up with imaginative ways to retain the experience of their older workers.

Action Points

If we are to cherish our old folk better, the main things we would need to do are:

· Spend more money on services (not just health services) to the elderly, without cutting back on money for individuals and institutions. 
· Introduce some initiative to make \'Free Travel\' mean something for elderly people in isolated rural areas where there is no public transport. 
· Give significantly more money to carers, and ease the criteria for eligibility. 
· Double the fuel allowance and make the criteria for eligibility less strict. 
· Introduce some measures, at government and firm level, to counter the \'culture of retirement\' and give older people the option of staying at work. 
· Introduce a special savings scheme for \'windfalls\'.

A Spirituality for Old Age?

Some of the deepest problems of old age cannot be fully answered by more income or more social services. Old age is inevitably a time of loss as friends, siblings and perhaps spouses or partners die or become so disabled that contact is lost. Children have usually moved away and our modern fast style of living means they spend less time visiting their parents.

Once we pass sixty there is a constant realization that we are "in the departure lounge" and that sooner or later our flight will be called. If we are to cope well with this period we need a philosophy of life or a spirituality which will enable us to put the finiteness of our lives into perspective. Depression is a common condition among the elderly. Although its main cause is often loneliness, it can also be caused by the realization that gradually we have to let go everything we cherished in life, even living itself. Unless we have or can cultivate a philosophical attitude that allows us to face dying as a normal biological event, or a spirituality that gives us hope of a new and better life, we can face a slide into depression. It is a time of life when some form of regular meditation or yoga can give us the inner calm to live our later years gracefully.

Old age will come particularly hard to people whose life has been totally bound up with their work and who have taken no time for themselves and neglected friendships. If our self-image has been linked for a long time to professional accomplishments we will have significant problems with identity and self-worth once work ceases to be a part of our everyday life. By and large, our lifelong pattern of activities, friendships, and social contacts will continue after we retire. If we have been sociable people - or loners - at 30 or 40, we are likely to be the same at 70. If we never read a book or cultivated a hobby we are unlikely to begin in retirement. Planning for old age requires much more than signing up for a pension scheme!

Notes

My thanks to a number of people and associations who helped with this article, particularly: Tony O\'Riordan, S.J. and Bill McKenna SJ who read earlier drafts and made valuable comments; John Dardis, S.J. Archbishop\'s House, Dublin; Michael O\'Halloran of the Irish Senior Citizens Parliament; Niav O\'Daly, Sheila Simmons, and Brian McNamee of the Irish Association of Older People; Sr Patricia Finucane of the Mercy Order; John Heuston of the National Council on Ageing and Older People; Donie O\'Shea of the National Rehabilitation Board; Eddie Collins-Hughes of the Carers\' Association; June Welsh of Age and Opportunity, Marino; a number of officials of the Eastern Health Board, Central Statistics Office, and Department of Social, Family and Community Affairs; and Jesuit colleagues and other older people who shared their insights and wisdom. This acknowledgment is not meant to imply that these people or agencies are necessarily in agreement with the views expressed in the article.

1. Central Statistics Office. Statistical Abstract 1998-99. Dublin 1999: Table 2.18. 
2. Ibid., Table 2.6 and Central Statistics Office. Actual and Projected Population Tables, 1996-2031 
3. Data from National Council on Ageing and Older People, \'Age and Attitudes\', Ageing in Ireland Fact File No.13, Dublin 1997, using information from the 1992 Eurobarometer survey. 
4. Hughes, G. and Whelan, B.J., Occupational and Personal Pension Coverage, 1995. Dublin: Economic and Social Research Institute. 
5. Source: Department of Social, Community and Family Affairs (Statistics Section). 
6. In a study undertaken by the National Council on Ageing and Older People. 
7. Central Statistics Offfice, Statistical Abstract 1998-9, Stationery Office, Dublin, 1999.The £99m. is made up of £44m.in grants to voluntary welfare agencies, £37m. spent on home nursing, £13m. on home-help services, £9m. on home care for handicapped children, £3m. on home maternity care, and £3.m on meals and wheels. The amount spent on home calls by G.P.s to medical card holders is excluded. 
8. From the Pre-Budget submission of the National Council on Ageing and Older People. 
9. Fahey, T. and Murray, P. Health and Autonomy Among the Over-65s in Ireland. Dublin: National Council for the Elderly. 
10. Statistics from the National Safety Council. 
11. Extract from the Eastern Health Board\'s 10-Year Action Plan for Services for Older Persons, p.4, emphasis added. 
12. National Council on Ageing and Older People. Ageing in Ireland, Fact File No.9 
13. Irish Times, December 4 1997, p.5 of Budget Supplement. 
14. National Council on Ageing and Older People. Ageing in Ireland, Fact File No.9. 15. National Council on Ageing and Older People. Ageing in Ireland, Fact File No,10. 
16. \'Ageing Workers\' in The Economist, 4-10 September 1999, p.75. Much of this section draws on this article. 
17. Central Statistics Office. Actual and Projected Population Tables, 1996-2031. 
18. Economic and Social Research Institute. Medium-Term Review, 1999-2005, Dublin 1999. 
19. \'Japan\'s New Work Ethic\' in The Economist, 20-26 November 1999, p.85. 
20. With acknowledgments to the Canadian Mental Health Association\'s booklet, \'Coping with Growing Older\' available from the Mental Health Association of Ireland.