EXECUTIVE SUMMARY
INTRODUCTION
The Scottish Executive has developed A Strategy for a Scotland with an Ageing Population (published March 2007), titled: "All Our Futures: Planning for a Scotland with an Ageing Population" to address the challenges and opportunities posed by Scotland's ageing population. The aim of the Strategy is to provide the framework for:
- access to opportunities for older people to make a continuing contribution
- effective integrated services for older people
- promoting and maintaining health and well-being
- people living in accommodation and environments which continue to meet their needs and wishes as they age.
To feed into the Strategy, the Scottish Executive commissioned Ipsos MORI to conduct qualitative research among the general public in Scotland. The research centred on the following themes:
- attitudes towards the ageing population
- how people view the impact of ageing on themselves - their aspirations for old age and barriers they perceive to fulfilling those aspirations
- perceptions of change needed to support an ageing population.
Seven focus groups and 10 depth interviews were undertaken between 9 th May and 17 th May 2006 in both urban and rural locations. The participants were of varying age, gender and socioeconomic status. One group consisted of lesbian, gay, bisexual and transgender ( LGBT) participants, one group consisted of Asian participants, five depth interviews were conducted with disabled people and five depth interviews were conducted with people aged 85+.
The topics discussed in the groups and depth interviews included:
- expectations and planning for old age
- society and older people
- contribution
- work
- services
- health and well-being
- housing
- transport.
CROSS-CUTTING THEMES
Participants strongly linked the term 'older people' and retirement, with the majority of participants saying that someone in their sixties might be considered 'older'. However, many other participants, especially those who were themselves aged 50 and above, felt that people in their sixties are not 'old' these days and that they would only consider 70 or even 80 'old'. Thus, the focus of the discussions, and therefore of this report, was people aged at least 60 and people who have retired. This differs, quite substantially in some cases, to the age range on which the Strategy is focused.
Most participants were aware of the fact that Scotland's population is ageing. However, they were less likely to appreciate the scale of the issue and the potential implications. There needs to be a shift in understanding before they will take action to better prepare for their own old age or accept the need for less popular government measures.
Participants were divided on how well society treats older people. Older participants themselves, however, generally felt that they were treated very well and the barriers they perceived related mainly to health rather than the negative attitudes of society.
However, participants' thinking was youth-centred, i.e. what is best for young people. For example, enabling older people to work longer was desirable - but not if this meant taking jobs away from younger people.
Beyond some participants planning their pension, participants were not typically planning for their old age at all. A number of reasons emerged to explain this. Most importantly, participants planning horizons tended to be short or medium term at best. Beyond relatively vague thoughts about how they might wish their future to be, most seemed not to actively plan anything much beyond the next year or so. A number of attitudes also explained the reluctance of participants to plan for their old age: the inevitability of ageing which appeared to mitigate against the need to plan for it; the fact that it is a very gradual process which means it is easy to put off action to another day; the lack of guarantees about planning for health or financial security; and the fact that ageing is too "depressing" and "scary" to think about.
CONCEPTUALISATION OF OLD AGE
Old age, or retirement, was primarily seen as a time free of work and family commitments - leisure time where you could go on holidays, spend time with grandchildren and pursue hobbies. The quality of this leisure time was dependent on three main factors, in order of importance: health, money and social contact.
One of the aims of the Strategy is to provide opportunities for older people to make a continuing contribution and remove the barriers to doing so. The Strategy will take a broad definition of 'contribution', including the payment of taxes, buying goods and services and involvement with friends and neighbours - as well as working and volunteering. However, participants took a narrower definition of 'contribution' and focused very much on employment, volunteering, caring for grandchildren and, in particular, on the wisdom, experience and skills they could pass on to younger generations. Using participants' own, narrower definition of 'contribution' then, it is important to note that there was little sense that they felt old age was about making such a contribution - rather they felt that older people had "done their bit" and that old age was therefore their time to do as they please. The barriers they perceived (e.g. poor health, lack of money, loneliness, inadequate services) were barriers to a fulfilling and enjoyable old age, not to making a contribution.
ASPIRATIONS AND BARRIERS
Health
There was optimism among the participants that they would be healthy in old age. However, health is the aspect of ageing about which they were most worried, with particular concerns about "being a burden" and having to rely on someone else to look after them.
In terms of trying to ensure good health in old age, behaviour was divided with some younger participants trying to exercise and eat healthily and others giving it little thought. Those who were not actively preparing for a healthy old age had a variety of reasons for this: some simply hadn't thought about it, others felt that you can try and be healthy but this will not guarantee health in old age as genetics and other factors mean that ill-health in old age can happen to the most health conscious people. There was also a more general feeling that it is hard to plan for anything that far in advance because people are dealing with more immediate issues. Overall, the motivations and barriers relating to healthy living for a healthy old age appeared much the same as the motivations and barriers which affect people thinking about health in the short and medium term.
Money
Although participants naturally wanted to have enough money to live on when they are older, they had concerns that this may not actually be the case. Among those below the state pension age, behaviour differed greatly in terms of contributions to pensions with some having started saving from a young age and others not saving at all. Reasons for not contributing to pensions ranged from the fact that it is too far ahead to think about, to it being too worrying.
In terms of what should happen to pensions in the future, the consensus was that there should be a government pension that guarantees people a certain standard of living.
Retirement age
There was widespread support for the retirement age being flexible and allowing people to work for as long as they wanted to and were capable. The main reason given for this was that it depends on the individual and, in particular, their health. At the same time, however, there was an equally widespread perception that retiring around 60 or 65 seemed "about right". Pros and cons emerged at both the individual and societal level in terms of enabling people to work longer.
Activities and social contact in retirement
Those who had already retired tended to spend their time on a range of hobbies which included keep fit, gardening, stamp collecting and playing bridge. Some were involved in community groups and clubs. A couple of the female participants aged 85+ appeared to have particularly active lives, with involvement in a wide range of activities. However, one male participant felt he had too much time on his hands.
When younger participants were asked what they wanted to spend their time doing when they retired, the most common answers were spending time with grandchildren and going on holiday (the latter, in particular, contrasts with what the retired participants actually did).
More generally, younger participants thought there were currently plenty of activities for older people which might help "get them out and about" meeting people. These younger participants perceived potential barriers to taking advantage of these opportunities including lack of publicity about what is available and accessibility. However, the attitude and willingness of some older people to take part was seen (rather unsympathetically perhaps) as the biggest barrier.
SERVICES
In the main, discussions of services for older people centred on the adequacy, or inadequacy, of current provision rather than on more aspirational ideas about future provision. Moreover, when asked about the implications of the ageing population on the provision of services, responses tended to be simply that more and better services would be needed. There was little appreciation of the economic and demographic problems that might be faced in attempting to meet these needs.
Care services
Current care provision was an area of some concern for participants. It was commonly felt that there is a shortage of such provision which can result in older people's needs being left unmet. In addition, there was also negativity about current standards of care. There was suggestion that care staff lacked both the qualifications and the dedication to carry out their job to a high standard. There was a general feeling that care services should be provided free for all older people who need them.
Health services
Health care provision for older people was also seen to be inadequate. Hospital closures and staff shortages were cited as the main reasons for the decline in the quality of health care provided.
Transport
Participants generally viewed recent developments in public transport services positively. There was particular praise for 'kneeling' and low access buses and for the new free bus pass for pensioners.
Housing
Younger participants had given almost no thought to where they might live when they were older. Although some older respondents were more conscious of health problems which might make their current accommodation unsuitable, the dominant view was that they would only move if, and when, they had to.
While some participants felt that Scotland's housing stock was suitable for an ageing population, the consensus was that greater thought needs to be given to the number and types of houses that are being built, for example more single-storey properties. There should also be more affordable housing provided for older people.
Advice services
There were some suggestions for new services that might be beneficial. In particular, participants felt that there should be dedicated advice centres for older people to provide assistance with such issues as benefits entitlements, application forms and so on.
IMPLICATIONS FOR THE STRATEGY
Understanding the ageing population issue
There needs to be a shift in understanding before participants would take action to better prepare for their own old age. Similarly, there needs to be a shift before they might accept the need for less popular government measures.
Emphasising the benefits to all of society
There appeared to be a prevailing youth-centred orientation - even among older participants. It may be some considerable time before this perspective changes. In the meantime, the Strategy should emphasise the benefits to all of society, not just older people, in addressing the ageing population issue.
Encouraging a continuing contribution
Participants' understanding of a 'contribution' was narrower than the relatively broad definition that will be used in the Strategy. This has implications for the language used in Strategy document if people are to understand 'contribution' in its broader sense.
Old age was conceptualised as a period free from work and family commitments. There was little sense that participants felt old age is about making a contribution in these areas. This suggests that initiatives to encourage and help older people make continuing contributions of this nature should emphasise the benefits to the older person (e.g. enjoyment and social contact) and should be voluntary and flexible, rather than focusing on 'contribution' as it may be currently understood.
Encouraging individual planning
It is important that initiatives to encourage better planning strike a balance between warning people of the implications of not planning and avoiding 'scare tactics'. In addition to educating without employing 'scare tactics', initiatives which emphasise the current benefits of taking action may have more impact. More positive images of old age could also be used to help combat the notion that ageing is too "depressing" and "scary" to contemplate.