Pensioners already claim a big slice of governmental budgets, and the share will only rise as their numbers swell
a hurry,” says Conny Helder, a Dutch minister who juggles the portfolios of sport and care for the elderly. She is referring to the second half of her job. The number of Dutch people aged 75 and older is expected almost to double by 2040, to 2.5m. The proportion of Dutchspent looking after the elderly is already among the highest in the world . Without big changes, it could double by 2050.
Some are beginning to make changes. In February President Joe Biden proposed minimum staffing requirements and better enforcement of rules in America’s nursing homes. A bill in Congress would boost state funding for the provision of care to people in their own homes. California’s “master plan for ageing” calls for the creation of 1m “high-quality caregiving jobs”. In 2021 Britain raised payroll taxes in part to pay for care of the elderly.
The less governments spend, the more individuals fill the gaps. In America 42m people take care of someone over 50, says Brendan Flinn of the AARP Public Policy Institute, which does research on issues that affect the elderly. The European Commission puts the value of informal care of elderly people and adults with disabilities at perhaps 2.5% of the European Union’s. Such responsibilities impose hidden costs in the form of stress and lost hours of paid work.
Ms Helder’s plan to make the elderly more independent is a bet that the interests of the old and those of the state coincide. She wants to “make sure people feel more independent…so they still remain part of society and interact with other people”. Over the next 20 years the government hopes to reduce the proportion of people receiving long-term care who are in institutions from 80% to 50%.
The shakier part of Ms Helder’s bet is her plan to use technology and non-professional carers as a substitute for paid human labour, for instance by offering video calls with nurses. A sign of the new thinking is the founding in 2018 of the Academy for Patients and Informal Caregivers at Maastricht University Medical Centre+, a partnership between a hospital and a university.
Els van der Doe, 75, a lively former bookkeeper, is a walking advertisement for the concept. Alone in a big house after she was widowed, she was enticed to move by Hof van Leijh’s ethic of “reciprocity”. Now she says she’s busier than she was when she worked. She helps neighbours operate their computers; they walk her dog.
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