Life expectancy in Australia is at an all-time high: pre-school-aged girls can expect to live to 84 years, around five years longer than their healthy brothers. By 2041, the 65-plus age group is expected to make up more than one fifth of the population, posing a number of inter-generational planning challenges.
Although disease and disability are far from synonymous with old age, chronic and debilitating diseases become more prevalent as we age. In 2009, for instance, more than 70% of Australians aged 90 years or older experienced profound difficulties getting around, caring for themselves and/or communicating.
In particular, the chances of developing dementia increase substantially with ageing. In those aged 95 years and over, prevalence of dementia escalates to 37% for men and 47% for women.
Dementia occurs because of changes in the brain, mainly from Alzheimer’s disease or vascular deterioration. Communication, in particular, is generally affected. Cognitive and functional deterioration tends to progress slowly, but inexorably, to death.
Concurrent illness in old age is now a major issue in health care and its impact crosses care settings. There is a growing group of older people who are frail and unwell in the years when they draw close to death; our challenge is to meet their care needs.
Caring for the aged
When concurrent illness occurs, care complexity increases. For example, recognising angina when a person has dementia requires special skills. Also, old age brings about physiological changes that impact upon treatment choices such as medication dosages. Therefore, there’s a growing need for health professionals with appropriate expertise.