10 November 2023 , 00:01
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The elderly could ditch the drugs and maintain “old fashioned” habits such as walking to stay healthy, Sir Chris Whitty has said.
England’s Chief Medical Officer has unveiled a report outlining how our elderly population will increasingly be concentrated in rural and coastal areas which must be redesigned to help them live independently for longer. He said we should all be encouraged to make end-of-life plans and break the taboo around death so people can live as well as possible to the end.
Prof Whitty also said some pensioners could ditch half their pills if medication side effects start outweighing their benefits during their final years
He told a media briefing: “There are lots of things people can do themselves, which will delay the point where they first have disability and then multimorbidity and they are old fashioned things actually. Lots of exercise, having mental stimulation and a social network, eating a reasonably balanced diet - not too much high fat, sugar, salt, moderate moderate alcohol - stopping smoking if you do. They're old fashioned, but they still work.”
There are now around 11 million over-65s in England or one in five of the population. This is due to increase to 13 million in the next ten years. By 2050 a quarter of the population will be over 65.
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While major cities are expected to maintain current young-to-old ratios, the growing elderly population will increasingly dominate smaller towns and villages. Prof Whitty said in later life it can sometimes be beneficial to go through medications with a doctor and to stop taking some.
He said: “The idea that you have a treatment that is highly effective and doesn’t have side effects is usually a fantasy. There’s always a trade-off. One of the things geriatricians are often very good at doing is meeting this person who’s on 25 drugs and just going through it and saying, 'Actually you just don’t need to have at least half of these. At this point in your life, this is not going to help you, the side effects cumulatively are going to be quite problematic.'.”
The report concluded that living longer in poor health is not inevitable but homes and public spaces must be changed to enable people to get out and about. And activity must be built into people's daily routines.
He said: “If I was to highlight just one (factor) it would be that exercising for the longest possible time has a huge positive impact on both physical and mental health. Let's take the rural environment, you think surely this person can do lots of exercise.
“Well if you actually look, they will often not have a pavement between their house and the walking trail that’s maybe half a mile away. So they'd have to either walk along a very busy road, or through a muddy field - both of those are difficult. You need to think about this from the point of view of older people.”
Research shows that people become less active as they get older, with a third of 75 to 85-year-olds and 57% of people aged 85 and over being physically inactive.
Prof Whitty said modern homes are designed for young families and should be designed with features like downstairs bathrooms so that in later life residents can live mainly downstairs.
Calling for people to discuss end-of-life wishes, he said: “We shouldn’t shy away from this. The difficulty often is someone gets ill in the middle of the night, in a care home, the carer doesn’t know them, the GP is an on-call GP. They come into hospital and the hospital doesn’t know them.
“If you don’t know what someone’s wishes are in advance it’s very difficult at that point to have a serious, rational conversation. That might be: ‘I want to go to hospital but I don’t want to go to intensive care,’ or ‘I want to have treatment but I don’t want to have an operation’.”
He added: “You’re very satisfied as a doctor when you meet someone who’s facing their end saying ‘I’ve had a good innings… I’ve had a great life’ and then work things through with them. That’s what most people want.”
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Prof Dame Linda Partridge, Vice President of The Royal Society, said: “Supporting an ageing population to live well for longer will be a defining challenge of the 21st century, for the UK and many other economies.”