Could these old and new ideas be the future of social care for the elderly?

In around six years’ time, it’s estimated that one in six people will be over 60. In the decade between 2020 and 2050, the share of the global population over 60 will double from 1 billion to 2.1 billion, says the World Health Organization (WHO).

During that time frame, the number of over-80s will triple to reach 426 million.

But what kind of life will these people be living and how will we look after them?

We’re living through a care crisis, as countries across the globe struggle to meet the needs of a growing elderly population, and employees leave care work due to low pay.

In the UK alone, there are an estimated 1.6 million people aged 65 or over who have “unmet needs for care and support”, according to the charity Age UK, which includes simple everyday activities such as just getting out of bed.

But the need for elderly care will be felt more acutely in some parts of the world. By 2050, the WHO says 80% of older people will be living in low- and middle-income countries.

In 2023, of the 55 million people living with dementia globally, more than 60% live in low and middle-income countries.

Dementia is the umbrella term for loss of memory and cognitive function, which mainly affects older people and includes Alzheimer’s disease. The condition is growing as people live longer – with 10 million additional cases each year.

The global ageing population is boosting demand for the “care economy”, which includes childcare and care for those with disabilities, and both paid and unpaid care work.

Unpaid care work accounts for the majority of care work globally, and would be worth the equivalent of around $11 trillion in global GDP, according to the International Labour Organization (ILO), if it were valued on an hourly minimum wage.

Women, particularly migrants and those from socially disadvantaged backgrounds, make up the majority of those working in unpaid and paid care work, where pay is low and they often work in poor conditions.

The ILO says that to promote gender equality, investment in the care economy needs to be doubled, which could lead to an additional 269 million jobs by 2030.

Without improvement in the care economy, the US alone could lose $290 billion in GDP in 2030, according to research from BCG. In January 2023, vacant care jobs stood at 1.8 million.

Dementia costs the global economy more than $1.3 trillion each year – a figure that could increase by nine times by 2030, according to the Davos Alzheimer’s Collective, which was launched at the World Economic Forum’s Annual Meeting in January 2021 to accelerate healthcare for the disease.

Here are just a few of the innovative, sustainable and cost-effective ways we could look after the elderly – and support good jobs in the care economy – in future.

Almshouses are nothing new – in fact, they were first built in the 10th century in the UK. The 2,600 purpose-built charitable communities for older people on low incomes that house 36,000 people in the UK today can give their elderly residents a longer life expectancy, according to research.

In 2017, Bayes Business School, at City, University of London, found the female elderly population of Whiteley Village (established in 1914) lived five years longer than other women their age elsewhere in England and Wales.

Intrigued to see if this “longevity boost” extended to other almshouses, the researchers broadened the scope of their study to include 15 and found that residents “are getting a boost relative to their peers who are not living in almshouses”.

They concluded this was down to the strong sense of community present, which was reducing loneliness and social isolation.

Elsewhere in Europe and the US, dementia villages are being established from Germany to Scotland and Rome to New Jersey, based on an innovative Dutch village called The Hogeweyk.

“The Hogeweyk is about small-scale living, which means people living together – seven in a house – with care staff,” one of the founders, Jannette Spiering, told the BBC, adding the concept was about reducing the stigma around dementia and “normalizing” the environment for residents.

"If you lock them up in a facility which looks like a hospital, then people … become anxious, and they want to get out because they do not recognize that environment, and they constantly think that they are ill."

Many countries, including the UK, are beginning to recognize the need to move care away from hospitals into the wider community, and Age UK says the development of community Falls Services, Hospital at Home services, Virtual Wards and Integrated Frailty Services offer a “glimmer of hope”.

China is home to one of the largest populations of older people in the world, according to The Lancet. By 2040, almost a third of the population will be 60 or over (an estimated 402 million people).

Meanwhile, the country’s former one-child policy means smaller families need to look after ageing relatives and many older people live alone.

To look after more vulnerable people as its population ages, the government is bringing in an elderly care system by 2025.

In May 2023, guidelines were issued requiring all provinces to implement a list of basic care services for the elderly, taking into account socio-economic factors.

The list includes nursing and caregiving, as well as visiting and caring services for those living alone and for families struggling financially, Reuters reports.