Second opinion: Currently, 16 per cent of the EU population is aged 65 or older. This is equivalent to about 74 million people.
The percentage of people over the age of 65 in Ireland is at the lower end of that in the EU. The EU's population has become younger with the addition of the 10 new member countries in 2004; this is a short-term trend. We will have an ageing population for better or for worse.
The percentage of elderly people will continue to rise over the next few decades in Europe, mainly in the 15 "old" member countries. The percentage of people aged 80 and older will increase on average by 50 per cent over the next 15 years.
Birth rates with an average of 1.4 children per woman are below the general average reproduction level, which is 2.1 children per woman. In many countries in Europe immigration is crucial for population growth. Despite continued immigration, the EU's population is stagnating and even decreasing, unlike the US.
The average pension age in the EU is 60; it is 63 in Ireland. The dependency ratio for the elderly, or the relationship between the number of people aged 65 and over and the number of people of working age, is an average of 24 in the EU. This means that 100 people of working age have to support 24 people aged 65 and older.
The working-age population in Ireland will begin to decrease after 2010 and the labour market will have to rely on the older workforce to a greater extent.
This is an issue especially for our medical and social services sectors where the average age is already high. Many countries are, therefore, addressing staffing issues for medical and social services; today 10 per cent of the EU's total workforce is employed in this sector.
Differences in supply of care for older people are greater among the EU countries, than say for supply of medical care. In some countries the family is still responsible for providing or paying for this care. In these countries, society only intervenes when the family can no longer provide care.
More and more countries are shifting to a broader distribution of responsibilities for care of the older person. It is common for local authorities to have this responsibility, as in Sweden. All countries have an infrastructure for professional care of the older person, but its significance varies, depending on factors such as the family's role and the scope of services.
Most EU citizens agree that home help is a better choice for older people than special housing. However, EU citizens are not in agreement over who or what should be responsible for the long-term needs of the older person.
The basis of public medical and social services differs greatly among EU countries. More than 80 per cent of Swedes believe that society should be responsible for the older person by providing home help and special housing.
In Spain and Greece, the relationship is the reverse, where 80 per cent or more believe that informal care by a relative is preferable. A larger percentage of the elderly population lives alone in northern Europe than in southern Europe.
The demographic trends within the EU involve a major strain on our social welfare systems, as they do on pensions, medical care and social care of the older person. These common challenges are described based on several aspects, including the relative reduction of the working-age population, the ageing workforce, pressure on pension systems, general government finances, increased need for medical/social services, the increased differences among our older people in matters involving health, housing, education and family situations. And yet, the debate in Ireland thus far has dealt primarily with the volume, resources and quality of care for the elderly as it is today.
We tend to focus on flaws and what does not work in the current system.
The majority of our older people manage on their own for a long time, even though most will require medical and social services at the end stages of life.
The question before us now is whether we need a change in perspective. Do we need to generate a debate as to how the needs of our older people and, indeed, of the total population will affect the social economy, housing policy, social planning and range of social services?
Should the focus be shifted from individual need to considering which tasks society is best at doing and which individuals themselves can manage? We all know that public finances will be strained when those born in the 1960s retire at the same time that those born in the 1940s will need increasing healthcare. There is also good reason to believe that the older people of the future will have other demands and expectations as to how and where they wish to live.
The issue is whether it is reasonable to assume that the core activities in care of older people will be the same as today. Perhaps we should instead see how the community can match and develop older people's own ability to stay healthy, making it easier for them to organise their daily lives. It is our duty as care providers to plan and implement the changes needed to provide for proper and effective care for our older people. Now is the time to act.
•Joseph Yazbeck is medical officer at Leopardstown Park Hospital, Dublin, a 200-bed facility caring for the elderly.