Services for the 21 st Century: meeting the needs of older people

Services in the 21st Century - or at least at the beginning of it - are likely to be shaped by current trends. The most significant is demographic change and the ageing of the population. Being older will be 'normal' and services will be increasingly shaped by the voice of older people themselves. The Human Rights Act and government emphasis on 'the civil society' will over time change the balance of power between the individual and the state, and technology has all sorts of possibilities in store. However, it seems likely that there will be enduring problems - notably persistent poverty in old age, endemic ageism in our society and a legacy of paternalism in our services. If services are going to meet the needs of older people in the 21st Century, they are going to have to change radically. What older people want is 'life, not a care plan'. The first priority will be to ensure that older people are able and encouraged to play a full part in society and in their own communities. The second priority is to have in place the right kind of help to ensure that people stay healthy and retain their independence. We are going to need older people in the 21st Century, because they will be a very significant proportion of our population. And they will be us - so it is up to us to make our own futures. The new millennium presents an irresistible temptation to think big, think broad and speculate on the future. This is clearly always a risky thing to do. What happens in the future is always a surprise and those who attempt to predict are inevitably heading for a fall. Leon Kreitzman, whose job entails thinking about the unknowable, likes to tell the story of the US Academy of Sciences which in 1937 undertook a study for President Roosevelt to predict scientific breakthroughs. It came up with some good guesses about agriculture, synthetic gasoline and synthetic rubber. It totally missed nuclear energy, antibiotics, jet aircraft, space travel, computers and transistors, as well as lasers, fibre optics and transplants [Kreitzman, 1996]. So perhaps we should be a little humble and stick to current trends and extrapolate from those, rather than trying to think the unthinkable.