When they were born one hundred years earlier the 1921 census found only 110 people who had reached that age. The number had remained relatively constant through to the 1961 census. Only then did it accelerate away. The benefits of public health, nutrition and medicine really came through. The impact is so good that 25% of todays Centenarians report themselves to have “good” or “very good” health. If I make it to 100 the ONS thinks there will be 33,000 of us.
These are people with memories that for most of us are history. At the age of 7 they will probably remember women being allowed to vote. They were 18 when the Second World War started. They were 28 when the UK National Health Service was created. They were 39 when the contraceptive pill became available. Decimalization of the UK currency happened when they still had half of their lives left.
The most positive finding was that 60% were living at home. The rest were living in care. 42% were living alone at home. The rest were living with family members. 18% were living with their spouses. There were even 14 married couples who were both over 100.
The Cost of Home Care
Some at least of those Centenarians are living at home with little outside help. Many will have a social infrastructure wrapped around them. In previous Newsletters I have talked of the role of family members as carers. The same census estimated that there were 5.7m unpaid carers in the UK. Many juggle work and caring for family members. This has both productivity implications for firms and mental health issues for individuals.
It will only be next year that the “Carers Leave Act” becomes law. This at least guarantees one weeks unpaid leave a year to care for a relative or dependent. By comparison the Japanese passed their first such law in 1999 almost 25 years ago. The current version of their “Child Care and Family Care Leave Act” is wide ranging. It allows for three installments totalling 93 days per family member in need of care. This covers children and ageing parents. There is an additional “Time Off for Care Givers” of 5 days per year/family member. You are also allowed three years flexible working. It is insightful that they make no distinction between childcare and elderly care.
Within the UK there are firms that are taking the initiative. Centrica believes that being proactive will lead to two benefits. It avoids unplanned absences and underperformance at a saving of £1.8m per year. It also improves retention, which they think is worth £1.3m per year. They have a package of measures. These include matched time off, flexible working and a “carers employee network”. No one has yet tried to measure a “Carers Penalty” to go along side a “Child Penalty” (see last weeks Newsletter). The logic will be the same. People will leave the workforce to care and may not return. They will miss promotions. The odds are high. The latest estimate is that 65% of people will have to care for someone in their lifetime. The bulk of the care is provided by women.
The Cost of Institutional Care
There are huge costs for both the Government and individuals in care and nursing homes. A study this week by the Health Foundation looked at Government costs in the UK. They estimated an incremental cost of social care at £8.3Bn over the next ten years. There are already funding gaps and they will only get bigger. The number of older people is growing. Not all can remain at home. For a 65-year-old woman who needs to enter a care home her life expectancy is 7 more years. Even at 90, entering a home, she could still expect to live for 2.9 years. The cost implications are huge.
For individuals in the UK there is a means- tested model. Many of those years in a home will be funded by the individual. The average annual cost in London is £58,000. It drops as low as £40,000 in Newcastle.
The Impact of Technology
There is a burgeoning business providing technological solutions to care homes. This week there was an Ageing Conference in the USA. It offered six start-ups the chance to "pitch their proposition" to venture capitalists and prospective clients. Most offered solutions to automate care homes and improve efficiency and service. HowsMom.com automates communications with families. It offers care and nursing homes an easy and automated way to give families on-demand information. Readyworks.com offers automation for all nursing administrative work. It takes away the paperwork using QR Codes and smartphones. MoMo Medical from the Netherlands provides activity monitors for patients’ beds. In an integrated system it can tell who is out of bed, who is showing signs of life and who is resting peacefully. Opeeka integrates medical records, electronic health records and the institution’s care management system. They work to draw insight from the combined data.
In Japan there are far bigger players involved. Sompo Holdings is one of Japan’s largest insurance companies. They also operate 280 care homes. They have equipped homes with activity sensors in beds. They can also remotely monitor heart rate, breathing, and assess sleep. Working with US data analysis giant Palantir they are using the data in two ways. They can predict demand for activities in the care homes more accurately. This has enabled them to take up to 15% of the workload out of a typical 60-person home.
They have used the aggregate care home data in their insurance business. They offer dementia insurance. This will pay out if dementia is diagnosed. They offer insurance premium discounts to people who undertake activities designed to slow any onset. The data from the care homes has allowed them to compute the risks and premiums.
The care industry in many parts of the world is fragmented. Will this kind of technology be adopted. It can probably mitigate cost increases but is it enough to avoid a growing care bill?