Not Dead Yet: A Manifesto for Old Age

The dog was the first problem: the benefits staff were very difficult about her bringing it in. But there then followed the most extraordinary, frustrating and undignified interview. The benefits officer kept asking her for evidence to prove who she was. This was particularly peculiar because I was there to vouch for her, and I had brought my passport to prove who I was. But the real point was that not only was she well known to the system, but this benefits officer actually knew her.

They could see she was vulnerable, and knew she had been mentally ill, but they still gave her a really difficult interview. It was as if the benefits officers had been trained to be obstructive, and so it proved. In fact, when I complained about her treatment, I was told that this was normal practice.

It was also deeply unkind. It had taken a great deal of guts to go to the benefits office in the first place after what she had been through. I realized that the fact that she was old and vulnerable made it easier for them to behave like that. If that is not discrimination against the elderly, I don’t know what is.

In the years since then, I have been struck by the huge differ ence between benefits offices. There are those that make an effort to reach out to older people and make sure they get any money they are entitled to, and there are those which – if they don’t actually bully older claimants – take advantage of their reluctance to be supplicants to a complex and aggressive bureaucracy.

Let’s not pretend that money is a problem for all older people. Many of them are extremely wealthy. But my time as a rabbi, and more recently chairing an NHS trust, has made me realize how many older people have real difficulty claiming what they are entitled to. They don’t want to beg, so they don’t try. The result is that, for those older people who are short of money, their financial problems are seriously exacerbated. There is a similar exacerbation of other problems in old age, like poor housing, for the same reason. That is how so many older people end up much more seriously impoverished than those around them.

Take the case of James Purvis, then 68, who featured in the series of articles written by the investigative journalist Nick Davies in the Guardian in 2005.1 (#litres_trial_promo) Mr Purvis lived in King’s Cross, in a small, dark, damp flat – so much of the poverty of older people is related to housing problems – with a ‘thin skin of mould … on some of his furniture’. He lived alone, seeing few people, but had one pleasure: he travelled around London on his free bus pass, taking photographs.

He could not afford to take many photographs on his pension – just one roll of 35 photos a week – because he had to pay Jessops £7.99 to get each one processed. He made it a rule never to spend more than £5 a week on gas – he lives on his state pension – so, in the winter, he often stayed in bed for much of the day, and he only spent £5 a week on electricity, using the microwave his daughter gave him to keep the costs down on cooking food.

‘Mr Purvis has cut down on eating,’ wrote Nick Davies. ‘Like many older people, there are other things he needs or wants out of not very much money, and food does not come high up the list.’ It is no surprise that malnutrition amongst older people is common. Indeed, the European Nutrition for Health Alliance argued in 2005 that poverty is probably the greatest social cause of malnutrition, combined with loneliness and social isolation, and the story of Mr Purvis fits this combination of categories perfectly.

His wife went back to Newcastle some 20 years earlier and he sometimes likes to hear voices that do not come from the television. Like many older men whose relationships have broken down, he also feels a bit of a failure, though he sees his daughter most weeks. But this is a common story of the absence of love, the absence of money to do the things he would like to do, and the recognition that – as he gets older and poorer, and costs of housing and gas and electricity go up – he will have to give up the one thing he really likes doing, his photography.

‘He thinks it’s a bit of a joke really, the idea of him sitting in this little flat all day, with the smell of damp and the curtains drawn,’ wrote Davies. ‘If there is no other way to make ends meet, he will just have to give up the photography and make the most of life alone.’

The story of Mr Purvis is one about a man who, though retired, does actually have a passion in life, which he is all but prevented from exercising because he is living in such poverty. Poverty and old age were such companions in debate a century ago, when the commission on the poor laws was first building a consensus for the first old age pension, that it was hard to discuss them apart, with the tragic separation of couples at the poorhouse door. The fact that we have had state pensions, however inadequate, for a century since then means that they no longer have to go together in quite the same way. As we shall see, many older people are quite well off these days.

Any book on old age must cover the question of money, but I am not going to write in detail about pensions, because it is a hugely vexed issue, and I am no expert. Pensions deserve a book of their own, and there are many of those already. Even so, money, its absence, and concern about it, are all key to any consideration of what old age can and should be like. It also looks as though our attitude to money in old age needs a great deal of re-examination. Whatever middle-aged people feel now, there is no doubt that younger people are feeling concerned that they will have to pay for their own pensions and their parents’ pensions too.

These are important considerations when it comes to practical politics. People resent having to pay for long-term care in old age, and having to sell their home in order to do so, but the cost of the state bearing the entire amount might just be too great politically. Younger people would object. The politics of dividing the national cake is beyond the scope of this book too, so this chapter will simply look at some of the outstanding financial issues facing older people, and some of the things we might be able to do about them if we are really creating a manifesto for old age.

Poverty

Before we look too closely at the issue of poverty in old age, we ought to be honest with ourselves about how much richer, relatively speaking, older people have become over the last generation. The average net income of all pensioners (the technical term for older people, though not all actually get pensions) grew by 63 per cent in real terms between 1979 and 1996/7. During the same period, the average earnings in the whole economy grew by 36 per cent, which suggests an astonishing rise for older people, admittedly from a very low base.

The image of the poor pensioner was not inaccurate at the end of the 1970s, but the trend has been moving in the right direction. Older people’s average income has grown even faster than earnings over the last ten years. The net income for pensioner units grew by 29 per cent between 1996/7 and 2005/6, whilst average earnings have risen by a mere 16 per cent in real terms over the same period, just over half the rate for older people. There have been substantial increases in incomes from occupational pensions, investments and benefits over the last 25 years. Also, average net income after housing costs has risen faster than the net income before housing costs are included, and this is at least partly because so many more older people own their own homes. Some two thirds of households headed by pensioners are owned outright.

Confusion about money

As I found when I was working on my last book, The Moral State We’re In, poverty may not be as much of an issue for older people as it was, though there are still some appalling examples. But these are often more to do with not being able to think properly about money, and manage the daily administration and bill paying we all have to do, than with actual lack of cash.

The shocking Christmas story of 2003 was about an elderly couple living in London, in the same house for 63 years, who had died respectively at 89 (the man, of emphysema and hypothermia) and 86 (his wife, of a heart attack).2 (#litres_trial_promo) This was not the surprise. The problem was that their gas supply had been cut off because the bill had not been paid. Yet there was £1,400 in cash in their home and a further £19,000 in a building society. This was not a case of poverty. What was happening to them was that they were finding it harder to cope, a nightmare that overtakes many older people and is feared by even more. Though they may well not have Alzheimer’s disease or any other kind of dementia, at the very end of their lives they often find it hard to organize things and get their paperwork sorted, to catch up with the bills and the personal administration, and to keep their affairs in order.

In the case of this couple, British Gas had cut off their gas supply but not alerted the local social services, and excused themselves for this appalling oversight on the grounds of protecting their customers’ privacy, because of the Data Protection Act. The Data Protection Act’s Information Commissioner responded immediately that this was not correct, and ‘there seems to have been some incompetence on the part of the energy company.’ Yet the seriousness of the case lies in the fact that two perfectly innocent, old and frail people – just about coping with the vagaries of life in their own home – died because no one noticed that they were a bit confused.

Much of that confusion was about money. They may not have been poor, but managing money, or trusting someone else to do it for you when you can’t do it yourself – particularly if you don’t have children or other close relatives – is quite difficult. It is also a source of concern, and even fear, among many older people.

Real poverty

Despite these trends, real poverty is still an issue for many older people. Some 1.8 million older people are still living in poverty in England, according to Age Concern, and inequality amongst retired people is greater than amongst the working population.3 (#litres_trial_promo) The top fifth of pensioner couples have a retirement income averaging around £45,000 per annum, whilst a quarter of all pensioners live below the poverty line (£5,800 for a single person).

All this is further complicated by the fact that some £4.2 billion in possible benefits for older people go unclaimed. Age Concern England has been trying to persuade the public to do more to make sure older people they know claim the benefits they are entitled to. After all, the Department for Work and Pensions is on record saying that no pensioner should be living on less than £119 a week. Yet a third of us are afraid that an older friend or relative is missing out on cash benefits, and almost half of pensioner households fail to claim Council Tax Benefit, leaving almost £1.4 billion unclaimed. As many as 40 per cent of pensioners fail to take up their entitlement to Pension Credit, 47 per cent to Council Tax Benefit and 19 per cent to Housing Benefit.

Older people’s charities, such as Age Concern and Help the Aged, already do a fair bit to alert older people and their families and friends to claim the benefits they are entitled to. But they could do much more, and this is where their polite approach to campaigning and providing help is less than useful. Many older people watch TV a great deal in the daytime, and a really angry television campaign might alert people to what they are entitled to. Giving them numbers to call and encouraging them to go to the Citizen’s Advice Bureau – even taking part in the campaign – might also help. There was a high-profile launch of Age Concern’s ‘Your Rights’ campaign, but we need to shame benefits officers into going out and finding older people who are not claiming. They are doing just this in some parts of the country; why can’t they do it everywhere?

Fuel poverty

The poverty that older people are often particularly prone to is ‘fuel poverty’, not being able to afford proper heating. This is defined by the Faculty of Public Health as the situation where any household has to spend more than 10 per cent of its income on keeping warm. Older people need their houses to be warmer than younger people do, and often live in poorly insulated housing, or in their former family home, not having wished to move house, which is expensive to heat, particularly if they are living on their own. A total of 1.25 million pensioner households spend more than 10 per cent of their income on fuel.