Summit on Dementia
Dementia already touches many of us but it will reach yet wider in the future.It requires attention and discussion across all levels of society, which is why the summit on dementia in Wellington is so important.
The powerful words of Dr Margaret Chan, Director-General of the World Health Organisation, speaking at the Conference on Global Action against Dementia, illustrate this.
“I can think of no other disease that has such a profound effect on loss of function, loss of independence, and the need for care. I can think of no other disease so deeply dreaded by anyone who wants to age gracefully and with dignity. I can think of no other disease that places such a heavy burden on families, communities, and societies.”
It is this very breadth of impact - from individuals across families and friendships, through communities and into wider society, that drives the need to step back and gain perspective. We need to take a strategic view.
This is because 85% of those aged over 60 will be touched by dementia.
Population Ageing - a global revolution
We all know that the world is ageing.
The speed of this change is both inspiring and disquieting. We know more – information is everywhere and constantly flowing; we do more – many lives are busy and pressured; there’s simply more - we accumulate more ‘stuff’. And the digital age stretches us in multiple directions.
We live in an age on the cusp of a remarkable transformation. Some of us are experiencing five generations of family living alongside one another. Workplaces will stretch from those who lived through a world war to generation Z.
New Zealand is not alone. This change is happening across the globe. By 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. The population of children, meanwhile, will be at a virtual standstill due to long-term declines in birth rates around the world. This is unchartered territory for us all.
As we know, change is uncomfortable, unsettling, and our instinct is often to resist. The effects of this disquiet is amplified by how we feel, hidden away in our deepest selves, about growing older.
Pervasive negative attitudes
The negative attitudes many of you will have seen expressed about those with dementia have parallels with age in general.
As I have travelled around the country talking with groups this is one point that always resonates. We don’t like thinking about getting old.
The images and stereotypes of ageing are deeply ingrained – frailty, loss of control and independence, loneliness, confusion, and our own mortality.
Language is laden with negative imagery – grey tsunami, cost, and burden. A good illustration was some recent research from TVNZ which surveyed people aged between 55 and 75.  Three-quarters of them said the advertising aimed at their age groups was patronising and stereotypical.
Research the Office for Senior Citizens conducted with the Human Rights Commission on attitudes towards older workers found 40% have experienced ageism in the workforce .
Although there is substantial evidence that older people contribute to society in many ways, they are instead often stereotyped as frail, out of touch, burdensome or dependent, as was highlighted in a recent report from the World Health Organisation. 
The WHO warned these ageist attitudes limit the way problems are conceptualized, questions are asked, and the capacity to seize innovative opportunities.
Change equals opportunity
There will be an extra 540,000 people aged 65 plus in the next 20 years while there will only be an extra 35,000 of those aged 14 and under.
So, how do we contemplate that future?
We also need to understand that living alone as an older person is common in New Zealand: one in four older people were living alone in 2013 and of all older people 65 years and over living alone almost 70% are women.
These figures highlight why we cannot afford for this to be about us and them. It is about all of us.
We will all be touched by these changes that lie ahead. It’s also about how we seek to live and care as those with and caring for those with dementia, and for all of us as we age-the society we wish to create, live, within and experience the end of life.
The opportunities presented by our ageing population are large.
Older people are a wonderful resource for their families, communities and in the formal or informal workforce. They are a repository of knowledge. They can help us avoid making the same mistakes again.
Indeed, if we can ensure older people live healthier as well as longer lives, if we can make sure that we are stretching life in the middle and not just at the end, these extra years can be as productive as any others.
The societies that adapt to this changing demographic and invest in Positive Ageing can reap a sizeable "longevity dividend", and will have a competitive advantage over those that don't.
At the heart of this approach is the Positive Ageing Strategy – which has stood the test of time, and has spanned across multiple governments. It presents a vision of a society where people can age positively, where older people are highly valued and where they are recognised as an integral part of families and communities.
As part of taking this positive approach we are seeking to reframe the debate.
We want to tackle the negative assumptions and the ageism that lurks beneath the surface. There’s a positive story to tell. Older people as volunteers, mentors, carers, workers, employers, involved in all aspects of life. For example, we know that older people will contribute, through unpaid and voluntary work, an estimated value of $20 billon per year in less than 20 years time, and that by 2051 older people will spend in total about $65 billon – quadrupling from spending levels today.
It is my proposition that by challenging and changing attitudes towards ageing, to create a society that celebrates positive ageing, we will also go a good way towards tackling attitudes held towards those with dementia.
A society which respects, enables and support those who are older will be positioned to embrace a future for those with dementia.
Currently in NZ discussion is quite muted on the demographic tipping point but that will change.
Boomers will be a vocal part of the debate in the future. They have already re-shaped every phase of life in their own image in a profoundly enduring way.
They have lived through times of change. They are the activists and protesters, they are articulate and organised. How things have been in the past is not the future that this group will create for themselves.
And this brings me to a topic that I am hoping will be part of that future – age-friendly (including dementia-friendly) communities and cities within New Zealand.
An age-friendly city or community is a good place to grow old. 
Age-friendly cities and communities foster healthy and active ageing and, thus, enable well-being throughout life. They help people to remain independent for as long as possible, and provide care and protection when they are needed, respecting older people’s autonomy and dignity.
The WHO Global Network of Age-friendly Cities and Communities was established in 2010 to support local councils and communities that wished to transform these ambitions into reality, involving older people in the process and maximizing their opportunities at the local level.
This network now includes more than 250 cities and communities in 28 countries.
How does it work?
As part of implementing the approach, network members commit to engage with older people and other stakeholders across sectors; assess the age-friendliness of their cities and identify priorities for action and use the assessment findings to engage in evidence-based planning and policy-making across a range of fields and perhaps most importantly, to adapt their “structures and services to be accessible to and inclusive of older people with varying needs and capacities.”
Initiatives communities have developed include, for example, in New York City, the Department of Transportation’s Safe Streets for Seniors programme which developed measures to improve the safety of older pedestrians in areas of the city where older people had been involved in accidents.
Between 2009 and 2014, more than 600 dangerous intersections were redesigned and pedestrian fatalities among older people decreased by 21%.
There are other ideas which resonate with programmes we already have here in New Zealand. One way of tackling social isolation and loneliness is through organisations such as Men’s Sheds – they offer activities of interest to them, such as wood turning, repairing vintage vehicles, compiling heritage memorabilia and classes on information technology.
I see great potential for this approach to help drive a dementia-friendly approach across New Zealand.
The Office for Seniors is working with a number of communities around the country who are exploring these concepts, and is developing an approach we believe will fit the New Zealand context – a kiwi twist on the ideas if you will.
Find out more at our new website: www.superseniors.msd.govt.nz.
This site was launched in September to provide easy access to seniors on information from across government and the community – and we’re always keen to hear new ideas for content as well.
"Grow old along with me! The best is yet to be." Robert Browning (1812-1889)
This very inspiring characterisation of old age fits with the concept of "successful aging," providing the view that it is possible to enjoy your later years in a way that exceeds your expectations.