In an ideal world we would all get the treatment we need to live as healthily and as long as possible. But in the real world we have limited resources and people are being denied treatments that would prolong their life.

It’s not just happening in poor countries. The UK has a National Health Service which promises to provide free and equal health care for all, yet healthcare providers are admitting that age rationing occurs. And the same dilemmas are being faced elsewhere.

Age discrimination is happening unintentionally. When you want to do as much good as possible with the resources you have, someone over 85 misses out on treatment that would extend their life because it would buy them less extra time than it would for a younger person.

I just watched a documentary called ‘The Price of Life’ in which a woman was given a drug which dramatically reduced the effects of her cancer. Her daily life went from being almost unbearable to being positively enjoyable. Since the drug was already working for her it was likely to increase her life expectancy if she continued taking it.

But it was part of a drug trial and she was not allowed to continue receiving the treatment when the experiment finished. Even though the drug trial had been successful it was considered too expensive for the NHS to provide. After long deliberation the NHS can now prescribe the drug, but in the time they took to decide, the woman was put on less effective drugs and died after suffering complications.

We can eat healthily, take exercise and not smoke, but when we live longer we still might get sick. Then even if there is a cure our life could be determined by a cost-benefit analysis which decides we’re not worth the expense.

Suddenly, comprehensive health insurance looks very attractive.

Don’t Get Caught Out – The Cost of Living Changes as You Get Older.

While we are young and healthy it’s easy to calculate how much money we need for necessities such as food, warmth and shelter. As we get older the situation changes. You may think you’ll need less and you’ll be able to live on your pension, but age related health issues are expensive to address and you may have to pay. In retirement the amount of money we spend on health increases, and this money often has to be found from savings or a pension.

Even in countries that provide free health care, people in the last 7 years of their lives tend to spend their own money on pills and products to improve mobility, reduce pain or relieve symptoms. Sadly some people who can’t afford to pay for treatment die waiting for operations or for Government approval to fund expensive drugs.

The state can’t pay for complete and perfect health care for everyone and as people live longer the systems we rely on are being put under even more pressure. Expensive drugs are available which extend life expectancy and improve the quality of life for people with certain diseases such as breast cancer and Alzheimer’s. Yet people die while experts decide whether to fund treatment or not.

Drug companies can charge a high premium for pills which reduce suffering, restore health or extend life. They know that if we have the money we will pay even if our governments or insurance policies won’t.

It’s very difficult to know how much money to provide for our old age. New treatments will be available by the time we need them, but will we be able to afford them?

Where do you want to live when you get old?

Some people dream of retiring to a small place by the sea, but for others moving is a difficult decision they face when they can’t continue living the way they used to. At that point the options available are limited, yet if we plan ahead we can enjoy a sustainable lifestyle surrounded by people we know and have an active role in our community at any age.

Four years ago I got together with a group of people and bought a country estate with a mansion and outbuildings, some of which were already converted into apartments. We have separate homes with small private gardens and share 10 acres of grounds where children play and we grow our own food.

None of us was thinking about retiring when we started. We were simply sharing resources in ways that benefit everyone and working together on common goals. This has led to deeper relationships and a true sense of community.

We are now in the process of converting a redundant outbuilding into new houses and we’ve found that a large proportion of people applying to join us are over 60. It’s a wonderful environment for young and old, but we don’t say yes to too many older people because we like the diversity of a balanced age range.

Many of these older people have thought hard about how they want to live and know that a community like ours would meet their needs better than anywhere else. But it’s better to make that choice earlier in life to have a chance of making it a reality.

Having seen the alternatives to living in a close knit community I’m glad I’ve started doing it in my 40’s.

I’ve just been to visit my mum who lives with lots of other retired people 200 miles away. Everyone living there has moved from their previous homes and needed to get used to new surroundings and make new friends. They all live independent lives in separate apartments and get together regularly to play cards or share common interests. In some ways it’s similar to the community I live in, but there are no young people living there and no sense of common purpose.

My mum doesn’t get a full range of social interaction and – in contrast with our community – children visiting quickly get bored and want to leave.

Older people are a valuable asset to our community. They have time for gardening, passing on skills and occupying children, sitting around the fire leading a sing-a-long, and contributing their ideas at meetings. It’s a far healthier and satisfying way to live. If you think it would suit you, why wait? It has advantages at any age.

There’s a moment in Indiana Jones and the Kingdom of the Crystal Skull where the hero is told he has reached an age when life stops giving you things and starts taking them away. If Jones subscribed to that view presumably most of the action in the film wouldn’t have taken place, but it does sum up a persuasive belief about old age. It’s particularly noticeable in films because there are very few good roles for older people.

For most of us, our fitness levels decline with age and as early as 27 our arithmetic, language and memory skills start to slowly get worse. But according to this week’s New Scientist there are compensations. While processes that rely on “fluid intelligence” deteriorate, our “crystallised intelligence” associated with wisdom, actually increases. And we can slow down the aging process by staying physically active, playing brain training games, eating a healthy diet and avoiding tobacco, alcohol and harmful drugs.

Catherine