The World Health Organization vision for healthy ageing is a world in which everyone can live a long and healthy life.
The report, published in 2010, outlined a new concept of “healthy ageing” that shifts our thinking about health in older persons from solely the presence or absence of disease to a focus on an older person’s well-being, as well as their ability to function well and meaningfully within the context that they live in. The report also presents evidence and a set of recommendations calling for radical changes not just to health and social care systems, but also to the way society perceives older people and supports them.1
By 2030, the number of older people is expected to reach 1400 million and then by 2050 this will be 2100 million.2
Action on healthy ageing in every country includes the implementation of national policy frameworks, building capacity for evidence to inform policy as well as combating ageism and transforming understanding on ageing and health.
Age-friendly environments foster older people’s autonomy, enable older people’s engagement and promote multi-sectoral action.
Health systems also need to be aligned to older people’s needs and systems orientated for functional capacity and ability. This includes access to personcentred and integrated care with an appropriately trained, deployed and managed health workforce.
Sustainable and equitable long-term care needs a sustainable and equitable system with enhanced workforce capacity and support for caregivers. It also needs quality person-centred and integrated longterm care. Effective methods to measure, analyse, describe and monitor healthy ageing would be useful as this would increase research capacity and incentives for innovation. This in turn would help synthesise evidence on healthy ageing.
When segmenting the older population, the specialist would look after the frail while primary care would focus on those at risk. Public health would be general well being.
In public health, five areas to change behaviours include: physical activity, social networks, selfesteem, distress and sleep, diet, alcohol and tobacco consumption.
In primary care, there are 49 top risks across seven domains and these include: communication, activities of daily living, mobility, housing and finance, safety and relationships, mental health and well-being, staying healthy and specialist care.
In specialist care the five principles for redesigning services include choosing to admit, early specialist assessment, discharge to assess, recovery before placement and schemes like Every Moment Counts, which is a narrative for person-centred coordinated care for people near the end of life. It sets out how good, coordinated—or integrated care—looks to people near the end of life and is written from their point of view.
In Warwick we implemented a proposed model of integrated care. There were many benefits realised by adopting this approach to a whole system redesign in Warwickshire over a three-year period. Outcomes included the promotion of successful ageing, extending healthy active life, relieving suffering in old age, reducing hospital and long-term care costs and reducing the burden on family care-givers.
Adopting a healthy living approach will create a culture of capability and empowerment from the current culture of welfare and care.