Ageing: Living Better In A New World

LIFESTYLE

Growing old used to be imagined as the closing chapter of life. You worked, raised a family, retired and gradually withdrew from the world.

That picture no longer fits the lives millions of people are living.

A person retiring at 60 today may have another twenty, thirty or even more years ahead. Those years could include work, friendships, travel, learning, romance, volunteering, entrepreneurship, grandparenting and experiences that previous generations might never have associated with old age.

Humanity has become remarkably successful at extending life. The more difficult question is whether we have learned how to make those additional years worth living.

That question acquired new urgency on 1 October when the World Health Organization released the midpoint assessment of the UN Decade of Healthy Ageing 2021–2030. The world passed one billion people aged 60 and above in 2020. By 2050, that population is projected to reach 2.1 billion. Most will live not in the wealthy countries traditionally associated with ageing populations, but in low- and middle-income nations.

The report contains an uncomfortable finding. Although people are living longer, the gap between overall life expectancy and healthy life expectancy at age 60 widened globally between 2000 and 2023. In other words, additional years of life do not automatically mean additional years of independence and well-being.

For people of Indian origin, this transformation has a particularly interesting dimension. India itself is ageing rapidly. By 2050, around 346 million Indians, nearly 21 per cent of the country’s population, are expected to be over 60. At the same time, millions of Indians who migrated decades ago to Britain, North America, the Gulf, Africa, Southeast Asia, Australia and elsewhere are themselves growing older.

The Indian diaspora is therefore entering a new era. It is no longer composed principally of young migrants building new lives abroad while worrying about parents back home. Increasingly, those migrants are the parents and grandparents.

The question is no longer simply how to live longer.

It is how to live well for longer.

THE EXTRA DECADES WE DID NOT PLAN FOR

Modern society still tends to organise life into three broad stages: education, employment and retirement.

Longevity is making that model increasingly inadequate.

Someone who finishes formal education in their early twenties, works until 60 and lives until 90 could spend three decades in what society rather casually calls retirement.

That is almost another adult lifetime.

Yet much of our thinking about ageing remains rooted in an era when retirement was comparatively short. The workplace often assumes older employees should make way for younger ones. Advertising frequently treats youth as synonymous with aspiration. Technology is marketed as though innovation belongs naturally to younger generations. Even families can unconsciously begin making decisions for older relatives long before those relatives have lost the ability to decide for themselves.

WHO takes a much broader view of healthy ageing. It defines it around maintaining the functional ability that allows people to do the things they value. That ability depends partly on physical and mental health, but also on the environment in which someone lives.

This changes the question completely.

Instead of asking whether a 75-year-old has a particular illness, we might ask whether she can visit her friends, manage her money, travel to the market, use public transport, pursue an interest, contribute to her community and make decisions about her own life.

Healthy ageing is therefore not the absence of disease.

It is the preservation of agency.

WHEN CHILDREN LIVE AN OCEAN AWAY

Few communities understand the changing geography of family better than the Indian diaspora.

For generations, Indian family culture rested heavily upon proximity. Parents raised children with an expectation, sometimes spoken and sometimes simply understood, that family would remain the principal source of support in old age.

Migration has complicated that arrangement.

A couple may live in Delhi while one child is in Toronto and another in Sydney. Parents in Kochi may have children in Dubai and London. A family originally from Punjab may now have three generations divided between India, Canada and Britain.

Technology has softened the distance. WhatsApp messages arrive every morning. Grandchildren appear on video calls. Medical reports can be photographed and sent across continents within seconds. Flights make reunions possible in ways previous generations could barely imagine.

But digital proximity is not physical proximity.

A child in another country cannot accompany a parent to a doctor at midnight. A video call cannot replace someone sitting across the table over tea. And the emotional consequences work in both directions. Older parents may feel abandoned even when their children are deeply involved from afar, while migrant children may live with persistent guilt that they are not physically present.

India’s own consultations on ageing have identified out-migration of family members as one factor contributing to isolation and reduced care among some older people.

Yet it would be equally misleading to romanticise the traditional joint family.

Living with children does not automatically guarantee dignity, companionship or independence. An older person surrounded by relatives can still be lonely. Some parents may actually prefer their own home, routines, friendships and freedom to becoming permanent members of their children’s household abroad.

The better question is not whether older parents should live with their children.

It is whether they have a genuine choice.

YOUR CHILDREN CANNOT BE YOUR ENTIRE SOCIAL LIFE

This may be one of the most important lifestyle changes required for longer lives.

Families matter enormously, but they cannot provide every emotional and social need of an older person.

WHO estimates that around 11.8 per cent of older people experience loneliness. Social isolation and loneliness are associated with poorer physical and mental health, diminished quality of life and reduced longevity.

Retirement can intensify the problem.

Work provides more than income. It gives structure to the day, regular human contact, a sense of competence and, for many people, identity. When employment ends abruptly, several of those things can disappear together.

Friends may move away or die. Children become absorbed in their own careers and families. Driving may become more difficult. A spouse may die after decades of companionship.

This is why friendships in later life should not be regarded as optional recreation.

They are part of the infrastructure of healthy ageing.

Community groups, neighbourhood associations, cultural organisations, religious congregations, walking groups, clubs, volunteering and simply maintaining friendships can provide something children cannot always supply: relationships between adults who meet as equals rather than primarily as parent and caregiver.

For diaspora communities, such networks can have another function. They preserve language, food, music, faith and cultural familiarity without requiring older migrants to retreat entirely into nostalgia.

The challenge is to create community without creating isolation from the wider society.

THE FIRST-GENERATION MIGRANT IS NOW GROWING OLD

There is another ageing story within the Indian diaspora that receives surprisingly little attention.

Many of the people who migrated from India in the 1960s, 1970s, 1980s and 1990s are now in their sixties, seventies and eighties.

They may have spent most of their adult lives in Britain, Canada, the United States, Australia or elsewhere, yet ageing can revive questions of identity that seemed settled decades earlier.

Where is home?

Is it the country in which you were born, the country in which you worked and raised your children, or the place where your grandchildren now belong?

Some dream of returning to India but discover that the India they remember has changed, while they themselves have changed too. Their friends and siblings may no longer be there. Healthcare expectations may be different. Property may have been sold or inherited across generations.

Others have no desire to return but want to grow old in surroundings that understand their food, language, religion and cultural habits.

Research among older South Asian communities in Britain has found a strong preference for ageing at home and continuing expectations that adult children will provide care. It has also found reluctance towards formal residential care, although culturally appropriate facilities offering suitable food, language support, prayer spaces and sensitive staffing can make such arrangements more acceptable.

This suggests that the future of senior living may need to become much more culturally intelligent.

The choice should not be between a traditional family household and an impersonal institution.

There is considerable space in between.

PERHAPS THE HOUSE IS GROWING OLD, NOT YOU

A person may be perfectly capable of independent living and still find the physical world increasingly difficult to navigate.

Consider something as ordinary as a staircase.

At 45 it barely registers. At 75, after knee surgery or with reduced balance, it can determine whether someone comfortably leaves home several times a day.

The same is true of bathrooms without grab rails, buildings without lifts, uneven pavements, distant bus stops, inadequate street lighting and public spaces without seating.

Sometimes we describe someone as becoming incapable when what has really happened is that the environment has become incapable of accommodating them.

This is precisely why WHO places age-friendly environments at the centre of healthy ageing. Functional ability results from the interaction between an individual’s capacities and the physical and social environment.

The best ageing-friendly design is often remarkably unglamorous: good lighting, non-slip floors, accessible bathrooms, lifts, handrails, nearby shops, safe pavements, public transport and places where people can meet.

These are not merely facilities for the old.

A ramp helps a wheelchair user, a parent pushing a pram and a traveller carrying luggage. A safer pavement benefits everyone.

Designing for ageing can make cities better places to live at every age.

RETIREMENT DOES NOT HAVE TO MEAN RETREAT

Another assumption deserves reconsideration: that productive life has an expiry date.

Some people desperately want to retire from demanding careers and should be free to do so. Others want to continue working, perhaps differently.

A 65-year-old may not want another decade of commuting and corporate meetings but might happily consult two days a week. A retired teacher may mentor students. An accountant may advise a small charity. Someone who spent a career in banking may finally open the restaurant he dreamed about at 30.

Others may choose activities that generate no income at all but provide enormous purpose.

The important distinction is between work as economic necessity and activity as meaningful participation.

The WHO midpoint report notes increasing recognition of older entrepreneurs and the wider “silver economy”. It also reports that more countries have introduced measures against age discrimination, with the proportion reporting relevant legislation rising from 44.5 per cent in 2018 to 57.7 per cent today.

Yet cultural attitudes can change more slowly than laws.

We routinely describe a 35-year-old changing careers as courageous. When a 70-year-old does it, we call it extraordinary.

Perhaps it should become ordinary.

TECHNOLOGY CAN GIVE INDEPENDENCE OR TAKE IT AWAY

Few developments have greater potential to transform ageing than technology.

A smartphone can connect an older parent in India with children on three continents. Telemedicine can reduce unnecessary travel. Wearable devices can detect falls or monitor heart rhythms. Digital banking can allow someone with limited mobility to manage finances independently. Online courses can open new worlds of learning.

For diaspora families, technology has already rewritten long-distance caregiving.

Children can arrange grocery deliveries, book medical appointments, pay bills, speak to doctors and monitor certain health information from another country.

Used well, technology can extend independence.

Used badly, it can create a new form of exclusion.

When banks close branches, government services move entirely online and essential transactions require multiple passwords, applications and verification steps, an older person who is less digitally confident can suddenly become dependent on somebody else.

That dependency can also increase vulnerability to fraud.

An age-friendly digital society should therefore not demand that older people prove their modernity by adapting to every new system.

Technology should adapt to them as well.

MONEY IS PART OF DIGNITY

Longer life also requires a different conversation about money.

Retirement planning traditionally focused on accumulating enough savings to stop working. Longevity changes the calculation. Savings may need to support someone for decades while healthcare, housing and long-term care costs rise.

Women can be particularly vulnerable because they often live longer and may have spent fewer years in paid employment.

For diaspora families, finances can become even more complicated. Assets may exist in more than one country. Children may contribute towards parents’ expenses across borders. Older migrants may have pension entitlements in one jurisdiction and property in another.

Financial independence, wherever possible, matters for more than comfort.

It preserves choice.

The ability to decide where to live, what care to receive, whether to travel and how to spend one’s own money is closely connected with dignity.

The WHO midpoint assessment shows that governments themselves are still struggling with this challenge. More than a third of reporting countries have very little or no dedicated resources for developing long-term care, while fewer than half have legislation guaranteeing access to assistive devices such as hearing aids, spectacles and walking aids.

Families therefore need to discuss ageing finances before a crisis makes the decisions for them.

HEALTH STILL MATTERS, BUT IT IS NOT THE WHOLE STORY

None of this diminishes the importance of physical health.

Regular movement, appropriate nutrition, sleep, preventive healthcare, vaccination, management of blood pressure and diabetes, hearing and vision care and attention to cognitive and mental health can profoundly influence later life.

India itself will need a major expansion of services as its older population grows. UNFPA has projected nearly 193 million older Indians by 2030 and has called for health systems to strengthen geriatric, preventive, mental-health and palliative care while improving financial protection.

But there is a danger in reducing healthy ageing to a list of medical instructions.

A person can have controlled blood pressure and still be profoundly lonely.

Someone can have arthritis and still lead an immensely satisfying life.

A person may require a walking stick yet remain intellectually curious, financially independent, socially connected and entirely capable of making decisions.

Ageing well cannot therefore mean attempting to remain biologically young forever.

It means retaining as much ability as possible to live the life one values.

THE FAMILY CONVERSATION WE NEED EARLIER

Perhaps families should begin talking about ageing long before anyone needs care.

Where would you like to live when you are older?

Would you ever consider moving closer to your children?

Would you prefer them to return to you?

Would you consider an independent senior community?

Who should make medical decisions if you cannot?

Are your finances organised so somebody trustworthy can help in an emergency?

What would make you feel that life still has purpose?

These conversations can be uncomfortable in Indian families, where discussions about dependence, wills, illness and death are sometimes postponed because they appear pessimistic.

But avoiding them does not prevent ageing.

It merely leaves important decisions until the moment when choices have narrowed.

For globally dispersed families, the conversation becomes even more necessary.

Love cannot eliminate geography.

Planning can make geography easier to manage.

AGEING IS NOT A FAILURE

Perhaps the greatest adjustment required is psychological.

Modern culture spends enormous amounts of money teaching people to fear visible ageing. Grey hair must disappear. Wrinkles must be corrected. Bodies must continue looking younger than the years they have lived.

There is nothing wrong with wanting to look good at any age.

But there is something peculiar about a society celebrating longer life while simultaneously treating evidence of having lived it as undesirable.

Ageing brings losses. Bodies change. Friends disappear. Some abilities decline. Illness becomes more likely. Eventually, many people will require help that they once provided to others.

Pretending otherwise does older people no favour.

But neither does defining an entire stage of life by decline.

An 80-year-old is not simply a 40-year-old with forty additional years of deterioration. Those decades contain relationships, judgement, memories, skills, disappointments, humour and perspective that did not exist at 40.

Healthy ageing must make room for vulnerability without taking away personhood.

ADDING LIFE TO THE YEARS

The WHO midpoint assessment contains reasons for optimism. More countries have legislation addressing age discrimination. More have national long-term-care policies. More are developing age-friendly programmes and integrated approaches to older people’s health.

But the report also makes clear that progress is uneven and investment remains inadequate.

That matters because the demographic transformation is already under way.

By 2050, there will be 2.1 billion people over 60. India alone will have hundreds of millions of them. Across the Indian diaspora, communities built by migrants who once arrived as ambitious young workers will increasingly need to ask what kind of lives those same people should have as they grow older.

The answer cannot simply be more hospitals, more medicines and more care homes.

It must also include homes people can continue living in, cities they can continue moving through, friendships they can maintain, technology they can use, work they can choose to continue, money they can control, communities to which they still belong and families that respect independence even while offering support.

Perhaps the greatest challenge of longevity is therefore not teaching people how to grow old.

It is teaching societies how to make room for longer lives.

Because the achievement of our century will not be measured merely by how many additional years medicine manages to give us.

It will be measured by how much life we manage to put into those years.