Australia, we’re getting old. And community care will be the overall winner, writes Michael Fine.

It’s not just you and me. Australia’s population is growing older, and larger, everyday, according to the latest projections in the 2010 Intergenerational Report. This was released by the Treasurer with much fanfare on 1 February, setting the government’s strategic direction for the second decade of the 21st century.

By 2050, if we live long enough to see it, we will all be older. That we’ll each be of a more advanced age in the future goes without saying. But it is our collective and average age that is what is most important to those charged with nation building. Now, rather than simplistic responses from government suggesting the answers lie in individualistic, market-based solutions, we finally see the Australian government talking about how we might manage growing older together.

Today, just over one in eight, around 13.5 per cent of the population, is aged 65 or over. By 2050, this will be almost one in four, 22.6 per cent of the total. And the biggest driver of that growth will be the increase amongst those aged 85, the largest group of users of community and aged care. On top of this, there will also be many more of us – 35.9 million is the figure currently projected, if the current birth rate and rate of immigration continue as they are.

The figure that has been given perhaps the greatest attention is the ratio of those of working age, 15-64, to those who are older and more likely to need assistance in the form of income support or care. Today there are just over five people of working age for every older person. By 2050, there will be just 2.7 of working age. This is the age group that provides the paid workers and pays the highest taxes.

The implications for health care, aged care and community care in particular, are profound. They are well worth thinking about now. Just as growing old is better than the alternative, most of the news is good for those who prepare for the journey.

Most important, no matter how good a job we are doing now, we can expect 40 years of ongoing reform, innovation, restructuring and change in the way we go about providing community care. Productivity increases is the way the government speaks about this in general, as a way of having a reduced working population paying for even more. Up untill recently, however, productivity increases were something only found in areas of automation such as manufacturing, IT or banking. Care requires people, and there is a limit to how much work any of us can do in a day or an hour.

Community care will be an overall winner, because it is simply more flexible, efficient and productive than the more traditional forms of acute and long-term care provided in large residential settings such as hospitals and nursing homes. But by 2050 it won’t be community care as we know it today. It will be enhanced, better, and even more effective – it has to be, because it will have to do much of the work that is currently being done in the other, much more expensive settings.

As just one example, consider the way in which the system has started to evolve from a program for maintenance, keeping people in their home, to one that seeks to enhance independence, stimulate wellness, activity and restoration of function. We all know that this won’t always succeed, but even modest success with a proportion of the existing clients – say one in five – will free up enormous resources and allows us to reduce waiting lists and meet increased numbers of referrals without requiring extra staff.

In turn, this requires skilled and motivated staff. We’ll need more education, not less, to make the decisions needed to match care to the individual. Higher levels of skill demands higher wages and conditions. Herein lies the opportunity for beginning planning to achieve a major improvement in the recognition of community care staff.

With far fewer people of working age available, we’ll also need to think hard about retaining staff and recruiting more. What about those over 65 who can work? It is well known but conveniently forgotten, that most of those caring for older people are already in this age group. Family carers, especially spouse and partner carers who provide the bulk of ongoing personal care, are usually not paid to do so and ignored by workforce planners.

Carers and volunteers already well outnumber paid staff in community care. Without their efforts most of the official programs would simply not be viable. For those of us who would like to think about working beyond the existing retirement age, the opportunities for paid will undoubtedly increase. Much of it is likely to be flexible and part-time, increasingly supported by technology as in other areas of the economy.

Growing old, Australia? Don’t think of it as problem. Let’s grow old together, collectively, helping each other and understanding that it represents a once-in-a-lifetime opportunity. It’s much better than the alternative.

Associate Professor Michael Fine is head of the Department of Sociology and deputy director, Centre for Research on Social Inclusion, Macquarie University.