Just when the failure of our National Health Service to look after the elderly properly is in the news again, I was coincidentally giving a talk in a West Sussex parish on end of life care and the various moral questions that this raises.
As always when one gives a talk on a subject that may not occupy all one’s waking thoughts, one discovers something about one’s own views on the subject, views you did not perhaps realise you held. So, for what it is worth, here is what I think.
First of all, we must look after our old people properly. No ifs, no buts. The alternative, the sort of society that deals with old people as nuisances, is not the sort of society that anyone would rationally wish to be part of.
Secondly, we are Christians: people are of value and to be treated as such. For those of us not Christians let us at least be Kantians: people are ends in themselves. We must not go down the Lady Warnock path and talk of old people with dementia having a duty to die. This is simply wrong, because, while it is true that people with dementia are non-productive and a drain on resources, people can never be reduced to mere economic entities.
But here is the crunch – if we want to look after our old people well, then it is going to cost us something. The price may not necessarily be one in money. The institutionalisation of old people needing care is very expensive, but there is an alternative – care in the home by members of the family. Most people I speak to think that is preferable: being in the home, not in a “home”; being looked after by your nearest and dearest, not by strangers who are paid to do so. But for this to happen, quite a few social and economic changes would have to take place. Family life would have to change: we would have to move away from more and more people living alone, towards more people living together, particularly in three generational family groups. It would mean more people working in the home and not out of it, and rewarding and valuing such work accordingly.
In Africa, which we Westerners sometimes think of as undeveloped, people are shocked to their core by the fact that we place our old people in nursing homes rather than looking after them ourselves. On this matter, we could profitably learn from Kenya, where old people are revered. Incidentally the word “Mzee” in Kenya means “old person” and is traditionally applied to people as a mark of respect: the first President of the country is usually referred to as Mzee Jomo Kenyatta; when you meet the President, you call him “mzee”; when you address a group of dignitaries, you use the plural, “wazee”. Now think of the way we use the term “old man” or “old woman” in this country. The difference is startling.