Prolonging health and the future of aged care 

Dr Robin Craig, co-founder, ThoughtWare/ionMy

The implications of increasing life expectancy

Over the past 50 years, life expectancy in Australia has risen from 73 to 84 years. This has been accompanied by an increase in healthy life spans, so that years lived with illness or disability has risen by only one year. In the same period, the number of people aged 70 or more has risen 10-fold, to three million people today. This is expected to rise to 5.5 million over the next 20 years. Thus, we might anticipate that the rapid growth in demand for both residential and home care will continue.

Even conservative estimates predict the current rate of improvement in lifespan will continue over the coming decades. Furthermore, with medical science and technology advancing exponentially, a significant number of gerontologists and futurists now predict multi-decade increases in both longevity and health in the near future. Ironically, the scientific advances which have fuelled the growth of aged care industries may be on the verge of transforming it.

Understanding life extension

Until now, progress in life extension has achieved improvement in outcomes with little if any improvement in the underlying ageing process. Thus, more and more people are living longer and healthier lives, pushing up against the maximum lifespan without extending that limit. The target of life extension research today is breaking that barrier: lengthening healthy human lives to beyond the current maximum. That is, not merely treating diseases of old age but slowing the underlying ageing process, or even reversing it.

The impacts on aged care

We can expect that progress in life extension will take time, and rather than a seismic shift overnight, its effect on aged care will be gradual. But now is the time to start thinking about that future. While aged care may start much later in life, when the cause is extended youthfulness, then the delay itself will not change care needs (same care, just older patients). The chief implications may arise from significantly extended independence in the following ways:

• The blurring of wellness services and aged care: As people stay independent for longer, the lines between retirement living, wellness services and aged care will start to blur. Providers may need to create more integrated models that offer social, health and housing support over many years.
• Gradual introduction of care: We will likely see a shift away from traditional high-care residential settings toward longer periods in independent or retirement-style living, with care introduced gradually as needed.
• A focus on wellbeing: The focus will move from passive care to more vibrant, lifestyle-rich environments. Think wellness programs, technology lounges, learning spaces and activities that keep residents engaged, mentally active and socially connected – not only for their own wellbeing but so they perceive real value from their aged care home.
• Evolution of workforce: Care teams will evolve too, from not only nurses and carers, but also wellness coaches, cognitive trainers, AI health assistants and technology support staff. Supporting emotional and spiritual wellbeing will matter just as much as managing physical health.
• Increasing technology use: Older adults of the future will expect highly personalised, technology-enabled care, shaped by their own preferences and powered by AI, genomics, predictive health tools and wearable devices. 
• Changing care funding: Paying for care will become more complex. Models based on current life expectancy, insurance assumptions, or home equity may not hold up. Finding ways to support flexible work or meaningful contribution from older adults could help address both financial and wellbeing needs.

Ethical and social implications of life extension 

The societal disruptions from practical life extension are not hard to imagine; parenthood, education, work, medicine, leisure and retirement will be transformed. But we should not think that is a bad thing. Our life expectancy in 1825 was only 40 years. We have already been the beneficiaries of life extension, society has been transformed already and has adjusted successfully. Life is a value, and therefore, healthy life extension is a value, and we should embrace it. But we should also think carefully about the implications. But we should also think carefully about the implications, particularly for the aged care sector. In essence, the very nature of ageing will be in flux. Providers will need to continually adapt their business models, workforce planning, infrastructure and care philosophies to meet a transforming world.