More and more people are ageing with no one to look after them in later life. These are the findings of a recent report released by the Office for National Statistics. This is, of course, the inevitable consequence of two demographic changes in Britain since the second world war: increased life expectancy and declining fertility. But it is also a reality that few are willing to face, and one for which our society is woefully unprepared.
The ONS report projects that by 2045 there will be a threefold increase in the number of women who reach the age of 80 without children. This is deeply concerning, since our society relies heavily on adult children to provide informal care for older people, and since there is already a staggering unmet care need among today’s older population. At present, 41% of those aged 80 and over are not receiving the help and support they need with at least one daily activity, a figure that is set to skyrocket unless we proactively change how we think about ageing, childlessness and care responsibilities.
One of the major problems in our current thinking is an implicit and pervasive gender bias. Not only does the burden of unpaid care work fall mostly on women’s shoulders – a fact that was thrust into the limelight with women’s plummeting productivity during lockdown – but it is also women who bear the brunt of criticism when their lives diverge from normative expectations. Jody Day, founder of Gateway Women – a global organisation supporting involuntarily childless women – notes that the ONS does not even collect data on men’s childlessness, “fuelling the sexist notion that this is exclusively a women’s issue”, when similar numbers of men are impacted.
She says: “There is an assumption that childless women have been selfish, left it too late, or prioritised their careers, and therefore the sense that it’s somehow their own fault if there is no one to look after them.” This, of course, is a stigmatising myth that is far from the truth. Childless women are not a uniform entity, and though some choose childfree living, many are “childless by circumstance” – meaning they wanted children but never had them. This may be either because they were not in a suitable relationship, or because their partners did not want any.
These women’s stories are a testament to the need to recognise the ways in which rising rates of childlessness are also tied to men’s preferences and lifestyles, and the changing nature of intimate relationships, at least as much as they are to women’s greater education and participation in the labour market.
While most people don’t consciously have children just to secure their care in old age, many do step up to the responsibility of caring for their parents when required: most of the 6.5 million informal carers in the UK are looking after a parent or a parent-in-law. Unsurprisingly, then, planning for old age becomes a stark practical consideration for those who are childless, with some walking the tightrope of caring for their elderly parents without a safety net in place for themselves. Jessica Hepburn, a fertility education campaigner, says: “I look after my 88-year old mother, and I am aware that I am not going to have that.” She says that for many on the infertility journey “it can be impossible to think about the future when you are in a paralysed present”.
It is, of course, not just childless people who may have to face old age without family to look after them. Adult children may be too far away, too busy, or too disconnected to care for their parents. Or they may have needs of their own that preclude them from becoming carers. Kirsty Woodard, who leads the Ageing Without Children consultancy, notes that although care services in the UK rely heavily on family carers, there are already more older people needing care than family available to provide it. She argues that the solution lies in designing robust care systems that do not rely on family input, but which cater to “the population we have now and will in the future, not one from the past”.
As the gap widens between our assumptions of informal family care and our demographic structures, we are sleepwalking faster and faster into a severe care crisis. Those ageing without children are 25% more likely to go into residential care – but our care homes are already undervalued, underfunded and struggling to cope, and it will be impossible for them to meet the rising demand. This reality is particularly poignant in the wake of the catastrophic impact of the coronavirus pandemic on Britain’s care homes.
The ONS report also highlights an issue that Ageing Well Without Children has been campaigning to raise awareness of for years – the need to plan ahead for the growing numbers of ageing childless people. As well as the infertile and the “childless by circumstance”, these issues also have a heavy impact on the LGBTQ community (of whom about 90% are ageing without children), and those living with disabilities (85% without children), creating further burdens for groups already facing disproportionate hardship and discrimination.
Adding her perspective as a psychotherapist, Jody Day says: “People do not want to think about ageing without children because in a society that does not value its elders, it touches on all of our deepest fears about being old, alone and vulnerable.” There is, unfortunately, no easy solution: this is a pressing issue that requires ideological, social and economic commitment. We urgently need to develop more positive models for ageing, and invest in formal care systems that are comprehensive and accessible to all who need them.
But first of all, we need to question the erroneous assumptions on which our current care provision is founded: that we can rely on informal and unpaid labour to look after society’s vulnerable members, and that women can and will continue to shoulder this burden.
• Zeynep Gurtin is a lecturer in the Institute for Women’s Health at UCL