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The number of people aged 85+ in England & Wales trebled between 1981 and 2021. I don't think you can pay for that sort of change by modifying the tax system, albeit you can absolutely make the situation better or worse. There still exists a large increase in an elderly cohort that need looking after.

Japan has staggering numbers of elderly - over 2 million 90+ by 2017. It will have 440,000 centenarians by 2050.

How is their economy gearing up to cope?

It’s not. It’s the epitome of doomloop, just with a somewhat less fractious and more stoical population.

Korea will follow next. Then Italy, Germany etc etc.

I guess we can look forward to a time when the care of the REALLY elderly is being undertaken by people over 80....

In my experience there are plenty of octogenarians caring for relatives at home.

A very good piece.

I'd add that dementia care is
A) skilled, my parent has gone through home care and a care home, only 2 or 3 of the carers can get them into a routine and cooperative with washing and dressing.
B ) carries a significant risk of violence

Another potential mitigation is that old people could minimise their health issues, not going to help Alzheimer's, but reductions in obesity, smoking and drinking will help other health issues.

The UK could also look at other countries, we have friends from across Europe some of whom have parents in the same situation and it is not as expensive in France and other countries.

Excellent point on the care skills and in particular dementia care.

I am sick of reading 'why can't the unemployed wipe their arses'.

If you think social care boils down to wiping bottoms then you haven't a frigging clue what you are talking about.

The key to social care was set out in the Dilnot report on Social care as long ago as 2011. We need the elderly to pay a lot more of their care. The idea that the inheritance for the family is more important than the cost to the taxpayer is simply not sustainable nor even remotely equitable. Taxpayers with no aspirations of money for themselves are paying higher taxes on their income to subsidise wealth for the privileged. It is outrageous. Theresa May wasn't right about much but she was right about this and the British people were delusional in rejecting her solutions.

If we are more aggressive about prioritising the debts of the elderly over the inheritance they leave we can save ourselves at least £10bn a year now and more going forward. It would not solve our deficit, that is on a truly different and frightening scale, but it would be a significant step in the right direction for once. Carpe diem.

Here's the thing, though.

This causes moral hazard, because why save if the state will step in if you have no assets?

So either people will just spend their money to avoid having it taken away to pay for care bills or, they will find a way to give their assets to their children.

I have never understood the logic behind elderly people scrimping in retirement in order to leave a legacy to their children who in most cases don’t need it and don’t want it. If you have the funds to help your children or grandchildren to e.g. get on the property ladder, why not gift it to them now, rather than wait until you are dead, and risk it being spent on a care home.
Enjoy your retirement, and spend it on yourself or maybe spend it on things that will help you remain in your own home instead of going into care?
Sorry kids!

I think some of it is a psychological “legacy” thing. This idea that no matter what I passed something down and people made something with it. Perhaps some people don’t like the idea of gifting because they’d actually rather not really know what it’ll be spent on.

The key to social care was set out in the Dilnot report on Social care as long ago as 2011. We need the elderly to pay a lot more of their care. The idea that the inheritance for the family is more important than the cost to the taxpayer is simply not sustainable nor even remotely equitable. Taxpayers with no aspirations of money for themselves are paying higher taxes on their income to subsidise wealth for the privileged. It is outrageous. Theresa May wasn't right about much but she was right about this and the British people were delusional in rejecting her solutions.

If we are more aggressive about prioritising the debts of the elderly over the inheritance they leave we can save ourselves at least £10bn a year now and more going forward. It would not solve our deficit, that is on a truly different and frightening scale, but it would be a significant step in the right direction for once. Carpe diem.

A couple of ways the British collective psyche really doesn't help here.

One is our obsession with inheritance- at some point, it flips from human and healthy into something more pathological; a last breath of power from beyond the grave. The other is our general dislike of the idea of paying enough tax to cover the cost of the things we want the state to deliver.

The other difficulty (as I understand it, others may know better) is that the costs of elderly care are very very lumpy. For some, it's not very much at all, whereas for others it would wipe out people wealthier than me. Spreading that risk seems fair enough- whether we do that by individual insurance or just by rolling it into what the state does, paid for by tax.

Part of the pathology of IHT may be its unfamiliarity - only 5% or so of estates pay* yet enormous fear is whipped up over it. Perhaps also projection - how people obsess about celebs, and celebs have to pay ... or for that matter, for all I know, aristos on telly programmes about upstairs and downstairs. I was really struck by Flatlander's remarks earlier about his mother being unhappy about days out at NT big houses because the poor aristos had had to give them up with IHT, one assumes thanks to Lloyd George and death duties etc. (for all that the true story is much more complex, and the aristos often did much better out of the NT than that, as the ensuing discussion showed ). Very revealing. Yet that was how they got the first OAPs under LG. There's the Para Handy story of that time, of an old woman having to beg a buckshee lift on the Vital Spark to go to ther workhouse - no family, couldn't cope any more, too poor - till the crew realise she hadn't heard about the new pension, and Captain Handy orders course reversed to take her back home. I don't know if it got into the film series, though.

*Not sure how this treats the case where IHT isn't paid till the second spouse dies: but the basic point remains.

That was one of the best Para Handy stories, and a change from high jeenks in Inverara’!

The key to social care was set out in the Dilnot report on Social care as long ago as 2011. We need the elderly to pay a lot more of their care. The idea that the inheritance for the family is more important than the cost to the taxpayer is simply not sustainable nor even remotely equitable. Taxpayers with no aspirations of money for themselves are paying higher taxes on their income to subsidise wealth for the privileged. It is outrageous. Theresa May wasn't right about much but she was right about this and the British people were delusional in rejecting her solutions.

If we are more aggressive about prioritising the debts of the elderly over the inheritance they leave we can save ourselves at least £10bn a year now and more going forward. It would not solve our deficit, that is on a truly different and frightening scale, but it would be a significant step in the right direction for once. Carpe diem.

A couple of ways the British collective psyche really doesn't help here.

One is our obsession with inheritance- at some point, it flips from human and healthy into something more pathological; a last breath of power from beyond the grave. The other is our general dislike of the idea of paying enough tax to cover the cost of the things we want the state to deliver.

The other difficulty (as I understand it, others may know better) is that the costs of elderly care are very very lumpy. For some, it's not very much at all, whereas for others it would wipe out people wealthier than me. Spreading that risk seems fair enough- whether we do that by individual insurance or just by rolling it into what the state does, paid for by tax.

My experience when I was working as an IFA was that long term care insurance was expensive and a very limited market.
What about a compulsory 1p on Income Tax for over 50s, to fund it. It could be called National Care Insurance.

The key to social care was set out in the Dilnot report on Social care as long ago as 2011. We need the elderly to pay a lot more of their care. The idea that the inheritance for the family is more important than the cost to the taxpayer is simply not sustainable nor even remotely equitable. Taxpayers with no aspirations of money for themselves are paying higher taxes on their income to subsidise wealth for the privileged. It is outrageous. Theresa May wasn't right about much but she was right about this and the British people were delusional in rejecting her solutions.

If we are more aggressive about prioritising the debts of the elderly over the inheritance they leave we can save ourselves at least £10bn a year now and more going forward. It would not solve our deficit, that is on a truly different and frightening scale, but it would be a significant step in the right direction for once. Carpe diem.

This is one option that puts the cost of care substantially onto those that lose the end of life lottery, who have illnesses that require lots of expensive care.

There is another option where the cost of end of life care is funded by everyone through compulsory insurance or taxes, whether they ultimately need it or not.

Either of these is better than an unmanaged ad-hoc as we have now.

I agree that both of these are better than what we have now but, for me, the lottery idea is oversold. What we are talking about is whether someone who ends up with hundreds of thousands of care costs should be able to leave hundreds of thousands in legacy. I mean, WTF?? People who are unfortunate enough to need end of life care (typically those with dementia) on a large scale simply have to use their own resources to meet that liability. I am not saying we cannot have Dilnot type insurance but the first claim on that estate is the debts incurred in life.

The key to social care was set out in the Dilnot report on Social care as long ago as 2011. We need the elderly to pay a lot more of their care. The idea that the inheritance for the family is more important than the cost to the taxpayer is simply not sustainable nor even remotely equitable. Taxpayers with no aspirations of money for themselves are paying higher taxes on their income to subsidise wealth for the privileged. It is outrageous. Theresa May wasn't right about much but she was right about this and the British people were delusional in rejecting her solutions.

If we are more aggressive about prioritising the debts of the elderly over the inheritance they leave we can save ourselves at least £10bn a year now and more going forward. It would not solve our deficit, that is on a truly different and frightening scale, but it would be a significant step in the right direction for once. Carpe diem.

This is one option that puts the cost of care substantially onto those that lose the end of life lottery, who have illnesses that require lots of expensive care.

There is another option where the cost of end of life care is funded by everyone through compulsory insurance or taxes, whether they ultimately need it or not.

Either of these is better than an unmanaged ad-hoc as we have now.

Compulsory insurance is another moral hazard. Why look after your old Dad if the state will do it for free, and he's already paid for it?

Without the army of family carers out there the government would have an even bigger problem.

I wouldn't be so defeatist about old age.

I have just spent the day taking my mum for a hospital appointment. She is 88, while my dad is 90. She struggles to walk more than 100 yards due to arthritis (she played tennis every week until she was 80 and it has finally caught up with her knees) while my dad can no longer drive because of his eyes. It all went well, the clinical service being excellent even if the Salisbury District Hospital is mostly portakabins, with long desolate corridors of derelict equipment. They have no external help apart me and my brothers dropping by every few weeks.

I dropped them off at their house after a pub lunch. I think there are several key factors to living well in old age.

1: good genes. The hand of cards we get at birth is critical in many ways
2: healthy eating, not much booze.
3: plenty of mental activity. My mum reads extensively, both play bridge weekly.
4: downsize to a manageable property no later than mid seventies, preferably somewhere where driving isn't critical.
5: stay married. Company is critical, both for mental stimulation, and for managing daily activities.

We should aim not at funding Social Care, but rather at avoiding it. Healthy lives, good access to timely healthcare, enough flexible working for family members in their fifties that they can help (my brothers are well aware that we will be doing much more as time goes on).

This isn't aimed at preserving our inheritance but rather at ensuring our parents enjoy life as much as possible. Social Care is sometimes the only way, but putting it off as far as possible should be our real aim.