By Hilary Woodhead, Chief Executive Officer, National Activity Providers Association (NAPA)
Today marks the United Nations International Day of Older Persons, and this year’s theme, “The Age of Longevity: Rethinking Systems for Longer Lives,” feels particularly relevant to the conversations we are having across health, social care and our wider communities.
Living longer is one of the great achievements of our time. It is also changing our society. The UN is asking us to think about how health systems, employment, social protection, education, housing and public policy need to adapt to support people throughout longer lives. Its focus on healthy longevity, prevention, lifelong wellbeing, financial security, integrated care and full participation is important, because none of these things exists in isolation. How well we age is shaped by our experiences throughout life, by the communities around us and by whether the systems we encounter recognise us as whole people.
For NAPA, there is an important contribution to make to this conversation. Longevity cannot only be measured in years lived or through traditional measures of health. We also need to think about what enables people to have a good life, whatever their age, circumstances, abilities or support needs. Relationships, purpose, identity, choice, creativity, contribution and belonging are fundamental to wellbeing throughout our lives. They do not become less important as we grow older or when we begin to need support. If anything, protecting opportunities for these things can become even more important.
This is why NAPA has always taken a broad view of meaningful activity. Activity is sometimes misunderstood as a programme, an event or something delivered at a particular time by a particular member of staff. Of course, organised activities can be enormously valuable, but meaningful activity is much wider than that. It is about how we live our everyday lives and remain connected to ourselves, to other people and to the world around us.
For one person that might mean continuing to garden, sing, paint, volunteer or follow a lifelong interest. For someone else it might mean preparing food, talking about current affairs, choosing the music, spending time outdoors, being part of their faith community, seeing family and friends or simply enjoying an unhurried conversation. It may involve trying something completely new. What matters is not whether something fits our definition of an activity, but whether it has meaning for the person.
That distinction matters as we think strategically about longer lives and the future of care and support. Good care must, of course, keep people safe and respond well to physical and clinical needs, but our ambition cannot end there. Care and support should enable people to continue living a life that feels like their own. Knowing somebody’s health needs is important, but so is knowing who they are, what has shaped them, what matters to them now and what they still want from life.
The UN’s emphasis on prevention and lifelong wellbeing also gives us an opportunity to broaden the way we think about prevention. Preventing ill health, falls, deterioration and avoidable hospital admissions is vital, but there are other forms of prevention that deserve our attention. We should be concerned about preventing loneliness and isolation, loss of confidence, disconnection from community and the gradual erosion of choice. We should notice when a person’s world is becoming smaller, or when their identity is beginning to be overshadowed by a diagnosis, age or support need.
Meaningful engagement has an important role here. Connection, purpose and participation are not simply pleasant additions to care. They are part of wellbeing and should be recognised as such in the way services are designed, commissioned, led and delivered.
Participation is particularly important. Older people are not a single group and ageing is not a single experience. People bring different identities, cultures, relationships, histories, beliefs, interests, abilities and aspirations to later life. They remain partners, parents, grandparents, friends, neighbours, colleagues, carers, volunteers, mentors, campaigners, learners and citizens. They have knowledge and experience to share, opinions to express and contributions to make.
We need to be careful, therefore, that support does not unintentionally become something that reduces participation. With the best intentions, it is very easy to begin doing things for people rather than alongside them. Over time, opportunities to make decisions, take everyday risks, contribute and feel useful can become fewer. A genuinely person-centred approach should recognise what a person can and wants to do, not simply what others believe needs to be done for them.
This is also why NAPA believes that meaningful engagement and quality of life are everybody’s business. Activity Providers play an essential role and bring specialist skills, creativity and leadership to this work. We are proud to champion and support them. But no single role can be responsible for another person’s quality of life.
Culture is created across organisations and communities. It is shaped by leaders and care teams, but also by families, volunteers, commissioners, health professionals, community organisations and the many people whose everyday interactions can help someone feel known and connected. A meaningful moment might happen during personal care, over a meal, in the garden, on a trip into the community or through a conversation with somebody who has taken the time to listen. This is why activity and engagement need to be embedded within the culture of care rather than seen as a separate service running alongside it.
The UN’s call for integrated approaches to longer lives is therefore significant. Integration should not only mean services working more effectively with one another, important though that is. It should also mean joining up our understanding of the person. We can hold detailed information about somebody’s health and care needs while knowing remarkably little about the life they have lived or the life they want to live now. Truly personalised support has to bridge that gap.
There is a wider point here too. Much of NAPA’s work is associated with care settings, but the conversation about meaningful lives is much broader. People are ageing in their own homes, in supported living, in retirement communities, with families and within neighbourhoods. Some will draw on formal care and support and many will not. Creating the conditions for people to live well for longer requires communities that are inclusive and accessible, where people can maintain relationships, interests and a sense of belonging as their circumstances change.
It also requires us to listen differently. If systems are going to be redesigned for longer lives, older people must be involved in shaping them. We cannot talk seriously about participation while designing services and communities around people rather than with them. Listening should not be an occasional consultation exercise. It needs to be part of how organisations work and how relationships are built. At an individual level, it means remaining curious about what matters to somebody today, recognising that preferences and aspirations can change and never assuming that we know what a good later life should look like on another person’s behalf.
There is perhaps a tendency to discuss population ageing predominantly in terms of pressure on services and systems. Those pressures are real and cannot be ignored, but if that becomes the whole story, we risk seeing longevity as a problem rather than an achievement and older people primarily in terms of need.
The age of longevity invites a different conversation. It asks what we need to change so that longer lives can be healthier and more secure, but it should also encourage us to think about the kind of society we want to be throughout those longer lives. A society where people continue to be recognised for who they are, where contribution has no upper age limit, where support strengthens rather than replaces independence, and where connection to community does not disappear when care needs change.
That matters because ageing is not something that happens to another group of people. It is part of all our lives. The services, communities and attitudes we shape today are part of the future we are creating for ourselves and for generations to come.
For NAPA, this International Day of Older Persons reinforces something we have long believed. Quality of life is not an addition to good care. It is the purpose of good care.
As we rethink systems for longer lives, meaningful activity, relationships, participation and belonging need to be part of that thinking from the beginning. Our ambition should not simply be to support people to live for longer. It should be to create the conditions in which all of us can continue to live lives that have meaning, connection, choice and purpose, throughout the whole of our lives.
Hilary Woodhead
Chief Executive Officer
National Activity Providers Association (NAPA)