Virtual issue: ENT care of older adults

Abstract

The demographics of the developed world have changed during the late twentieth and early twenty-first centuries such that the care of older adults has assumed ever more importance. In the UK in 2016, there were 11.8 million residents aged 65 years and over, representing 18 per cent of the total population; 25 years before, there were 9.1 million, accounting for 15.8 per cent of the population. The projection is that by 2066, this will have risen to 26 per cent of the population. Not only are adults living longer, but they have longer ‘active’ lives and are often also economically productive. The reasons for this are numerous and well documented: better nutrition, medical care and fewer wars; a rise in retirement ages well beyond 60 years for both men and women in most Western countries; young families with two working parents; a reduced proportion of young adults in the population compared to older adults; economic barriers to the provision of adequate pensions; and both older adult and child care provision, with the potential this brings for intergenerational conflict. The result is that the later period in a person’s life is unlikely to be spent principally in gardening (‘growing cabbages’, as a retired Roman Emperor was described). An ‘elderly’ person will spend some of their time in the world of work, whether paid or voluntary, and have an important role in caring for spouses, children or grandchildren, and friends, often in combination with work. These activities require a fully functioning physiology. Therefore, specialties such as ENT and the healthcare of older adults must strive to limit or ideally abolish disability and handicap in older patients, to allow them to function in these important roles. Both specialties are as much involved in improving quality of life as in extending the lifespan of their patients.