Preparing SA’s infrastructure and economy for an ageing population

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SIMON BROWN: I’m chatting with Barry Kaganson, CEO of Auria Senior Living. Barry, appreciate the time.

One of the often made comments about South Africa is how we have a young population. That is a true statement, but the other side of the statement is that there are still ageing South Africans. We still have a population that ultimately is ageing.

In a recent piece you put out you talk around the fact that as a country we need to start planning for that ageing population. We can’t just sit back and let it happen. We need to be smart about it.

BARRY KAGANSON: Yes, absolutely, Simon. That’s correct. Currently the projection is that about one in six South Africans will be over the age of 60 by 2050.

But I think what’s even more important than that is – and this is the same in South Africa as it is globally – that the amount of all the adults over the age of 80 is expected to triple by 2050, in the next 24 years, which has a major impact across various aspects of society.

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SIMON BROWN: Agreed. Frankly, across practically all aspects of society. Some of it is just how cities are operating, but I imagine particularly healthcare systems prepared for people into their 60s, to your point now into their 70s and 80s – whether it be public or private.

BARRY KAGANSON: Correct. A generally accepted statistic is that approximately 30-40% of people over the age of 80 need assistance with two or more activities of daily living. Those can be hygiene, meals, medication management, ambulation – which is getting around – et cetera.

So if you consider that in a relatively short space of time the number of people needing that will triple, I guess you can kind of appreciate the scale of the problem.

As you say, it cuts across all demographics because people are people, no matter their LSM [living standards measure], which is their affordability of procuring these services.

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So that is something that needs to be looked at from all aspects, including by government. I know government in South Africa has a number of priorities that require attention and funds, but this is certainly one that is also going to compete with whatever else the country needs, quite frankly.

SIMON BROWN: That’s a good point. This is a healthcare issue, but it’s a lot more than just a healthcare issue. It is also going to be an economic issue, an infrastructure issue. And in both cases we’re looking at municipalities, at provincial and national government to come to their help to a fair degree.

Regardless of your LSM, some of this stuff needs to be done at governmental level.

BARRY KAGANSON: Absolutely. The thing about care for older people is that it takes one of two things. It takes money or it takes time. ‘Time’ would be if it’s a family caregiver situation. But that time also has a cost, because it means that the person doing the caregiving has fewer hours in the day to be productive – and by ‘productive’ I mean earning an income.

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So there’s an economic impact to tying up people’s time in caregiving for families – that’s the one aspect.

The other aspect is that they’re not always qualified to be able to give the care that is needed. So, as you say, it cuts across healthcare and there are a whole lot of economic implications as well.

SIMON BROWN: Also, when we think about our retirement, obviously initially we think about the saving; then we start to think, okay, it’s the spending. We get the sense that, yes, medical’s going to cost us more in retirement – and that’s a true statement.

But it’s a lot more than that. The key one is where we’re going to live, because we’re going to need places that have the support services that we can then afford.

BARRY KAGANSON: Correct. Again that talks to the demographics. There’s a range of affordability from almost nothing to quite a lot. I think the main benefit of living in a senior living community – I guess that’s what you’re talking about – is actually more than just the care and support.

It’s actually the social interaction, because that’s actually one of the key determinants of healthy ageing and arresting the decline that comes with age, both physically and mentally.

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So, as you said, we need to think about the environment that people are living in that’s going to be able to foster social interaction. Believe it or not, you can make new friends after 80. I see it all the time.

People think that you can’t and that you need to sit at home alone. That’s absolutely not true and it has a detrimental impact on health, for sure.

SIMON BROWN: That also then says to me that some of this is actually kind of soft touch – to your point around having companionship, friends, and the inability to get from A to B, whether that be just getting to a lounge or perhaps getting to a shopping centre.

Some of this is, I want to say, easily solved. I don’t mean ‘easy’ in that we can do it, it’s easy in that maybe it doesn’t need giant budgets and infrastructure changes.

BARRY KAGANSON: Yes, it’s a very good point. And I think certainly on the mobility side or the transport side, South Africa generally doesn’t have a great public transport network around the country – and that would be something hugely beneficial to older people.

It crosses all demographics. People aren’t able to drive, or don’t have a car – or have never been able to drive, have never owned a car, et cetera.

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It opens up the world, essentially, if you have a reliable and safe and accessible public transport system – which we certainly don’t have in this country. That also contributes to the factor of isolation.

SIMON BROWN: Yes, governments, municipalities – we can see where they fit in. But does business have a role here as well, where it can assist as we get an ageing population, a population living longer?

BARRY KAGANSON: Yes. I think the senior living sector in South Africa is definitely growing in response to demand and in response to the ageing population, as it is everywhere in the world.

But what happens – I’m going to use New Zealand as the example.

New Zealand has a number of private providers of aged care services and facilities, and what the government does is to contribute, on behalf of residents, on a financial need basis.

So the lower end of the affordability [range] will be covered almost 100% by government. The upper end of the affordability, those who are able to pay, will have 0% funded by government because they should pay for themselves, because they have the funds.

So I think there is a way to work with government and the private sector, but I do think that currently and realistically we are a fair long way away from that.

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SIMON BROWN: I think we are. To be clear, as I said, we’re a young population. But like all populations the world over, we age, we get older. That is a stark reality.

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We’ll leave it there. Barry Kaganson, CEO of Auria Senior Living, appreciate the time.

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