Joan Bakewell: The old are left to fend for themselves

I have my own story of ageism at first hand in the health service

Spry as mountain goats, some six hundred people reached the peak of Everest this spring. There were six deaths. More surprising is the fact that quite a number of those who take on the mountain are old people. Since 2000 an average of 13 sexagenarians have attempted the Everest climb each year. Edmund Hilary and Sherpa Tenzing Norgay were in their thirties when they first beat the peak. It is no news at all that the older climbers are more likely to die in the attempt. But, hey, lucky them. They made the choice, they had the money, they took the risk, and they, presumably died happy.

That's not the lot of many old people. I make no apology for coming back to the subject yet again, because the evidence just keeps on piling up. This week alone there have been two spankingly up-to-date reports detailing the unhappiness that awaits us in our final years. First the UK Inquiry into Mental Health and Well-being in Later Life tells us that the majority of older people with mental health problems just do not receive the services they need. There are some 2.4 million older people with depression, and that figure is predicted to rise to 3.1 million in 15 years time.

How do they know this? Presumably they don't expect much to change either from governments or from society, and with changing demographics there'll simply be more old people to get depressed. The report recommends a whole swath of changes: the rooting out of ageism in our health services, the provision of activities and oversight for the old, better training for carers and young people so they regard the life of someone old and decrepit as of much value as someone lithe and youthful. How often have we heard recommendations like this, and it seems nothing gets done.

I have my own story of ageism at first hand in the health service. When I passed 70, I ceased to get the reminder form telling me a mammogram was due and that I could take up any of several offered appointments. Yet the risk of breast cancer goes on being just as serious for the elderly as it is for younger women. Yet, paradoxically, as my memory declines, I am expected to remember these things for myself. Another yellow sticker to add to the other reminders!

But how many older women know it's up to them to arrange and book appointments, and can be bothered to take the trouble? It is a case of simple discrimination that cries out to be put right at once. Yet, so far no leaflet has come through the letter box telling me, aged old-age pensioner that I am, that the mammogram facility is now ready and waiting for me.

The second report comes from the Parliamentary Committee on Human Rights and finds the human rights of older people in hospitals and care homes are often grossly neglected. We all know what they mean: old people can be routinely ignored, their food dumped unceremoniously in front of them, then, if they don't eat it, collected up and taken away, untouched.

Many old people need help with feeding, and that's not the only service shortcoming. They also dislike mixed-sex wards, having their confidential details shared too promiscuously. They need water constantly available, provision for leaky bladders and the knowledge that someone will come when they call. Many also like to be consulted before doctors and nurses make familiar use of their first names. Older people grew up in more formal times. This is surely not too much to ask.

Of course, old people can be difficult. According to Nina Taunton's fascinating book about Fictions in Old Age, King Lear got it wrong. He made a show of giving up power and then caused mayhem by trying to hang on to it. He can't have been much good at parenting, either. But then he probably blamed Mrs Lear. It was, the book argues, the crucial contradictions in his behaviour that led on to madness and death.

The truth is many old people send out mixed signals and there can be unresolved tensions between the generations that makes the elderly angry and resentful. Its natural for the old to think that the world has gone to the dogs. The good things they recall are theirs no more, and they haven't acquired a taste for the new-fangled ways of the young.

They grouch about falling standards: music, television, exams. Too often it makes them sour and crotchety. But that's not a crime: and it certainly isn't helped by treating them with casual cruelty. Nonetheless, it's worth staying on good terms with your children. You'll one day need them to be nice to you.

So how many more reports like these must there be before good intentions become deeds. The population statistics are tilting towards the old, they are staying fitter, expecting to work longer. But we have yet to make our concerted voices heard. The Americans are better at this sort of thing.

The American Association of Retired Persons has 33 million members and is the country's most powerful lobby. It is, though they wouldn't like the term, a trade union of the old, funded almost entirely by membership subscription. With staffed offices in 50 states, it is taken seriously be America's government. It probably helped defeat Bush's attempt to curb social security.

We have dedicated charities, of course: the ever-vigilant Age Concern and Help the Aged. And we have Saga, with its magazine, and cut-price deals. But we're beginning to need something more co-ordinated, something along the lines of the AARP. Year after year, people in good health and full of stamina and purpose are retired from their jobs and looking around for direction in their lives.

There are enough healthy and vocal over-sixties - most of the House of Lords for a start - to kick up some serious fuss. The Queen might lead the way, making pointed inquiries when she next opens a geriatric wing of a hospital. The truth is we can't wait for the next generation to mobilise on our behalf. They have other things to worry about: their children's well-being and education, mortgages and redundancies. Taking up the cause of the old is not going to be a top priority for them.

The even younger generation can often be glib and indifferent, turning away from the sight of sagging flesh and stooped shoulders, mocking those who have lost their looks and their physique. To them, the old have had their lives and will be gone soon enough anyway. So why bother?

The answer is that it costs nothing to be kind, making other people happy feels good, and the world will then be a better place when they grow old themselves. But until they listen, we shall have to fend for ourselves.

Joan.bakewell@virgin.net