TOPIC 4: END OF LIFE CARE, AGEING POPULATIONS 4TASK ① END OF LIFE CARE, AGEING POPULATIONS, POSTERS TASK 1A DISCUSSION. Discuss the message communicated by the following pictures. 1 2 3 4 Picture 1 taken from: http://www.tneel.uic.edu/tneel-ss/demo/impact/frame1.asp/ Picture 2 taken from: http://www.deathreferencedesk.org/2012/07/29/do-not-resuscitate-tattoos-cannot-be-stopped/ Picture 3 taken from: http://hospicefoundation.ie/hospice/hospice-palliative-and-end-of-life-care/ Picture 4 taken from: https://cz.pinterest.com/nlm4caregivers/end-of-life-care/ 4TASK ② END OF LIFE CARE TASK 2A Read the introductory text about palliative care and answer the questions. To prepare for the introductory text study the following vocabulary. 1 hospice (noun) a hospital that looks after people that are dying 2 multidisciplinary (adj.) involving different subjects of study or areas of professional activity 3 diagnosis (noun) a statement about what disease someone has, based on examining them 4 symptom (noun) a sign that someone has an illness 5 palliative (adj.) reducing the pain or other bad effects of a terminal illness (=one that cannot be cured) Definitions taken from: www.macmillandictionary.com TASK 2B Read the introductory text about palliative care and answer the questions. 1 What is palliative care? 2 Who is it for? 3 What is its goal? Palliative care is a multidisciplinary approach to specialised medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. The goal of such therapy is to improve quality of life for both the patient and the family. Palliative care is provided by a team of physicians, nurses, and other health professionals who work together with the primary care physician and referred specialists (or, for patients who don't have those, hospital or hospice staff) to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment. The focus on a person's quality of life has increased greatly since the 1990s. In the United States today, 55% of hospitals with more than 100 beds offer a palliative-care program, and nearly one-fifth of community hospitals have palliative-care programs. A relatively recent development is the palliative-care team, a dedicated health care team that is entirely oriented toward palliative treatment. Adapted from: https://en.wikipedia.org/wiki/Palliative_care 4TASK ③ PALLIATIVE CARE – ONE PATIENT'S STORY TASK 3A Study the following phrases and translate them into Czech. 1 to come to terms with one's own mortality = ________________________________ 2 deceased person = ________________________________ 3 to be entitled to finances = ________________________________ 4 to suffer from an incurable disease = ________________________________ 5 terminal diagnosis = ________________________________ 6 the patient valued the treatment = ________________________________ 7 to improve the quality of life for patients = ________________________________ 8 to take advantage of sth = ________________________________ 9 to make the very best of a situation = ________________________________ 10 she was diagnosed with liver cancer = ________________________________ ^RECORDING 1 TASK 3B Watch the video and answer the questions. 1 What symptoms other than physical ones is palliative care interested in? 2 How did Davine, a woman with a terminal diagnosis, respond to the possibility of being placed in a home with professional care? 3 What facilities are family members of those placed in homes entitled to? 4 What support does palliative care offer to relatives of the deceased? TASK 3C WORDFORMATION. Complete the gaps with words made from the words in brackets. 1 Palliative care is for patients with ______________________ diseases. (CURE) 2 We are interested in emotional symptoms, such as ______________________. (ANXIOUS) 3 Upon further ______________________, she was diagnosed with secondary liver cancer. (INVESTIGATE) 4 A huge ______________________ was lifted off her shoulders, when the patient was first introduced to Sue Ryder Care. (WEIGH) 5 She was able to come to terms with her own ______________________. (MORTAL) 6 The family took advantage of ______________________ facilities offered by the programme. (RECREATE) 7 She got on well with all the ______________________ staff. (NURSE) 8 She became ______________________ and had to be hospitalized. (WELL) TASK 3D PREPOSITIONS. Complete the gaps with suitable prepositions. 1 She gave her children things to remember her ______ . 2 I was looking forward ______ our next conversation. 3 She was able to cope ______ her illness well. 4-5 She was able to come ______ terms ______ her own mortality. 6 She was able to deal ______ her problems. 7 Patients do not know what care they are entitled ______. 8 Who will look ______ me if I become ill? 9 The staff are aware ______ pain and distress relatives experience when they lose a loved one. Adapted from: https://www.youtube.com/watch?v=BuF5qxIDa3c 4TASK ④ DEATH TASK 4A DISCUSSION. Answer the questions below on your own and then discuss the results with your partner. 1 How do you feel when the subject of death comes into the conversation? A Uncomfortable – I don't want to talk about it. B It depends how other people react. C Fine - it's perfectly natural to talk about death. D other reaction 2 You have to tell a close friend that a mutual friend of yours has just died. You know that they were very close. How would you start the conversation? A I'm afraid we won't be meeting Mary for lunch on Friday after all. B Have you heard? Mary's just died. C You'd better sit down. I've got some bad news about Mary. She died last night. D other reaction 3 A friend of yours (a rather unreliable one) has just died, owing you a lot of money. After the funeral his sister comes to talk to you. Do you say? A I was hoping to meet one of the family. I can get my money back. B Poor George! He was such a good old friend. (and I forget about the money) C I will miss George – but not as much as the £1, 000 he owed me! D other reaction Taken from: MacAndrew, R. & Martínez, R. (2001). Taboos and Issues. Thomson, Heinle, pp. 1. 4TASK ⑤ ASSISTED DYING DEBATE TASK 5A Give words transcribed by the following and translate them into Czech. TRANSCRIPTION STANDARD SPELLING TRANSLATION INTO CZECH 1 /ˌjuːθəˈneɪziə/ 2 /ˈmænˌslɔːtə(r)/ 3 /ˈmɜː(r)də(r)/ 4 /ˈsuːɪsaɪd/ 5 /ˈvɒlənt(ə)ri/ 6 /ɪnˈvɒləntəri/ 7 /ˈkɒnʃəsnəs/ 8 /ˈpʌnɪʃmənt/ 9 /ˌɪrɪˈvɜː(r)səb(ə)l/ 10 /ˈɡɪlti/ 11 /sɪˈvɪə(r)/ 12 /strəʊk/ Pronunciation transcripts taken from: www.macmillandictionary.com TASK 5B DEFINITIONS. Match the words with their definitions below. EUTHANASIA, MANSLAUGHTER, MURDER, SUICIDE 1 ___________________ = the painless killing of a patient who is suffering from an incurable and painful disease. 2 ___________________ = the action of killing oneself deliberately 3 ___________________ = the illegal, deliberate killing of a human being 4 ___________________ = the crime of killing a person illegally but not intentionally Taken from: MacAndrew, R. & Martínez, R. (2001). Taboos and Issues. Thomson, Heinle, pp. 28. TASK 5C Study the following phrases and translate them into Czech. 1 at the request of his daughter = _______________________________ 2 to charge sb with murder = _______________________________ 3 to have/suffer a stroke = _______________________________ 4 severe irreversible brain damage = _______________________________ 5 to commit a crime = _______________________________ 6 to give a punishment = _______________________________ 7 to regain consciousness = _______________________________ 8 to be in great pain = _______________________________ 9 to commit suicide = _______________________________ 10 to arrest sb = _______________________________ 11 to realize what has happened = _______________________________ 12 to inform the police = _______________________________ 13 to be guilty of = _______________________________ TASK 5D DISCUSSION. In pairs or small groups, read the following situations and discuss the questions below each one. 1 Alan Jones, aged 78, had a second stroke three weeks ago. He has severe brain damage and his condition is getting worse. At the request of his daughter, a nurse stops giving him oxygen until his heart stops. The nurse then starts giving oxygen again. People think Mr Jones died naturally. Later, Mr Jones's daughter tells a friend what happened. The friend is married to a police officer. As a result, the police charge the nurse with murder. o Do you feel that the nurse has committed a crime? o Do you feel that the daughter has committed a crime? o What punishments, if any, should be given? 2 Antonia James, aged 24, suffered severe, irreversible brain damage in a road accident six weeks ago and has not regained consciousness. She is breathing on her own but being fed through a tube. Her parents feel that Antonia's existence is no more than a living nightmare. They want the doctor to stop feeding her so that she will die. The doctor refuses, saying that food and fluids are not "medical treatment" but the basic necessities of life. o Who do you feel is right – the doctor or the parents? o Who should make this decision - Antonia's parents? The doctors? A court of law? 3 Mike O'Brien, aged 58, has terminal cancer. He is no longer able to live a normal life and is often in great pain. He has always said that when this happened, he would take his own life. However, he is now so weak that he cannot open the bottles of pills he wants to take. His son opens the bottle for him. Mike takes the pills and dies peacefully. The doctor is surprised at Mike’s sudden death, realizes what has happened and informs the police. The police arrest the son for helping his father to commit suicide. o Is the doctor right to inform the police? o Is the son guilty of committing a crime? 4 The wife of a close friend has died recently. Your friend has been terribly upset since her death. In a conversation with him you begin to suspect that he is thinking of taking his own life. o What would you do? 5 A woman terrorist was found guilty of planting a bomb which killed 20 people. She has been sent to prison for 20 years. She now refuses to eat and says she is not guilty. o Should she be allowed to die or should she be kept alive? Taken from: MacAndrew, R. & Martínez, R. (2001). Taboos and Issues. Thomson, Heinle, pp. 28. TASK 5E DISCUSSION. Are these the same in the Czech Republic? Four types of euthanasia Suicide = killing yourself. In the UK it is illegal to help someone commit suicide. Voluntary euthanasia = when someone asks to die. They may not be able to commit suicide so they need help or they may not be able to ask to die, but they have left instructions. Involuntary euthanasia = this is when someone has not actually asked to die. However, they are killed so that they do not have to suffer any more. Non-voluntary euthanasia = killing someone who is not able to ask to live or die. For example, they might be in a long-term coma. Taken from: MacAndrew, R. & Martínez, R. (2001). Taboos and Issues. Thomson, Heinle, pp. 28. TASK 5F DISCUSSION. Work in groups of three. You are each supposed choose 1 of the posters below (1 poster will not be used) and orally present its message to the rest of the group. 1 2 3 4 Pictures taken from: https://www.google.cz/search?rlz=1C1EODB_enCZ656CZ656&espv=2&biw=1920&bih=911&tbm=isch&sa=1&q=ASSIS TED+DYING&oq=ASSISTED+DYING&gs_l=img.3..0j0i30k1l4j0i5i30k1l3j0i24k1l2.5719015.5721880.0.5722510.14 .13.0.1.1.0.203.1000.11j1j1.13.0....0...1c.1.64.img..0.14.1007...0i67k1j0i10i67k1.bLaHXI8MQkQ&dpr=1 &cad=cbv&bvch=u&sei=2J_KV63jO8OTU9iIj_gL#imgrc=Ma_UKIJ0gfPnAM%3A TASK 5G LAW TO ALLOW ASSISTED DYING IN THE UK. To prepare for the listening exercise, study the following vocabulary. 1 of sound mind 2 modelled on 3 disabled 4 backing 5 significant rational, mentally healthy following the example of lacking some physical abilities support important ^RECORDING 2 TASK 5H LAW TO ALLOW ASSISTED DYING IN THE UK. Listen to the recording, take notes in order to be able to present the content of the recording orally. TASK 5I VERBS. Complete the gaps with the correct forms of the following verbs. ALLOW, CAUSE, END, GIVE, PUT 1-2 A law which would __________________ assisted suicide is being discussed in Britain. This law __________________ controversy. 3-4 This law would __________________ you a right to __________________ your life under certain circumstances. 5 Opponents say it will __________________ vulnerable and disabled people at risk. 4TASK o AGEING POPULATIONS TASK 6A Using the below picture, make a presentation about the "Historical and Future Expected Age and Sex Distribution in the Canadian Population". Taken from: http://www.cihr-irsc.gc.ca/e/documents/ihspr_strat_plan_2015-19-en.pdf TASK 6B Before you listen to the recording, study the following vocabulary. To get the right definitions, match the numbers in the left column with the letters in the right column. Complete the middle column with the Czech translations of the English words or phrases. English Czech Definition 1 ageing A a serious illness affecting someone’s brain and memory in which they gradually stop being able to think or behave in a normal way. Most forms of dementia usually affect only old people 2 phenomenon B problem with the brain which can make someone unable to move a part of their body, a medical condition in which blood is suddenly blocked and cannot reach the brain, or in which a blood vessel in the brain breaks, often causing a loss of the ability to speak or to move particular muscles 3 burden C a serious illness caused by a group of cells in the body increasing in an uncontrolled way. It is often treated by chemotherapy (=special drugs) or by radiotherapy 4 stroke D a serious medical condition in which your body does not produce enough insulin to reduce the amount of sugar in the blood 5 cancer E a difficult thing people have to deal with 6 diabetes F a medical condition in which the force of blood in the veins is too high 7 dementia G getting older 8 chronic H serious and lasting for a long time, the opposite expression: acute 9 the global community I an event or situation that can be seen to happen or exist, something unusual that happens 10 high blood pressure J the group of countries which sees itself as connected, often helping each other economically and socially Definitions adapted from: http://www.bbc.co.uk/worldservice/learningenglish/language/wordsinthenews/2012/04/120405_witn_agein g_population.shtml Definitions adapted from: www.macmillandictionary.com ^ ^ ^ ^RECORDING 3 TASK 6C Based on the information in the recording say whether the following statements are true (T) or false (F) and justify your choice. 1 Health systems around the world are adequately equipped to deal with population ageing. T/F 2 Population ageing is fastest in high-income countries. T/F 3 People in the poorest countries suffer from chronic conditions rather than acute conditions. T/F 4TASK p AGEING POPULATION AND RETIREMENT AGE TASK 7A DISCUSSION. Discuss the message communicated by the below pictures. 1 2 Picture 1 taken from: http://chieforganizer.org/2013/03/13/raising-retirement-age-is-the-poor-subsidizing-the-rich/raisin g-the-retirement-age/ Picture 2 taken from: http://www.usatoday.com/story/money/columnist/powell/2015/11/07/full-retirement-age-magic-number-so cial-security-benefits/74656796/ TASK 7B DISCUSSION. To be able to participate in the following discussion, make sure you are familiar with the following words and phrases. to pay enough social insurance contributions to save up for your retirement qualifying years to raise / lower the retirement age old page pensions sufficient to live on to be eligible for old age pension 1 What is the age of retirement in your country? Is it different for men and women? Has it been raised or lowered recently? 2 Have you ever thought of this stage of your life? What are some of your thoughts? 3 Have you planned for your retirement or will you ever plan for it? 4 Do you think people have to get retired at a certain age or according to their ability? 5 Do you think retired people miss their jobs? How about you, will you? 6 What are some difficulties that retired people have? 8 Do you think that current state old-age pensions are sufficient to live on in the Czech Republic? 9 Do you think that old-age pensions will be sufficient in the Czech Republic when you retire? 10 What conditions do you need to fulfil in the Czech Republic to be eligible for the state old-age pension? Questions 1-6 taken from http://www.languageties.com/en/conversation-questions/topic/retirement TASK 7C Before you listen to the recording, study the following vocabulary. To get the right definitions, match the numbers in the left column with the letters in the right column. Complete the middle column with the Czech translations of the English words or phrases. English Czech Definition 1 pensions A where one generation (people born at about the same time as each other) has done something which leads to unfair treatment for another generation 2 retirement B very frightened 3 OAP C study of changes or trends in the number of births, deaths and diseases in a community 4 senior citizen D money regularly paid to a person by a company or government after he or she is too old or too ill to continue working 5 terrified E age at which a person usually stops working. In the UK it when you reach the age between 60 and 65 6 generational injustice F American English phrase for old-age pensioner 7 demographics G old-age pensioner, a person who has retired and collects his or her pension Definitions adapted from: http://www.bbc.co.uk/worldservice/learningenglish/general/sixminute/2010/09/100916_6min_ageing_popu lation_page.shtml ^RECORDING 4 TASK 7D Listen to the recording and write a 50-70-word summary of it. TASK 7E VERBS. Complete the gaps with the correct forms of the following verbs. BLAME, COLLECT, REACH, STAND FOR 1 There are lots of terms for people who ____________________ retirement age. 2 OAP ____________________ an old-age pensioner. 3 It is wrong to ____________________ people for having been born in better times and having easier lives. 4 In the future people will simply have to work longer before they start ____________________ a pension. TASK 7F WORDFORMATION. Complete the gaps with words made from the words in brackets. 1-2 You come across the phrase old-age pensioner less ____________________ as it is thought to be less ____________________ to older generations. (FREQUENT, RESPECT) 3 More and more people will spend longer in ____________________. (RETIRE) 4 She is not sure whether she will survive ____________________ when she stops working. (FINANCE) 5 Raising the retirement age is a very ____________________ issue in a number of countries. (CONTROVERSY) 6 These generations had a very ____________________ position. (ADVANTAGE) TASK 7G PREPOSITIONS. Complete the gaps with suitable prepositions. 1-3 Some people are not saving ________ retirement and are therefore in danger ________ not having enough to live ________ when they are old and unable to work. 4 People who own property can earn money by renting it ________. 5 People really need to sort ________ their financial future. 6 Someone may say that some generations who lived easier lives are "guilty" ________ generational injustice. VOCABULARY ageing /ˈeɪdʒɪŋ/ stárnutí to arrest sb /əˈrest/ zatknout burden /ˈbɜː(r)d(ə)n/ břemeno cancer /ˈkænsə(r)/ rakovina chronic /ˈkrɒnɪk/ chronický to comfort sb /ˈkʌmfə(r)t/ utěšovat comfort /ˈkʌmfə(r)t/ útěcha deceased /dɪˈsiːst/ zesnulý dementia /dɪˈmenʃə/ demence demographics /ˌdeməˈɡræfɪks/ demografie diabetes /ˌdaɪəˈbiːtiːz/ diabetes eligible for /ˈelɪdʒəb(ə)l/ mající nárok na, způsobilý pro hospice /ˈhɒspɪs/ hospice insurance /ɪnˈʃʊərəns/ pojištění multidisciplinary /mʌltiˈdɪsəˌplɪnəri/ multidisciplinární nurse /nɜː(r)s/ zdravotní sestra palliative /ˈpæliətɪv/ paliativní phenomenon /fəˈnɒmɪnən/ jev physician /fɪˈzɪʃ(ə)n/ lékař relief /rɪˈliːf/ úleva to relieve /rɪˈliːv/ ulevit symptom /ˈsɪmptəm/ symptom euthanasia /ˌjuːθəˈneɪziə/ eutanázie manslaughter /ˈmænˌslɔːtə(r)/ zabití (neúmyslné) (to) murder /ˈmɜː(r)də(r)/ vražda, zavraždit stroke /strəʊk/ mrtvice sufficient /səˈfɪʃ(ə)nt/ dostatečný, dostačující suicide /ˈsuːɪsaɪd/ sebevražda voluntary /ˈvɒlənt(ə)ri/ dobrovolný involuntary /ɪnˈvɒləntəri/ nedobrovolný, mimovolní SELECTED PHRASES high blood pressure = vysoký krevní tlak at the request of his daughter = na žádost jeho dcery to be guilty of = být vinen to be in great pain = mít velké bolesti to charge sb with murder = obvinit někoho z vraždy to come to terms with one's own mortality = vyrovnat se s vlastní smrtelností to commit a crime = spáchat zločin to commit suicide = spáchat sebevraždu to be entitled to finances = mít nárok na finance to fulfil a condition = splnit podmínku generational injustice = mezigenerační nespravedlivost to give a punishment = udělit trest to have/suffer a stroke = utrpět mrtvici to improve the quality of life for patients = zlepšit kvalitu života pacientů to inform the police = informovat policii to lower retirement age = snížit věk odchodu do důchodu to make the very best of a situation = využít / zvládnout situaci co nejlepším způsobem palliative care = paliativní péče patient valued the treatment = pacient si cenil léčby to pay enough social insurance contributions = zaplatit/odvést dostatečnou částku na sociálním pojištění physical stress = fyzická zátěž, fyzický stres qualifying years = odpracovaná léta potřebná pro pobírání státního starobního důchodu to raise retirement age = zvýšit věk odchodu do důchodu to reach retirement age = dosáhnout věku odchodu do důchodu to regain consciousness = nabýt vědomí to realize what has happened = uvědomit si, co se stalo severe irreversible brain damage = těžké, nevratné poškození mozku to suffer from an incurable disease = trpět nevyléčitelnou nemocí terminal diagnosis = konečná diagnóza to take advantage of sth = využít něčeho TRANSCRIPT 1: PALLIATIVE CARE – ONE PATIENT'S STORY Specialist: Palliative care is the care of patients, their friends, their families who are living with an incurable diagnosis, and our aim, really, is to improve the quality of life for those patients and those who care for them. People die of all kinds of illnesses and most palliative care teams are very open to care for people with any incurable disease, so we're interested in how, physically, a patient might feel, and I guess that's the issues around pain and those problems. And we're interested in those emotional symptoms, the fear, the anxiety. Husband: Davine was really struggling and you could tell that something wasn't right, and sure enough, upon further investigation, she had secondary liver cancer diagnosed, so we were given a terminal diagnosis. That was when we were first introduced to Sue Ryder Care. It was as if a weight was lifted off Davine's shoulders. She immediately felt that this was somewhere she needed to be because such a huge weight had been placed upon her coming to terms with her own mortality and this was, I think, where she felt she could address it and deal with it. Specialist: Those questions like "Who will look after me if I become unwell at home?" Or maybe "What finances am I entitled to?" And the last part of care which we're involved in is what we might call spiritual care. So helping patients to find, if possible, some kind of meaning from their situation. Husband: I think here she was able to think about lots of things, her own mortality, write lots of things, she wrote in a journal, she wrote letters to family. She came up with ideas as to how she wanted to be remembered. Son: Yeah, she made us these special boxes at Easter and they had different stuff in, photos. She was always like that, she was quite into making little arts and crafts. And I think she knew it was terminal and she just wanted to give us something to remember her by. Daughter: We've got pictures of us with her on them. We just store them up on a shelf and every now and then we just get them down, look at all different things that we've put in there to remember her by, like photos and things she's given us, and I think that helps a lot as well. Specialist: You recognise that all of us at some point are going to die, but even if you have a terminal diagnosis you're still very much living, and so what we would want to do is improve patients' quality of life. Husband: Sue Ryder Care enabled such a positive quality of life that we were able to take advantage of family trips away, family holidays, going away to Scotland, taking advantage of all of the recreational opportunities that a family could want in a summer. Specialist: Part of our role is to support the patient and the families around about what care they want at the end of life and what choices they may want to make, and that might be around where they want to die. Husband: I arrived five minutes after she had died, but it's never been a problem for me because I knew of how much she valued the treatment, the care from all of the nursing staff. I know that one of the nurses was holding her hand at the time. She was holding someone who was caring for her, was doing exactly what she would want. Specialist: Palliative care is also very aware of the enormous pain and distress of grief and so most teams would want to support relatives and friends of patients after the patient has died. Husband: After Davine died we received a monthly call from the Sue Ryder Care support team. I would always wonder, "What am I going to talk about?" and then 40, 45 minutes later be saying goodbye and perhaps looking forward to our next conversation in a month's time. Specialist: One of the ways we work is to say to patients and carers, but also to other health professionals, "We're here, we're friendly. Come and speak to us." Son: You go to places like hospitals or you talk about it at school and it's more... it's the illness you're talking about and the symptoms, whereas here it's coping with it and support and stuff. Daughter: People are friendly and the atmosphere's nice and everything. It's just a nice warming place to be. Husband: I think it was a good way to go and making the very best of a bad situation. I think physically, emotionally and spiritually she was ready and in hindsight it made it a lot more bearable. Taken from: https://www.youtube.com/watch?v=BuF5qxIDa3c TRANSCRIPT 2: ASSISTED DYING DEBATE A law which would allow assisted suicide is being discussed in Britain. The proposal is based on laws already in place in the US states of Oregon and Washington. It has caused controversy. The BBC's Fergus Walsh reports: The Assisted Dying Bill would allow adults of sound mind with six months to live the right to end their lives at a time of their choosing. It would be a profound step for society modelled on the law in Oregon. If experience there is a guide, it could lead to around 1,000 people a year in England and Wales choosing an assisted death. Opponents argue it would put the frail, vulnerable and disabled at risk. Whilst it's unlikely to get sufficient backing or parliamentary time to become law, simply passing its second reading today would be significant – the first time such a bill would have done so. Taken from: BBC learning English, Words in the News, 18 July, 2014 Taken from: http://www.bbc.co.uk/worldservice/learningenglish/language/wordsinthenews/2014/07/140718_witn_suici de.shtml TRANSCRIPT 3: AGEING POPULATIONS The World Health Organisation has given a warning that health systems around the world are not adequately equipped to deal with population ageing where it is now happening fastest: in less well-off countries. The WHO says there is a rising burden of heart disease, stroke and similar problems among older people even in very poor countries. The BBC's Mike Wooldridge reports. While Europe and Japan were among the first places to see their population ageing, the phenomenon is now occurring fastest in low and middle-income nations and WHO says the most dramatic changes are taking place in countries such as Cuba, Iran and Mongolia. This means that where in the past infections were considered the greatest challenge, now even in the poorest countries the biggest health burdens for older people come from conditions such as heart disease, stroke, cancer, diabetes, dementia and sight and hearing loss. W.H.O. says present health systems are poorly designed for the chronic care needs arising from this pattern of disease. The campaigning organisation HelpAge International welcomed the new focus on the impact of ageing but said the global community was still worryingly slow to act. HelpAge cited Ghana where it said nearly sixty per cent of older people suffer from high blood pressure often leading to strokes and heart attacks but only five per cent are able to control it through medication. Taken from: BBC learning English, Words in the New, Ageing populations, (5 April, 2012) Taken from: http://www.bbc.co.uk/worldservice/learningenglish/language/wordsinthenews/2012/04/120405_witn_agein g_population.shtml TRANSCRIPT 4: AGEING POPULATIONS AND RETIREMENT AGE Alice: Hello! I’m Alice and this is 6 Minute English. I’m joined today by Abdu. Hi Abdu. Abdu: Hi Alice. Alice: Today we’re talking about ageing populations, pensions and retirement. I’m going to start by asking you Abdu – what age do you expect to retire? Abdu: I’m planning to retire around 65 to 70. Alice: And do you have a pension? Abdu: Unfortunately not. Alice: I’ve also got a third question – according to the United Nations in 1950, 8% of the world’s population was over 60 years old. Currently 11% of the world’s population is over 60. Any guesses what percentage will be over 60 in 2050? Abdu: I’m not sure – it looks like it’s going up? I would guess 15%. Alice: Have a think about it and I’ll let you know at the end of the programme. There are lots of terms for people who have reached retirement age. Official terms in British English are ‘OAP – which stands for old aged pensioner’ and in American English ‘Senior Citizen’ or ‘Senior’. Abdu: You hear the term OAP less frequently these days in the UK. It doesn’t sound as respectful perhaps as ‘Senior Citizen’. Alice: In many countries, economists and politicians are talking about the impact of an ageing population. In many countries around the world people are living longer and will spend more time in retirement. Experts are worried about how we will pay for the health and services for an increasing number of people in retirement. Abdu: Some people save money in pension plans or retirement funds as they’re called in the United States. What’s interesting is how many people don’t have pensions despite the warnings given by governments about saving for retirement. According to a BBC survey, only 2 out of every 10 people around the world have a pension. Alice: We asked people if they were scared about getting old and not having enough money to live on. Here’s what they said: Extract 1: Goodness there’s a question – I currently have a pension in my job so I’m not too worried that way and I’m also hoping to save for my retirement and for later years by owning property and renting that out and selling it on when I need more income. I’m not fussed about getting old –we all have to get older sometime, you know, so I’m not scared about it. Life is life and that’s the way life should be. I’m not scared about getting older or being unemployed, at all. Not very scared – I’m more scared about getting older than being unemployed. Terrified. Absolutely terrified – I don’t know what’s going to happen in the future. I’m really worried and I really need to sort that out. Alice: Some people have other plans for how they will survive financially when they retire. One man said he was hoping to save for retirement by owning property and renting it out or selling it when he needs more income. Abdu: And one man said he was terrified – very very frightened about what’s going to happen in the future because he hasn’t thought about planning for retirement Alice: In some countries the age of retirement is being increased so that people will work longer before they collect their pensions. This is very controversial in some societies. Abdu: In France people went on strike to complain about proposals to increase the retirement age from 60 to 62 Alice: And in the UK, some people in their 20s and 30s are annoyed that they may have to work longer than people in previous generations – especially those born in the 1940s and 50s who are sometimes called the baby boomer generation. Abdu: The baby boomers – people born between the years of 1945 and 1964 after the Second World War, when there was a large increase in the number of children born. Alice: Here’s Rosamund Irwin, a 26-year-old journalist, talking to her father Nigel, a 60-year-old lawyer. She thinks life is going to be very difficult. Extract 2: Well, I think the baby boomers are guilty of great generational injustice. What they’ve done to the future is they have had the very advantageous position of having access to very generous pensions. They’ve had cheap housing when they came out of university and they didn’t pay to go to university. This problem that arises is because of changes in demographics, and the expectation that we’ll all live longer and I think that the next generation has every prospect of living longer, than we baby boomer generation. And so if they want to complain that they’ve got to work longer to earn those pensions it’s because they will live longer overall. Alice: So Rosamund Irwin says it’s unfair that her generation will have to work longer than her parents did. She says there is generational injustice. Abdu: She says her parent’s generation started from an advantageous position. Alice: They have generous pensions and had cheap housing compared to today. But her father says his generation shouldn’t be blamed. He thinks the problem arises because of changes in demographics. In this case, that’s the spread of ages across the population, the fact that there are more older people than there were before. Abdu: But he says that younger people have every prospect of living longer. Alice: I think he means that the younger generation should be grateful that they will live longer than people have ever done before – but they will have to pay for it. So have you had a thought about our question at the beginning of the programme Abdu? What percentage of the world’s population will be over the age of 60 in 2050? Abdu: I’m sticking with my original answer – 15%. Alice: Actually, it’s a bit higher. By the middle of this century, the United Nations estimates that 22% of people will be over the age of 60. Well that’s all we’ve got time for today. Thanks for joining us and see you next time. Alice/Abdu: Bye! Taken from: http://downloads.bbc.co.uk/worldservice/learningenglish/6minute/100916_6min_ageing_population.pdf