We do not tend to associate the elderly with homelessness or malnutrition, let alone substance abuse or severe mental illness. But those who work with people on the fringes of society know that many among the older population are experiencing such dire challenges.

The risk of the elderly experiencing these problems is increased by poverty and social exclusion.

It is worrying, then, that the figures issued by the National Statistics Office show that one in three people over 65 is at risk of poverty or social exclusion. This is a three percentage point rise between 2021 and 2022. Over 40 per cent of people over 65 who live alone are at risk of dropping below the poverty line.

But older people are not just a statistic. It is crucial to identify the various causes of poverty and social exclusion among older adults, come up with strategies to reduce their incidence and reach out to those who need help to be given a stronger foothold in life.

As people age, the likelihood of poor health and of living with long-term conditions or disabilities increases. The public health and social care facilities are overstretched, with older adults among those most likely to suffer as a result.

For instance, the health minister recently confirmed that the waiting list for surgeries is again getting longer. Many senior citizens need cataract surgery to improve their quality of life. They should not have to wait for over a year to get treatment.

One reason healthcare resources can get overstretched is that older adults with long-term health problems are sometimes kept in hospitals because they cannot care for themselves at home. Those suffering from senile disabilities are often marginalised unless their families have the financial resources to care for them continuously.

While the family continues to play an essential role in caring for older adults, it usually requires tremendous physical and mental effort. More assistance may need to be provided to those who care for older family members. The modern family tends to be under great financial and other pressures, so many elderly persons have no family support that they can rely on. Too many live trapped and isolated in their homes, without communication with their family or neighbours. The story we carried about cancer sufferers stuck in their apartments in a housing block with no lift was a stark illustration of that phenomenon. There are many other reasons why the elderly get isolated in their homes or rooms at their care homes, alone and lonely.

Older people experience alienation when they are excluded from social interaction. The rapid retirement and removal of older people from productive work can accelerate their social exclusion and impoverish their social life. Social isolation can lead to poor health, undernourishment and feelings of rejection, helplessness and lack of purpose. The next step is to give up on life entirely.

Reducing the incidence of social isolation among older adults needs a lot of effort. Healthcare policymakers need to acquire a better understanding of the needs and experiences of a wide range of older people by engaging with those who have experience in supporting them, in public, private and voluntary sectors.

Improvements must be made and misjudged and ageist stereotypes tackled – everyone should have access to health and support services when needed, whatever their circumstances.

As the population ages, the social exclusion of older people could become an epidemic if steps are not taken to confront this challenge and stop the downward spiral.