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Improve care for the elderly: Adapting to an aging population
Everyone ages
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E
veryone ages. So does a population. Population aging is a term used to explain the period when the demographic makeup of a society experiences a shrinking number of children and youth, and a rising proportion of people aged 60 and older. The growth of the elderly age bracket in a society is generally the result of an improvement of people's health and welfare.
All countries experience population aging at a different pace. This process is slower in developed and industrialized countries than in developing countries. It took France longer than a century to double the proportion of 65 plus (from 7 percent to 14 percent). In Sweden and Australia such a state was reached in 60 years.
As a contrast, in Singapore, Brazil and Indonesia the population of the elderly doubled within 20 years. Having a longer time to age, developed countries were able to adjust their social and economic fabric and lifestyle to the new situation. Developing countries have little time to prepare themselves for facing the consequences of an ageing population.
The acceptance of family planning as a government policy in many developing countries leading to the rapid decline of fertility and the drop in the average number of births per woman is the leading cause of this demographic phenomenon. The proportion of youth diminishes, leading to more adults and elderly citizens. Moreover, improvement in people's health due to better access to health care and the decline in the mortality rate lengthen life expectancy and facilitate a population aging process. The number of centenarians will continue to rise.
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Are developing countries including Indonesia ready to face a rapidly growing number of elderly people ...?
Better female education facilitates the global progress of family planning achievements and the decline of mortality, although in a number of countries (i.e. in Africa and Middle East) the fertility is still relatively high (more than five children per woman).
During the aging transition the population structure shifts slowly but steadily from a predominantly young (pyramid shaped) to a mostly elderly (barrel shaped) profile.
In a transition period many changes happen that may create commotion and resistance. Politicians, scientists, individuals and social organizations need to continuously adapt to changes in lifestyles and the social fabric. People will be confronted with more elderly people with slower rhythm in their daily lives. Older people need assistance with their mobility. They wear certain styles of clothing, like different kinds of music and entertainment and demand a stronger voice in politics. In the Netherlands, for example, a political party representing citizens of 50+ years old has won a seat in the parliament and senate.
The transition will end when a country has reached a stable population i.e. a state wherein the population growth rate and the relationship between age groups have stabilized over time. Worries over the burden of a fluctuating population will then be a thing of the past. The ratio of youth (under 15) and elderly (60/65 plus) compared with the working-age group will remain unchanged.
Are developing countries including Indonesia ready to face a rapidly growing number of elderly people in a changing society? Real action needs to be taken in delivering provisions such as suitable housing and its amenities, reading glasses, hearing aids, wheelchairs and crutches to the aged from all strata and areas, not only the happy few in urban areas.
To improve elderly people's mobility, free local transportation should be organized to take them to the market or shopping area, and to help maintain social contact among their peers and with younger people. Provision of decent and accessible ambulatory health facilities is essential to serve the people in isolated areas such as on mountain slopes and on remote islands.
As Indonesia still has some 22 million children below five years old but is already experiencing an aging population, Indonesians ought to better understand the needs and conditions to create acceptable and pleasant living arrangements and accommodation for the elderly. A shift in the people's mindset is required, from the earlier emphasis on child-rearing, to enhancing our care of the elderly.
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The writer is an economist-demographer, residing in The Netherlands.
