“They think they are elderly and it is a normal consequence of ageing to be in bed,” says Dr Al Suwaidi.
The United Arab Emirates (UAE) is a small country in the Middle East, nestled between Saudi Arabia to the West, Oman to the East and Iran to the North. A cross-sectional study reported that 95% of its participants, all adults over the age of 65 years, rated their health as satisfactory or higher. There is a general perception of good health among the elderly. Despite this fact, the UAE has the 2nd highest incidence of diabetes in the world, and 4th highest rate of glucose intolerance in its population. Very little in known about elderly health in the UAE and even less is known about elderly health beliefs in this population.
Dr. Al Suwaidi, Director of Geriatrics at Dubai Health Authority, provides insight into what elderly health could be. She suggests the norm to be a passive acceptance of poor health during aging. Religion also plays a significant role in health care seeking behavior. A recurrent theme is the idea that ‘Health is from God‘, discouraging individuals to take action for better health which can imply going against the will of God. Another factor influencing health care seeking behavior is the presence of symptoms. Good health is equated with lack of visible disease, making it less likely to seek care for silent or underlying cases such as diabetes and hypertension.
There is a high regard for elders within the family structure. Common features of the family structure include a practice of traditional values, religion and high economic resources. Understanding the role of elders within the family is essential to providing adequate geriatric care. Dr. Al Suwaidi suggests that there is a greater need for day care centres than long term nursing homes since families would not be receptive to placing their elders in old-age living facilities. This shows the importance of encouraging families and increasing geriatric care that focuses on home-based elderly care.
Geriatric care is a relatively new branch of medicine in the UAE. There is a high disparity of geriatric care provided between the seven emirates, or regions, of the country. The emirates of Umm Al Quwain and Fujairah have relatively poor geriatric care facilities. This is because different governmental bodies govern and offer different services to their respective elderly population. In addition to disparity by location, there is also disparity by citizenship. UAE has one of the world’s highest proportions of an expatriate population, accounting for close to 90% of the country’s total population. This vast majority have limited access to health insurance and social welfare programs.
Current government initiatives include the Elderly Happiness Initiative (EHI) and Weleef. EHI aims to improve the quality of life of elders living alone by providing funding for health care workers to visit and provide home-based care. Weleef is a program that imparts knowledge on best practices to health care providers on a regular basis. Both programs operate in the Emirate of Dubai and are accessible only to UAE nationals or Emiratis. In Dubai, the elderly population, constituting 0.5% of the total population, accounts for 5% of out-patient visits. In addition to improving health, revisiting the current situation of elderly health can also help defray the costs of aging. The UAE needs an inclusive geriatric care model that incorporates local ideas on elderly health. The UAE needs an inclusive geriatric care model that takes local models of elderly health into account
Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.