All posts by Global Health Aging

Europe

Sweden: A Role Model for Elderly Care

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Elderly
As mentioned in previous blog entries, worldwide, countries are facing challenges due to aging. By 2050, the elderly will outnumber children under the age of 15, mostly in developing countries. So, reforms for more cost-effective health care systems for elderly’s long-term care are becoming more and more important. Sweden is known for its universal and comprehensive social and health care programs. Most care is funded by citizen’s taxes. In fact, Sweden allocates 3.6% of its GDP on long-term care and also provides the highest number of health care workers for the elderly over the age of 65. As a result, it is not surprising that in 2013, Sweden was ranked first for treatment of elderly in a United Nations (UN) supported global study, The Global AgeWatch Index (BBC).

Sweden is one of the nations that established reforms which focus on and encourage high quality long-term care for elderly in institutions as well as in home care. In Sweden, municipalities are responsible for elderly care and provide funding for in home assistance as well as manage the needs of accessible housing. 94% of the elderly over the age of 65 live at home and are given the opportunity to live an independent life, even if someone is in need of supported assistance. If an older person needs assistance from a health care worker, he or she can apply for this assistance. In addition, most regions offer ready-cooked meals which are even delivered to the elderly’s home.

Sweden’s approach of taking care of the elderly in their own home is unique and allows them to keep their independence. In addition, their families are at ease knowing that their loved ones are in good care. Is this a system that can be adopted by other countries? Who wouldn’t wish to live at home until the end of life? Don’t the elderly have a right to decide where they want to live? It is great to see that the Swedish local governments give them the option to either live at home or in accessible housing. The seniors contributed to their communities all their lives. They have worked, raised a family, and paid taxes, therefore securing care for their countrymen and women. They deserve to receive the same high quality of care. In addition to the care the elderly receive, health care workers are needed and appreciated. So it is a win-win situation for everybody: the elderly, their families, as well as all current and futures citizens of Sweden.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

 

Asia

Women in India – Longevity, Health Disparities and Empowerment

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Being over 65 years and living in India is an increasingly common phenomenon. The Indian population over 65 years is steadily on the rise, totaling to a whopping 90 million people in 2011. Estimates suggest that this number will exceed 227 million by 2050. Within this giant aging population, there is a unique sub-section of disadvantaged people who are women. Women in India live longer than men, but consistently report poor health, higher disabilities, lower cognitive function and lower utilization of health services.

Elderly-Indian-women-400x230
A study in 2008 showed wide health disparities between elderly men and women. Even after controlling for demographics, medical conditions and known risk factors, the gap still existed. Controlling for economic independence, however, reduced the gaps significantly. This emphasizes the necessity for financial empowerment among older women for them to enjoy a healthier life. Financial empowerment may be the key to improving health outcomes of elderly women. However, the barriers of gender discrimination and poor education are hard to overcome.

The Longitudinal Aging Study in India (LASI), the first of its kind in the country, found that elderly women have lower cognitive function than elderly men, and linked this discrepancy to gender discrimination. This study was conducted in two southern states, Karnataka and Kerala, and two northern states, Rajasthan and Punjab. In the southern states, the gender difference was accounted for by poorer education, health and social engagements. However, the disparity in the two northern states existed even after controlling for these known risk factors, indicating a high level of discrimination against women.

Gender bias is evident in all life stages of a woman – female infanticide, poor education facilities, dowry practices, stereotypical roles of women as home-makers and discrimination against widows. It is exceptionally hard for elderly women to have good health and quality of life. Stigma needs to the fought at the grassroots level. The existing government initiatives for the girl child are commendable, but they do little for the current generation of elderly women who continue to face discrimination, poor health, poor education and economic dependence. While the ongoing LASI study will continue to provide a comprehensive understanding of geriatric health in India, targeting elderly women will go a long way in improving health outcomes among the elderly population. The provision of medical, financial and social support for elderly women is empowering, and can improve their overall health and quality of life.

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. 

Asia, North America

A Comparative View of Elder Abuse in Israel and the United States

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Photo Credit: Hamed Masoumi

I spend every Tuesday morning visiting a dear friend at a local nursing home. My friend is a Holocaust survivor and at 90 years old, her mind is sharp since she easily recounts the story of her life – from the horrors of the camps to the beauty of Israel and finally to the hard work, freedom, and challenges of America. As I am ready to leave her and return to school each week, a look of loneliness washes over the smile on her face and I am reminded that her only other visitors are nurses and her daughter who can visit once a week.

The elderly comprise a significant amount of the U.S. population and statistics indicate that 10,000 baby boomers will turn 65 each day for the next 15 years. As the U.S. population ages, older adults are often viewed in a negative light, and hence a target group for all kinds of abuse: physical, sexual, verbal and financial exploitation. It is estimated that a shocking 500,000 older adults are abused each year in the United States, with family members as the overwhelming majority of abusers (mainly partners and children of the individual). Most of these cases go unreported because the victim does not have the physical capability or mental capacity to inform an official of the mistreatment.

Elder abuse is a major issue currently plaguing Israel as well. A report by the University of Haifa indicated that 18 percent of elderly participants were subject to some form of abuse. The most common form is verbal abuse, indicating a potential problem in interpersonal relationships as people age. Verbal abuse may also be used as a method to instill terror and power in a relationship, lending the way to more types of abuse.

Many religions teach people to respect and revere the elderly. In short, an individual’s exterior does not properly convey the depth of its contents. My dear friend appears to be a frail old woman with a failing body but her mind is very active. The elderly are people above all else and they deserve to be treated as such.

It is impossible to ignore the fact that everyone will grow old one day. With this in mind, I urge you to take some time and think about giving back by volunteering with a senior in your area. You may be the only contact the person has with the outside world beside the caregiver, and can advocate on their behalf if you suspect abuse. For U.S. residents, visit Give Back to Seniors to search for volunteer opportunities in your community.

Linda Nakagawa is a rising senior at Brandeis University. She is a double major in Psychology and Politics with a minor in Social Justice Social Policy. Linda is originally from Newburgh, New York and is a member of Temple Beth Jacob. As a Machon Kaplan participant, Linda was a public policy intern at the National Association of States United for Aging and Disability.

Global

Aging, Health, and Social Networks

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Across the globe, nearly every country of the world is experiencing population aging. According to the United Nations, the number of people aged 60 years or older is expected to increase to more than 2 billion by 2050. While this shift in demographics carries implications for the social and economic makeup of our global society, it is important to also consider the unique health needs of the aging population.

Included among the most pressing health needs for the aged are managing chronic disease, preventing falls, maintaining cognitive function, and ensuring improved quality of life throughout the life span. Of additional importance to healthy aging, particularly in terms of health related quality of life, is the social support older adults receive from their family, friends, and communities. A known contributor to health related quality of life (HRQOL) is the strength of one’s social networks. It has been shown that individuals who report close bonds with family and friends are more likely to positively self-report their health. This was shown to remain true among elderly in the U.S., who reported improved health if they felt satisfied with the support available to them from family members, friends, and their communities.

From the perspective of the elderly, however, changes that occur late in the lifespan also translate to changes in their social networks and their social support. Social networks have been defined to include family members, friends and acquaintances, work and school connections, and relationships built in formal and informal organizations. Among the elderly, connections may be lost for a variety of reasons throughout the aging process, including retirement, limited mobility that prevents participation in previous activities, as well as the aging and death of close connections. Such changes to the social fabric, that a person formerly engaged with, carries implications for the health related quality of life an individual experiences.

For the elderly, a strong social network often translates into diminished feelings of loneliness, support for mental and physical health needs, as well as improved cognitive functioning. The elderly who feel supported by their community are less likely to report feelings of isolation and report better health than those who do not feel supported. With global population aging, ensuring that all individuals age with dignity, respect, and support should be of paramount importance.

The lengthening of the lifespan should also come as an increase in the number of years lived in high quality health. To protect the health of the aging population, concerted efforts should be made on the part of health care providers, communities, governments, families, and friends to ensure that all individuals enter into the late stages of life with the support that is necessary to live positively and healthfully.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Africa, South America

Quality of Life for Elders: Lessons from South Africa and Bolivia

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Photo Credit: Pixabay
                                                                                               Photo Credit: Pixabay

Last year, the Global AgeWatch Index published a report on the quality of life for elders in 91 nations. The report included several factors such as income security, health and well-being, employment and education. African nations did not fare well. South Africa was the highest ranked African nation at number 65 while Ghana, Morocco, Nigeria, Malawi, Rwanda and Tanzania came in at numbers 69, 81, 85, 86, 87 and 90 respectively. Other African nations were not included in the report because there was not sufficient data. With South Africa leading the pack in elderly well-being, it helps to decipher the various ways South Africa deals with its senior citizens.

South Africa has the second largest and most developed economy in Africa with the old age pension reaching 72% of the older population. The pension system is the second most distributed of the African countries that are in the Index. Namibia is the first at a whopping 167.3% although there was not enough data in other areas to include the nation in the report. While South Africa performed moderately well in income security, the nation ranked low in elderly health status. There are only eight registered geriatric doctors to serve an older population of 4 million in South Africa. Since 1994, dramatic changes have taken place in the structure of health services. The government prioritized maternal and child healthcare because of the HIV/AIDS pandemic in the 90’s.

Although South Africa was ranked at number 65, Bolivia, one of the poorest countries on the list was ranked at number 46. This shows that higher-income does not always correlate with better quality of life. In fact, some lower-income countries that invested in aging saw positive impacts. Bolivia, for instance, implemented a national plan on aging and free health care for older people, which vastly improved quality of life.

The rankings illustrate that limited resources need not be a barrier to countries providing for their older citizens, that a history of progressive social welfare policies makes a difference, and that it is never too soon to prepare for population aging. This is important for African nations because the elderly are a significant boon. African nations can do better by learning from each other as well as non-African nations. The outcomes may vary but the collective goal is to improve the elders’ quality of life for present and future generations.

Sophie Okolo is the Founder of Global Health Aging. 

Asia

Singapore: Prevention is Better Than Cure

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As we all know, in today’s world, people have longer life expectancies. In fact, 75% of the world’s population is older than 60 years of age (WHO). We live longer but the fact is the fact is that we are not aging very well. Once we reach a certain age, chronic diseases occur and hinder us from living a healthy long life; two out of three global deaths are due to chronic diseases such as heart disease or stroke. Due to the aging population, these chronic diseases and necessary expensive treatments put a financial burden on nations’ healthcare systems. As Dr. Lim states in the video, “the healthcare system in Singapore has worked well the last few decades, but was not built for such an aging population and a population that struggles with chronic diseases.”

                                                                                          Photo Credit: Niall Kennedy

Singapore has responded to the trend and puts emphasis on preventative health strategies rather than on just treating or curing the diseases. In Singapore, many fitness parks with workout stations have been built, which not only help the elderly to get active and stay physically healthy, but also to meet and get to know one another. With the increasing aging population possibly living alone, the social aspect of these fitness parks is important and improves the mental state of the elderly.

Public Health professionals can only hope that such preventative initiatives towards healthy living situations for the elderly, or better yet all age groups, will be continued not only in Asia. If we can persuade the entire family to get involved in these types of physical activities, we will have healthier children, adults, and elderly and can lessen the financial burden on the healthcare system. Other community organizations may get involved by offering exercise classes and promoting fitness among seniors.

In addition, local governments need to be convinced that building fitness parks has a positive impact not only on the elderly, but all residents’ physical and mental health. Governments overall need to rethink and focus on disease prevention, and not only treatment and cure.

What else can WE do to improve the health of our community members?

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

Global

June is Alzheimer’s and Brain Awareness Month

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Photo Credit: Pixabay
                                                                                                                          Photo Credit: Pixabay

June is Alzheimer’s and Brain Awareness Month. Worldwide, there are at least 44.4 million people living with Alzheimer’s disease and other dementia’s. Dementia is a non-communicable disease and one of the main health challenges for the elderly in continents such as Africa and Asia. The current health systems of these continents are not designed to meet such chronic care needs, hence dementia is set to become a major problem in the long run.

The World Alzheimer report 2013, from Alzheimer’s Disease International, estimated that by 2050 the number of people living with dementia would rise from 44.4 million to 135.5 million. The proportion living in low- and middle-income countries would rise from 62% to 71% therefore much of the increase will be in developing countries. If current population trends continue, the number of people with Alzheimer’s disease will increase significantly unless the disease can be effectively treated or prevented. The increase in population aging is also linked to Alzheimer’s since the risk of Alzheimer’s increases with age. China, India, and their south Asian and western Pacific neighbors are the fastest growth in the elderly population.
Alzheimer’s disease is the most common cause of dementia and may contribute to 60–70% of cases and dementia is one of the most common diseases among elderly people. It is a leading cause of disability, institutionalization, and mortality; therefore it has a tremendous impact on both the individual and society. This month, there are many ways to help raise awareness and inspire action. These include:

  • Talk about Alzheimer’s each time you meet other people
  • Post, tweet and share the facts about Alzheimer’s disease and other dementia’s
  • Show your commitment to the cause by wearing purple, the official color of the Alzheimer’s movement

According to World Health Organization, health systems around the world, especially in Africa and Asia need to adapt to meet the chronic care needs of the elderly as the shift to aging populations gathers pace in low- and middle-income countries in the world. As populations age rapidly, infrastructure must be put in place to address the needs of elderly with dementia. The United Kingdom is a great example because they are leading the way in tackling the global crisis of dementia. These are not limited to websites about dementia, books that raise awareness of dementia among young people, or hosting the 2013 G8 Dementia Summit in London. The 2013 G8 Dementia Summit launched the World Dementia Council that exists to stimulate innovation, development and commercialization of life enhancing drugs, treatments and care for people with dementia, or at risk of dementia, within a generation.

This June, let’s observe Alzheimer’s and Brain Awareness Month. Everyone who has a brain is at risk to develop Alzheimer’s – but everyone can help to fight it, according to the Alzheimer’s Association. The goal is for the public to get involved and hopefully end Alzheimer’s disease.

Sophie Okolo is the Founder of Global Health Aging.