Tag Archives: Reform

Government Response to Tackling Elder Abuse in South Africa

This is Part 2 of a two-part series on elder abuse in South Africa. In Part 1, the main focus was raising awareness of elder abuse. In Part 2, societal responses from both public and private sectors are stressed.

As a result of recent news reports on elder abuse, the South African Human Rights Commission (SAHRC) visited KwaZulu-Natal from Aug. 15-19 to examine human rights matters impacting older adults and individuals with disabilities. The five-day visit was led by Commissioner Bokankatla Malatji who manages the portfolio on disability and older persons.

The government’s prompt response to elder abuse suggests that this problem is not being taken lightly. Elder abuse is any form of mistreatment that results in harm or loss to an older person. It is one of many challenges faced by older people in South Africa. In fact, elder abuse is expected to rise as the population ages. This is not necessarily the case but societies that have no regard for elders will need to anticipate elder mistreatment if it is not tackled beforehand. Much like other nations around the world, the silver tsunami has left many nations ill-prepared; even the most developed countries are struggling to find solutions for the foreseeable challenges of the future. It is therefore the responsibility of both public and private sectors to make dignified and healthy aging a leading priority.

Dr. Matshidiso Moeti, the World Health Organization (WHO) Regional Director (RD) for Africa, states that “only with full, strong political will and commitment by governments, participation of communities, families and individuals can we achieve the vision of a continent in which everyone can live a long and healthy life.” Hence societies must hold governments accountable to ensure expedient and beneficial outcomes.

As the global population continues to age, reaching an estimated 2 billion by 2050, it is imperative that nations take a multifaceted approach to ensure the protection of older adults. Elder abuse is not reserved exclusively for citizens of developing countries. It is a public health problem that goes beyond regions, languages and ethnicities.

WHO believes that in order to adequately address the issue of elder abuse across continents, citizens must utilize approaches that are “placed within a cultural context and considered alongside culturally specific risk factors.” Such methods, with the collaboration of “both primary care and social service sectors,” can enhance the comprehensiveness of future programs, policies and legislation.

Andria Reta-Henke is a Credentialed Professional Gerontologist and Professor of Health Administration.

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Population Aging and Urbanization in Europe

Cities are seeing a rise in ageing populations. In the European Union (EU), 75 percent of residents live in urban areas. As urban populations continue to rise, more and more people will grow into old age. For instance, the over age 65 group makes up 20-27 percent of the population in cities inside Portugal, Italy, and Spain. Since population aging will influence health, social exchanges, and well-being of older adults, hundreds of cities are designing urban environments to foster active and healthy aging.


Urbanization affects many areas including the health and well-being of society. As a result, many sectors are collaborating to keep populations engaged and healthy. Adapting cities to demographic trends accommodates residents, allowing for independent living and participation in society. The European Commission estimates that over 75 percent of housing in the EU is not suitable for independent living. Other aspects of physical environments including adequate sidewalks, transportation, and functional green spaces can increase physical activity and improve mobility, which reduces the risk and effects of chronic disease. Social issues, such as employment discrimination, negative stereotypes, and ageism, also play a role in the health of aging populations. It is important to involve older adults’ perspectives on urban planning to identify issues and barriers which prevent participation in society.

To help cities adjust to demographic trends and support healthy ageing, the World Health Organization (WHO) created a Global Network of Age Friendly Cities and Communities and Affiliated Programs, as well as a guide for policy and action in fostering age-friendly urban environments. Over 300 cities in 33 countries are currently involved in the Global Network, including 19 Member States in the European Region. The WHO guide advises on eight areas¹ considered the most influential, which also reflect the UN Principles for Older Persons. Through the work of the European Innovation Partnership on Healthy and Active Ageing (which has a dedicated Action Group on Innovation for age friendly buildings, cities and environments) the European Commission has published a guide on innovation for aging, with examples from 12 countries in Europe.

EuroHealthNet’s Healthy Ageing website also highlights examples of initiatives and key resources on healthy and active aging throughout the European Union. Arup, Help Age International, Intel, and Systematica have produced an overview² of aging in 10 European cities with comparative data on both urbanization and aging. AGE Platform Europe published a guide³ aimed at helping European cities to use the Urban Agenda to become more age-friendly and as a repository of innovative solutions for age-friendly environments. These networks and initiatives encourage cities to be health-promoting environments as they adjust to population aging, and share innovative ideas, experiences, and lessons learned along the way.

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By 2020, more than 50 percent of the global population over 60 years old will be living in urban areas. Planning now can stimulate active and healthy aging both for current and future generations.

1. The WHO guide addresses: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services.
2. The ”Shaping Ageing Cities” publication examines: society; mobility; built and digital environments; politics; planning; and aging.
3. The AGE Platform Europe guide addresses the eight areas in the WHO guide as well as eight themes corresponding to the Urban Agenda: inclusion of migrants and refugees; jobs and skills in the local economy; urban poverty; housing; air quality; urban mobility; digital transition; and innovative and responsible public procurement.

Carrie Peterson covers Europe for Global Health Aging. She is a Gerontologist and Consultant in eHealth and Innovation.

Employment Prospects Among Older Adults in South America

Photo Credit: Alex Proimos
Photo Credit: Alex Proimos

Many adults eagerly look forward to their “Golden Years” and one of the key features of this period is retirement. It is easy to imagine golf courses, beaches and time to catch up on reading lists. In reality, many older adults continue to work after age 65. The entirety of South America is undergoing a demographic shift due to an aging population. Thus, many countries are re-examining their existing government pension systems. While it is important to provide economic security in old age, it is also crucial to allow continued avenues of employment and meaningful engagement with society for older adults.

The quality of life in retirement is dependent on the financial resources of the individual. Adults aged 65 and over generally have income from four sources including government funded pensions, private pensions from employers, savings and employment. In the United States, adults with higher education and income potential will often remain in the workforce past age 65. In contrast, adults with lower income levels in low- and middle-income countries remain employed past age 65 to stay out of poverty.

There is a huge variability in percent of the aging population that is working in Latin America. Some Latin American countries, such as Brazil, Argentina and Columbia, have relatively low participation of older adults in the workforce. Such countries are similar to the United States, with only 10-15% of adults past age 65 engaged in paid work. In other countries, such as Peru, Paraguay and Ecuador, 40-50% of adults age 65 and older are still participating in paid work. These countries also have relatively low coverage levels by government and private pension plans, but the correlation between working and government funded pensions is not perfect.

Many countries in South America are re-examining government pension programs to accommodate the aging population. Recent reforms in Paraguay have instituted new rules that prevent individuals collecting government pensions from participating in paid work. Better pension systems may provide more security for older adults, but preventing work has problematic implications for the future role of older adults in society. Social engagement is correlated with improved health and employment can be a meaningful avenue of engagement.

Building strong government and private pensions that will allow a retirement free from financial hardships or poverty is important. However, building systems that prevent older adults from working is equally problematic. Older adults in countries with strong pension systems, such as the United States and Britain, are fighting to re-enter the workforce and be productively engaged in society. It is important that South American countries do not build a pension system that prevents older adults from contributing paid work to the economy.

Grace Mandel is a Masters of Public Health student in Health Policy and Systems at Johns Hopkins University Bloomberg School of Public Health.

The Problem with Being Old and Incarcerated

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In the January issue of The New Statesman, Britain’s leading weekly magazine of politics, culture, and international affairs, Andrew Katzen examined elderly inmates in British prisons. His article, “Should we be sending the elderly to prison”, argues that British prisons are slowly turning into dysfunctional nursing homes. According to Katzen, Partner at Hickman & Rose, prison conditions for the elderly are tough and little, if any, rehabilitative purpose is served in holding them. His main point is that Britain’s aging population is causing an increase in the number of old people behind bars hence a new and improved prison reform has to be considered.

This topic is quite controversial because it focuses on criminals who have broken the law. Therefore we need to be mindful of how these offenses were committed and to whom, especially since both victim and perpetrator are human beings. The ethical component of this issue is complex because, while the range of offenses differ, the state of elderly care in prisons needs improvement. Before this article tackles the reasons, there are a few things that need to be clarified. This article is not whether the elderly deserve imprisonment or about the type of sentence older prisoners deserve. Everyone is entitled to their opinions due to strong views about this subject. As a health care professional, the goal is to improve the social and natural environments in order to better the health of marginalized populations.

The world’s population is aging. According to the National Institute on Aging, the number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050. This trend may result in a shift in prison demographics as prisoners will grow older whether they are young or new. A prime example is 82-year-old Teresa de Jesus Tello who was incarcerated in a Peruvian prison for an alleged case of drug trafficking…and she isn’t the only elderly prisoner. In Peru, there are 2,500 inmates over the age of 60 in prisons. Most of the elderly women are imprisoned for drug trafficking. While prison reform is important, it is important to tackle these issues in a sensible and sensitive way, involving all facets of society such as the public and private sectors.

Katzen’s article also discusses the design of prison estates stating that current designs are only suitable for the young and able. Although the issue is important, he fails to take into account the extra costs needed to build prison estates that are suitable for older prisoners. In developed nations, this cost can result in a tax increase which is often debatable. Alternatively, developing nations can make a case for better living conditions as prisons can be characterized as hazardous and chaotic places for offenders.

Although this topic is complex, societies can start with meeting the most basic personal activities such as carrying their meals and washing themselves, especially if prisoners are unable to care for themselves. Addressing the existence of chronic illnesses in older prisoners is vital and designing new environments should be considered for easier access and mobility for older populations. Moreover, appropriate medical care needs to be a priority for older prisoners as this can improve quality of life. As societies start to tackle this issue, the goal should be to prevent prisons from turning into dysfunctional nursing homes.

Sophie Okolo is the Founder of Global Health Aging.

The Need for Improved Health and Social Reforms for Britain’s Aging Population

Photo Credit: Garry Knight

In today’s society, social and health care reforms for the elderly are more important than ever due to increasing aging populations worldwide. In Britain, these reforms have not greatly supported elderly care and need some major improvements. The current situation is shameful as more elderly should receive the care they need. Funding for health and social care services have been decreasing since 2005. In 2005-2006, a total of 1.231 million people aged 65 and older received some form of social care while in 2012-2013, a total of 896,000 received assistance. This shows a decrease of 335,000 elderly who did not receive the necessary care and services, although the overall number of elderly has been increasing in the last years. These services, such as Meals on Wheels or visits to daycare centers, had been terminated but are important to the elderly since it allowed them to live at home independently and have daily social interactions.

Oftentimes, the elderly do not have the support of their families and rely on these social services. As we get older, illnesses and disabilities can prevent us from getting out and becoming socially active. Life-changing events such as retirement and death of a family member or friend can also increase the risk of loneliness and isolation. In fact, 46% of people aged 80 and older reported that they often feel lonely. In addition, 10% of the population mentioned that television is their main form of company. This is sad and shocking at the same time. Are we all too busy to visit our parents or grandparents? “Each and every lonely person has someone who could visit them and offer companionship,” states states British Health Secretary Mr. Hunt to the Daily Express.

What can we do to involve the elderly in our lives and communities? Britain has started to recruit volunteers since they are important to nursing homes and older adults living at home. Volunteers provide much needed companionship and connections to communities. For example, Prime Minister David Cameron activated 30,000 teenagers to help people with dementia. In addition, these teens will teach the elderly modern technology so they can use Skype to talk with their families via internet.

Britain can also learn from health care or social systems in other European countries. A study showed that the elderly in Britain are poorer and lonelier than in similar European Countries. In addition, “they are more likely to suffer ageism in health care and in their daily lives than in either Germany, Sweden or the Netherlands.”

A role model for elderly care is the Asian culture that is well known for the respect and good treatment of the elderly. If an older person cannot live at home anymore, he or she will be taken in by family members. Nursing homes are usually the last option family members will consider as there is a strong social interaction and relationship among all generations. Britain as well as other countries can learn from this and strengthen the social relationships between generations.

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