Tag Archives: Sophie Okolo

Africa Must Prepare for Aging Population Now

Photo Credit: United Nations Photo

As countries like Japan and Italy prepare for the challenges of an aging population, African countries are focusing on the need for youth empowerment. Youth make up the next generation of workers, parents, and leaders in Africa; hence investing in them is top priority for the continent’s transformation. While empowering youth is important, African nations cannot ignore the outcome of greatly increased birth rates.

Since Africa is the most youthful continent in the world – two-thirds of the continent’s 1.1 billion people are younger than 35 – what will happen when the youth become elderly citizens? And what will happen to elderly citizens if the continent does not plan for increased birth rates now? The rise in the number of elderly citizens may take a strain on families and the incidence of aging-associated diseases like cancer will hit an all time high.

This situation is especially complex because agencies like the World Health Organization and United Nations Population Fund support the use of contraceptives to space out births’ for maternal and child health. The use of contraceptives is a controversial issue in Africa as opponents may argue that contraceptives will prevent women from having children. Proponents for contraceptives may find the concept ludicrous although in countries like Germany, where the use of contraceptives is widely accepted, women have fewer children or no children. Having children or not is one’s personal choice; the concern is the result of choices that a nation made.

West African nations are among the continents most fertile – the average woman in Niger has nearly seven children in her lifetime. With the current youth population, increased birth rates and use of contraceptives, African nations are facing an unforeseen future. Currently, aging Africans are facing new problems including the changing practice of extended families taking care of elderly members. Children are now migrating to other nations for better opportunities, leaving their parents to care for themselves. If African governments do not address current problems as well as prepare for the increased birth rates, it is likely that the future will bring many challenges to the aging population and continent as a whole.

African countries that currently have large youth populations are poised to experience a potential demographic boost to their economies. While such countries will see this population age into the workforce, they will also experience rising proportions of seniors with this group. It is critical for governments to plan now for the future with smart government policies. Training citizens to embrace the aging process and raising awareness of the challenges associated with this stage of life is important. Companies should also be encouraged to work with the elderly so as to improve their health, lifestyle and wellness.

Equipping older adults with coping skills, and encouraging people of all ages – especially the youth – to not smoke, do more physical activity, and practice moderate alcohol consumption and good nutrition will pay good health dividends later in life.

Sophie Okolo is the Founder of Global Health Aging.

A Call to End Elder Abuse and Neglect in 2015

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Elder abuse continues to be a worldwide problem. This year, former minister of social welfare, Paurina Mpariwa, accused the Zimbabwean government of neglecting the elderly. Since the Older Persons Act was signed into law, the government has failed to implement the provisions including protection from all forms of abuse such as physical and psychological harassment and social neglect. Due to the global prevalence of elder abuse, the world observes World Elder Abuse Awareness Day (WEAAD) on June 15 each year. WEEAD provides an opportunity for communities around the world to promote a better understanding of abuse and neglect of older persons. This event is achieved by raising awareness of the cultural, social, economic and demographic processes affecting elder abuse and neglect.

The significance of elder abuse as a public health and human rights issue has been acknowledged by the United Nations International Plan of Action. Elder abuse diminishes the quality of life of elders. For instance, neglect is a type of abuse that can be inflicted either by the elder’s caregiver or oneself. Signs of neglect include malnutrition and dehydration, poor hygiene, noncompliance to a prescription medication, and unsafe living conditions. In Africa, this abuse can cause the elderly to leave their homes and families. Since old age homes are not widespread and elder abuse is rarely reported, the elderly end up living on the streets. Elderly street begging is common in Africa and there are very few health systems that currently address the problem. In addition to being a marginalized and vulnerable group, elderly street beggars are at risk for diseases, malnutrition, and mental health issues.

It is unfortunate that elder abuse also happens in institutions of care like nursing homes and more. In Cape Town this year, an old age home was investigated for the alleged abuse of the elderly. According to the Department of Social Development, the allegations ranged from deaths due to poor treatment and human rights violations. The Department also stated that if there was a need to go to court, they would obtain an order to close the old aged home. As professionals in aging and health, these issues are troubling because they still persist with no lasting solution. Elder abuse can happen in families and institutions of care; places where elder abuse should not happen. Although the old age home in Cape Town was unregistered, which is a huge grievance, the main goal is for everyone to have dignity and respect for each other irrespective of age. Without this mindset, elder abuse can persist despite policy recommendations, health interventions, etc. The United States is a good example.

WEAAD serves as a call-to-action for individuals, organizations, and communities to raise awareness about elder abuse, neglect, and exploitation. Everyone should make elder justice a priority by launching various initiatives such as old age homes or shelter homes in Africa. The shelter home provides greater protection and psychosocial assistance to the elderly especially those that are in family abandonment situations. These homes will help to decrease the incidence of street begging among the elderly since the elderly leave their own homes due to elder abuse. The shelter homes will also contribute to the elder’s social and economic conditions and thus retrieve the respect to people submitted to various abuses. In the long run, the elder’s quality of life will be improved.

Let’s take a stand against elder abuse and protect seniors today!

Sophie Okolo is the Founder of Global Health Aging

Ebola and the Elderly: Focusing on a Vulnerable Population

Certain diseases like pertussis and dementia are associated with distinct populations. Pertussis is generally linked to children and dementia is generally linked to older adults. While both diseases can affect atypical populations, health professionals cannot have the same mindset when rare diseases like Ebola are concerned.

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The Ebola outbreak continues to make headlines around the world and the focus has been on adults and children. If one studies the media and research papers, older adults are nearly absent. The aging population remains sidelined from the Ebola epidemic although the disease has affected the elderly around the world. Some may argue that Ebola mainly affects adults and children but few reports have shown that the elderly are also casualties. The rate of casualties regarding the elderly may not be accurate since there is little focus on this population. How long will older adults continue to be sidelined from issues that also affect them? Ebola attacks the elderly in unique ways compared to adults and children. For instance, older adults are prone to disease and disability because of their age. Specific risk factors that affect older adults also include:

  • Injury and poverty
  • Development of non-communicable diseases
  • Social isolation and exclusion, mental health disorders
  • Elder maltreatment.

These medical conditions in addition to contracting the Ebola virus disease (EVD) make matters worse for the elderly.

Cases regarding the elderly and EVD are not widespread in the media hence this piece will highlight just a few of these instances. The first case is an elderly woman who tested positive of the Ebola Virus Disease in Port Harcourt, Rivers State, Nigeria. The elderly woman had been quarantined in the Ebola Isolation Centre because she shared the same ward with the late Dr. Ike Enemuo, a Port Harcourt-based medical practitioner who treated an ECOWAS diplomat with the Ebola virus. Dr. Enemuo was ill and receiving treatment at the Good Heart hospital in Port Harcourt. He died of Ebola on August 22, 2014. The second case is an 87-year-old woman from Madrid, Spain, who was isolated in the senior center where she lives. The elderly woman was driven in the same ambulance as Nurse Teresa Romero, the first person to become infected in Europe. A key point about this case is that the elderly woman had suffered a fall which made matters worse. Another case in Spain is 75-year-old Miguel Pajares, an elderly priest who was working in Liberia. He was carrying out missionary work when he tested positive for Ebola.

The goal is not to ignore populations that are affected by certain diseases. Health professionals need to have a holistic view for disease outbreaks, knowing that outbreaks still affect populations that are marginalized. As Ebola remains in the news, let us remember the elderly, people with disabilities, and more because each population faces unique challenges during disease outbreaks. Treatment is not just for certain groups, it’s for all groups affected. Health and media professionals can think outside the box when it comes to reporting events. If not, public health interventions may continue to ignore elderly issues around the world.

Sophie Okolo is the Founder of Global Health Aging.

Promoting Advance Directives, Reducing Medicare Spending

*This article was extracted from a longer, in-depth, paper written during my internship with a policy forum in Washington, D.C. 

More and more people are living to the age of 100. As our longevity increases, it is crucial to have an advance directive to make health care decisions, which may reduce the overall cost of end-of-life care. While Medicare guarantees access to health insurance for individual Americans and lawful residents aged 65 and older, the program faces significant fiscal challenges over the long-term. Advance directives may reduce Medicare spending since older adults can opt out of aggressive medical intervention by dictating their wishes in the event of a life-threatening illness. As Congress continues to debate over the best way to fix Medicare, costs will likely increase if older adults continue to ignore advance directives.

Living Will document with pen, closeupAbout 27.4 percent of Medicare expenses for the elderly are spent in the last year of a person’s life. Advance directives can reduce that percentage because older adults may not prefer lifesaving machines that impact costs. If a person wants to avoid lifesaving machines without having an advance directive, doctors will keep such people alive at the expense of other patients. The latter will be deprived of necessary medical treatment and hospitals may become overcrowded. Also, these machines and other medical resources will contribute to the cost of care because they are expensive and scarce. Unless people write binding living wills, families are reluctant to “pull the plug,” and medical professionals are afraid of being sued if they do. Increasing the use of advance directives is necessary for preventing such problems.

Studies have shown that adults are more likely to complete advance directives that are written in everyday language and less focused on technical treatments. However, many people are currently unaware of advance directives and even fewer complete them. Since advance directives are very lengthy and tedious to complete, most seniors prefer family surrogates. The present state of healthcare systems also compounds the problem. For instance, there are only two states that offer living will “registries.” Residents can file their living will and allow doctors and other healthcare providers to have access to their documents. However, the Washington State living will registry has been closed by the state government because of lack of funds, among other problems.

If insurance pools take into account the costs spent on people that will never get well, premiums for younger and healthy people are going to be very expensive. It is difficult when people are without an advance directive and do not want lifesaving machines. At the same time, if such people wish to have invasive and aggressive medical treatment in poor prognosis states, then health systems should accommodate and respect their wishes.

Advanced directives are not only for the elderly. Our society is getting older, and people have to deal with it. Health professionals need to determine effective ways of promoting advance directives among elderly patients. For example, a study showed that a replicable intervention mainly targeting doctors achieved a moderate increase in advance directives among older ambulatory patients. Future interventions may need to address doctors’ attitudes and comfort discussing these documents since patients cite their physician most often as the one who influenced them most to make a health behavior change. Increasing the use of advance directives among elderly persons is essential since it reduces Medicare spending and the national budget concurrently.

Living wills and health care proxies need restructuring hence these documents have to be well prepared to reduce confusion, jargon, and ambiguity. It is also vital for healthcare institutions to advocate and support the use of advance directives. More states should invest in the living will “registries” and promote advance directives to increase enrollment. If a patient has an advance directive and requests lifesaving machines, families and health professionals should respect their wishes. In the long run, advance directives are necessary because they can reduce the overall cost of end-of-life care for individuals and families.

Sophie Okolo is the Founder of Global Health Aging.

Alzheimer’s and Parkinson’s: A Great Threat to the U.S. National Budget

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Since the last Presidential Election, the national budget has been a sore spot for Republicans and Democrats, the two major political parties in the U.S. While government programs such as the Affordable Care Act (ACA) are leading debates on reducing the national budget, politicians are oblivious of a looming threat to the budget. People with Alzheimer’s and Parkinson’s diseases require constant and very expensive care. Also, these debilitating illnesses can prevent affected persons from working, which may have a devastating long-term impact on the budget.

Alzheimer’s disease (AD) is the sixth leading cause of death in the U.S. and an estimated 5.4 million Americans currently suffer from AD. 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 U.S. population is aging and the risk of Alzheimer’s increases with age. For instance, Alzheimer’s usually begins after age 60 and the number of people with the disease doubles for every five-year interval beyond age 65. About five percent of men and women ages 65 to 74 have Alzheimer’s disease and it is estimated that nearly half of those age 85 and older may have the disease. Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and affects one million people in the United States. Symptoms of PD include muscle rigidity, tremors, and changes in speech and gait that worsen as the illness progresses over time. PD is more common in the elderly and most often develops after age 50. Sometimes, Parkinson’s disease occurs in younger adults. When a young person is affected with PD, it is usually because of a form of the disease that runs in families.

With strong research investment, heart disease deaths in the U.S. fell by 13 percent in the past decade. Alzheimer’s deaths rose by 68 percent from 2000 to 2010 and continue to increase. The issue is not how, but why we cannot increase our investment in research into fighting these diseases that have a tremendous impact on both the individual and society. Alzheimer’s and Parkinson’s get comparatively less funding than other top diseases because they are more common in the elderly and largely ignored. Stigma is another reason why it is hard to raise money since people with Alzheimer’s and Parkinson’s rarely talk about the disease. Also, Alzheimer’s is different from other diseases because Alzheimer’s patients rarely lead marches to fight for more funding since their memory is impacted. It is important to our nation’s economic future to reduce the deficit, but we cannot ignore the importance of investing in Alzheimer’s and Parkinson’s research. As the nation’s older populations grow, the cost of care for these diseases will rise dramatically. In fact, Alzheimer’s is expected to cost the U.S. more than $1 trillion annually and persons who leave the workforce to care for an affected family member impact economic productivity. Increasing funding for Alzheimer’s and Parkinson’s will require difficult choices and shared sacrifice in spending reductions and increased revenues.

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As the U.S. Congress continues to agree or disagree on the best way to fix Medicare, a government health program, the national budget will likely increase if there is no dramatic increased investment in research into fighting Alzheimer’s and Parkinson’s disease. The devastating statistics continue to increase and rising health care costs pose a great problem to the U.S. economy.

Sophie Okolo is the Founder of Global Health Aging.

Old and Forgotten: The Crisis of Africa’s Elderly

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Africa is currently the most youthful continent in the world. At least 35 per cent of its more than one billion population is between the ages of 15 and 35. While investing in the youth is a priority for the continent’s transformation, the elderly should not be forgotten. As Africa’s population grows, the number of older people also increases therefore it is important to highlight the issues that affect this population.

Traditionally, extended families have taken care of elderly members but since that is changing, aging Africans are now facing new problems. The United Nations Population Fund estimates that around 50 million people above the age of 60 account for around five percent of Sub-Saharan Africa’s population. In the past, most of them turned to families for help but the practice is becoming less widespread. It is difficult to convince people that the elderly in Africa are in need of help. Issues affecting this population are not popular because either everyone is just focusing on children, which is important, or they are under the notion that the elderly live happily with their extended families. It becomes more difficult when even development policy debates marginalize issues related to the elderly. For example, the Millennium Development Goals (MDGs) focuses only on women and children.

Despite these issues, society should not give up on the elderly because they need our assistance. There are many ways to help the elderly in Africa such as organizations can partner with local hospitals to train volunteer healthcare assistants who will visit the elderly in their homes and ensure that they receiving the care they need. Other complex issues can be tackled efficiently. For instance, there are at present senior citizens who cannot afford sufficient medical care in South Africa. The situation is more problematic because advocates for the elderly state that the services for senior citizens have dramatically decreased in the last two decades.

According to Anita Powell, Southern Africa reporter for Voice of America, few among South Africa’s rapidly growing elderly population are faring well, health wise, due to economic insecurity which is linked with worse health outcomes. Elderly advocates insist that Nelson Mandela, South Africa’s most famous senior citizen, is not the standard by which South Africa’s treatment of its weakest members should be judged. Unlike other aging South Africans, Mandela spent nearly two weeks in a Pretoria hospital for a lung infection, and received the best possible medical care. The nation’s growing elderly population is increasingly marginalized by a government that has focused its health care on young people and women. While child health is very important, the health care needs of the elderly should not be overlooked especially in a nation with only eight registered geriatric doctors. Despite these issues, it is good to know that South Africa’s pension system was the second most distributed of the African countries in the Global AgeWatch Index, the first-ever overview of the well-being of older people around the world. Without a formal pension system, the prevalence of poverty among older persons will likely increase. Currently, there are no formal systems in most other African countries.

It is critical to provide proper assistance and support to combat poverty and economic security for today and tomorrow’s seniors. Africa’s elderly still contribute to development, civic life, and the economy in many ways including caring for grandchildren when the middle generation has died or become very sick from HIV/AIDS. Ultimately, they need to be rewarded. This video portrays the work of the Ikaheng Daycare Centre for the Aged in the South African Township of Ikaheng.

Sophie Okolo is the Founder of Global Health Aging.

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

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. 

June is Alzheimer’s and Brain Awareness Month

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.