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Family & Relationships


Caring For Older Persons

Thus says the Lord of hosts: Old men and old women shall again sit in the streets of Jerusalem, each with staff in hand because of their great age. And the streets of the city shall be full of boys and girls playing in its streets. (Zechariah 8:4-5)

Consider:

# Babyboomers (those born during the postwar baby boom) will double the proportion of people over 65 from 2 per cent in 1995 to 4 per cent in 2025. When they want a retirement place, the experts predict, they'll want more than a 'granny flat'. They'll want more room/s, a two-car garage, more security (so more senior citizens' places will be high-rise). They'll be more affluent, so they'll want computer centres and workshops, and financial services to advise re their investments. A decade ago, most retirement villages were provided by churches or charities. Now the private sector accounts for nearly half the residents in village accommodation.

# Epidemiological studies suggest that successive cohorts of the elderly arriving at the same age have better levels of health, and it is expected that, as men and women live to increasingly greater ages, major disabilities will largely be compressed into a narrow age range just prior to death.

# 'The family, regardless of its form or organization, is recognized as a fundamental unit of society. With increasing longevity, four- and five-generation families are becoming common throughout the world. The changes in the status of women, however, have reduced their traditional role as caretakers of older family members; it is necessary to enable the family as a whole, including its male members, to take over and share the burden of help in and by the family. Women are entering and remaining in the labour force for longer periods of time. Many who have completed their child-rearing roles become caught between the desire and need to work and earn income and the responsibility of caring for elderly parents or grandparents' (United Nations International Plan of Action on Ageing).


The United Nations International Plan of Action on Ageing has suggested the following principles and ways to enhance the lives of older persons:

# Ageing is a lifelong process and should be recognized as such. Preparation of the entire population for the later stages of life should be an integral part of social policies and encompass physical, psychological, cultural, religious, spiritual, economic, health and other factors. Young people can be educated to become aware of the changes which will occur as they grow older; to develop a healthy general life-style; make appropriate adjustments to working hours and conditions; split up each individual's time and responsibilities among various types of activities so that he or she can have several different jobs as they grow older, and achieve the best possible balance between time spent in leisure, training and work.

# Realize that people are often judged to have reached old age simply in terms of the number of years they have completed. If the loss of employment status entails their being placed on the sidelines of their own society, this should be viewed as one of the sad paradoxes of the process of socio-economic development in some countries. The living conditions of the elderly in most countries have by and large lagged behind those enjoyed by the economically active population. Older persons have rights to income security, the right to work and the right to retire.

# Everything we do should enhance human dignity and ensure equity among all age groups in the sharing of society's resources, rights and responsibilities. Individuals, regardless of age, sex or creed, should contribute according to their abilities and be served according to their needs

# There is ample evidence of the high esteem in which older people are held in developing countries. Trends towards increasing industrialization and urbanization and greater mobility of the labour force indicate, however, that the traditional concept of the role of the elderly in the family is undergoing major change. Worldwide, the overall responsibility of the family to provide the traditional care and support needs of the ageing is diminishing.

# A fundamental principle in the care of the elderly should be to enable them to lead independent lives in the community for as long as possible. Special support must be given to home care services, by providing them with sufficient medical, paramedical, nursing and technical facilities of the required standard to limit the need for hospitalization.

# Health care: The care of elderly persons should go beyond disease orientation and should involve their total well-being, taking into account the interdependence of the physical, mental, social, spiritual and environmental factors. Care designed to alleviate the handicaps, re-educate remaining functions, relieve pain, maintain the lucidity, comfort and dignity of the affected and help them to re-orient their hopes and plans, particularly in the case of the elderly, are just as important as curative treatment.

# Particular attention should be given to providing health care to the very old, and to those who are incapacitated in their daily lives. This is particularly true when they are suffering from mental disorders or from failure to adapt to the environment; mental disorders could often be prevented or modified by means that do not require placement of the affected in institutions, such as training and supporting the family and volunteers by professional workers, promoting ambulant mental health care, welfare work, day-care and measures aimed at the prevention of social isolation.

# Attentive care for the terminally ill, dialogue with them and support for their close relatives at the time of loss and later require special efforts which go beyond normal medical practice. Health practitioners should aspire to provide such care. The need for these special efforts must be known and understood by those providing medical care and by the families of the terminally ill and by the terminally ill themselves. Bearing these needs in mind, exchange of information about relevant experiences and practices found in a number of cultures should be encouraged.

# A proper balance between the role of institutions and that of the family in providing health care for the elderly -- based on recognition of the family and the immediate community as elements in a well-balanced system of care -- is important. Existing social services and health-care systems for the ageing are becoming increasingly expensive. Means of halting or reversing this trend and of developing social systems together with primary health care services need to be considered

# Those who give most direct care to the elderly are often the least trained, or have insufficient training for their purpose. To maintain the well-being and independence of the elderly through self-care, health promotion, prevention of disease and disability requires new orientation and skills, among the elderly themselves, as well as their families, and health and social welfare workers in the local communities.

# The trend towards the successive ageing of population structures is bound to be one of the main challenges to international and national planning efforts well into the twenty-first century. There are gradually deteriorating ratios between the economically active and employed sectors of society and those dependent for their sustenance on the material resources provided by these sectors. Countries with established social security systems will depend on the strength of the economy to sustain the accumulated charges of income-basis and deferred retirement benefits for a growing elderly population and the costs of maintaining dependent children and of ensuring training and education for young people.

# Governments, non-governmental organizations and all concerned have a special responsibility to the most vulnerable among the elderly, particularly the poor, of whom many are women and from rural areas. Further study on all aspects of ageing is necessary. Expenditure on the ageing should be considered as a lasting investment.

# Governments and, in particular, local authorities, non-governmental organizations, individual volunteers and voluntary organizations, including associations of the elderly, can make a particularly significant contribution to the provision of support and care for elderly people in the family and community. Governments should sustain and encourage voluntary activity of this kind.

# Ageing, in addition to being a symbol of experience and wisdom, can also bring human beings closer to personal fulfilment, according to their beliefs and aspirations. Older persons should be active participants in the formulation and implementation of policies, including those especially affecting them.

# As most people can expect to survive their own retirement age by a substantial number of years, the concept of 'preparation for retirement' should not continue to be conceived as a last-minute adaptation but be proposed as a lifelong consideration from adulthood onwards.

# The need for continuing adult education at all levels should be recognized and encouraged. Consideration should be given to the idea of university education for the elderly. Furthermore, cultural centres should be asked to organize for and with the elderly workshops in such fields as handicrafts, fine arts and music, where the elderly can play an active role both as audience and participants.

# Organise or join in events that celebrate the increasing importance of older people in today's society.

# Strive for a balance between supporting dependency and lifelong development.

# Pursue the ideals of a multigenerational society that is age-inclusive, where people of different generations are committed to creating an enabling environment for healthy life-styles as people age.

# Governments should: Ensure that food and household products, installations and equipment conform to standards of safety that take into account the vulnerability of the aged; Encourage the safe use of medications, household chemicals and other products by requiring manufacturers to indicate necessary warnings and instructions for use; Facilitate the availability of medications, hearing aids, dentures, glasses and other prosthetics to the elderly so that they can prolong their activities and independence; Restrain the intensive promotion and other marketing techniques primarily aimed at exploiting the meagre resources of the elderly.


DISCUSS:

1. How do these principles and recommendations impact on your lives, and the lives of older persons you know? What more can be done to care for older persons with dignity?

2. Can you think of other principles/factors not included in the above (like housing and transport of the elderly, for example)?

3. What can governments and others do to help families care for the elderly at home?

4. When the elderly live in institutions, how can their families and institutional carers enhance their lives? Sometimes we have an image of lonely older people 'sitting in chairs all day dozing and looking bored'. Is this the reality? What can be done about this stereotype?

5. How can children, young people, and animal pets help enhance the lives of institutionalized older people?

6. Discuss the pros and cons of setting a 'retirement age' for different jobs/persons. How can we be more flexible about preparing people for retirement - eg. by adjusting their workloads as they get older, etc.

7. What are the special needs of the migrant elderly - including refugees? How can we best help them?

8. Some older persons have adjusted to technological innovations (like the Internet) but in many instances, the knowledge explosion is resulting in information obsolescence, with, in turn, implications of social obsolescence. How can we help older persons here?

9. What do you understand by 'ageism' - discrimination towards others on the basis of age?

10. Why not write down your concerns about any/all of the above, and post them to both:

Mr. Andrew Tongue
Assistant Secretary
Office for the Aged, MDP 10
Department of Health and Family Services
GPO Box 9848, Canberra, ACT, 2601
AUSTRALIA
TEL: 61 6 289 5246
FAX: 61 6 282 4412

Senator Kay Patterson
Parliament House
Canberra ACT 2600
AUSTRALIA
TEL: 61 6 277 3800
FAX: 61 6 6277 3804

Rowland Croucher



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