1. 5th GO-NGO Forum Strengthening Family Institution: Caring For the Elderly
By Braema Mathiaparanam,
Regional President, Southeast Asia and Pacific,
International Council of Social Welfare
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2. Outline Definitions The Phenomenon Family Patterns The Impact
Support: Structures, Policies, Progammes
The Gaps
Recommendations
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3. Definitions Who is an Older Person? Age of 60, 65
Old-Old eg today, persons aged 80 years or over account for close to one in every seven older persons (for those aged 60 or over). By 2050, this ratio is expected to be one person aged 80 or over for every five older persons
Definitions affect data, research, trends, policies
What Constitutes Family?
Nucleus family
Extended family
Rural/Urban Models
Migrant Workers’ Families
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4. The Phenomenon Key Global data Key ASEAN data Total Fertility Rates
Proportion of Older Population
Dependency Ratio
Development Transition Gap
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5. Key Global Data Ranks of elderly growing by 2.6 % per year
22 per cent of world’s population will be aged 60 and above in about 40 years time, that is, about two billion people
Dependency ratios will triple in Asia by while Latin America and the Caribbean will more than triple
Feminization of Ageing
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6. ASEAN Key Data
435 % increase bet 2000 and 2050 – a rise from million to million people 60 and above
By 2050 all 10 ASEAN countries will see 10 per cent of the popn at aged 60 or above with Singapore reaching almost 40 per cent and Vietnam, almost 30 per cent.
Dependency Ratio ( old-age dependency ratio is the ratio of the population aged 60 or over to the population aged 15 to 59 expressed per 100 population) in ASEAN will triple with Brunei having the highest number of people aged above 60 as compared to the younger population
Fertility Rates and Shape of Families are changing - eg family size in Indonesia and Thailand decreased from about five in 1980s to four in 2000; and from 6.6 to five in the Philippines; In Malaysia, proportion of extended families decreased from 28% in 1980 to 20 % in 2000 and proportion of nucleus families rose from 55 percent to 65 percent during the same time.
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7. Source: World Population Prospects: The 2008 Revision, United Nations Population Division, New York.
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8. Source: World Population Prospects: The 2008 Revision, United Nations Population Division, New
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9. GO-NGO Forum/brunei/icsw/bm
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10. Family Patterns Urban model - rise in nucleus families
Rural – rise in out-migration to Urban
Cross border migration
In some countries, eg Indonesia more households and in some cases even bigger family size but increase in nucleus families
Divorce , widowhood and rising singlehood eg in Malaysia one in 10 households were either single out of choice, divorce or widowhood
Marrying later eg Singapore age of 28 for women and 30 for men and rise in DINKS( Dual Income No Kids Syndrome)
Live-in foreign domestic helper as caregiver
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11. The Impact
Women - more women living alone eg the sex ratio of males 60 and above for 100 females is 79 for Thailand, 82 for Philippines and 86 for Malaysia and Lao PDR; more women with less social security as there is higher illiteracy; women prone to lifelong disabling illnesses
Isolation – social and psychological
Income Security
Rural areas – fields to till and out-migration
Older people and employability
Special support for growing numbers of Old-Old
Changing demand on healthcare and co-morbidities as people grow older
Caregiving structures – family and community level
New Products to help the elderly
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12. Support: Structures, Policies, Programmes ( 1)
International – Madrid International Plan of Action on Ageing(MIPAA); Macao Plan of Action on Ageing for Asia and the Pacific; UN recognizing the rights of the elderly
Coordinating Mechanisms at the national level; focal points; cross-sectoral
Concept of Ageing-in-Place – jobs, flexibility at the workplace, recreation, family to community structures
Intergenerational solidarity – financial support from government ( eg Thailand); deeper tax reliefs for children
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13. Support( 2)
Family support – flexible work hours; access to caregivers; support services ( day-care, short term, respite, long term care)
Income Security – money for the older person, universal and some access to healthcare and transport subsidies, cash transfers(privileges or subsidy)
Health promotion as a family affair
Social activities
Training of caregivers and accreditation systems
Law eg Singapore and the Maintenance Act
Tax reliefs
Housing schemes
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14. The Gaps
Vulnerable elderly communities - Limited access to healthcare or transport; limited access to information
Inconsistent barrier-free access
Inconsistent flexible workplace practices for the elderly and the family
Capacity building to meet growing needs
Privilege versus Subsidies – Handling older persons for their Dignity
Those who live alone Die Alone – care beyond death
Definition of Neglect – different from those applied to children?
Severe mental impairment – dementia
Images of ageing
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15. Recommendations
Income Security – cash transfers, social pensions, social insurance, medical insurance; privilege benefits, social protection floor initiative
Capacity-Building - Caregivers, policy makers, employers, family members, schoolchildren, older persons
Mechanisms – A Coordinating National Effort
Accept that the needs of the elderly cannot be met by the family alone ‘cos of the social and cultural changes
More Support Structures to Complement the Family
Access to healthcare with specialized tracks at hospitals and clinics; access to transport, buildings
Flexible work plans for the elderly
Vulnerabilities of older women - access to social security, health
A lifecourse approach to ageing; Ageing-in Place.
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18/9/2018