International Association of Homes and Services for the Aged conference

“Connecting our Global Community”

Shanghai18th October 2013

Mark Gorman Director of Strategic Development

HelpAge International

The 21st century is the century of aging

“The new millennium closes the first chapter in human history: when we were young” (Paul Wallace: “Agequake”)

Life expectancy is extending worldwide, fertility rates are falling, and demographic ageing is accelerating -

“The ageing of humanity across the world is a defining stage in history. It will change everything from business and finance to society and culture”

Global ageing is a triumph of human development

Twentieth Century advances...

Health and sanitation

Education

Poverty reduction

Development progress...

more people are surviving childhood

more women are surviving childbirth

fewer children are being born...

...and people are living longer

Scale and rate of global population ageing

The deficit approach to ageing

strained pension & social security systems

increasing demand for acute & primary care services

increased need for long-term and social care

Reduced family care and support

A global aging crisis?

Many low- and middle-income countries are said to be “growing old before they grow rich”

Media headlines on aging...

“Aging population may explode global economy by 2050”

“Silver Tsunami”

“World faces ageing population time bomb says UN”

The “burden” of old age

For the state - fiscal load of income support and health and social care costs

For individuals - care-giving effort and stress.

The “burden”…

“tends to simplify relationships... between age-groups ...or between a carer and an older person, and communicates senses of a nuisance and an excessive charge”

Ageing is largely ignored as a global challenge...

a lack of preparedness (governments and societies)

fear of old age & a wish to avoid it

a reaction against older people

fear-mongering today reinforces a fatalist approach to the future

Old age is seen as a disease

older people frequently report this attitude among health staff

Older people are seen as a problem

economic pressures are challenging traditional caregiving

Older people are seen as a threat

destabilising economies and societies

A new view of old age

Attitudes to ageing formed when there were far fewer old people

Changing social structures over the last century -

In “developed” world education, work & retirement - the normal life-course

For the majority in developing countries lifetimes of work, a short “old” age in poor health, & an early death

Life-courses are changing dramatically

Longer working lives in the developed world

A long old age is increasingly expected in the developing world

Many older people remain connected to family & community...

...And play active roles in community life

A new view of old age

Focus on the individual and not the age – her/his capabilities and assets, not deficits

Old age is not the problem...

...Societies need to adjust– social structures, physical environments, attitudes

The Millennium Development Goals

Poverty

Education

Gender equality

Child mortality

Maternal health

HIV & AIDS

Sustainability

Global development partnership

After the Millennium Development Goals – what next?

From 2015 Sustainable Development Goals

Not just developing countries - collective responsibility for global future

Aim - raise living standards and control the global burden on natural resources

“… As the international community embarks on...the post-2015 development agenda, it is clear that the issue of population ageing should be fully addressed as part of this process”.

Ban Ki-moon, UN Secretary-General

Ageing in the “post-2015” agenda

a forward-looking global agenda on health, poverty, rights, the environment -

must recognize demographic change and global ageing

needs a life-course based, inclusive approach

A UN Convention on the rights of older people?

Growing concern over challenges to older people’s rights…

…and abuses – physical, social, financial

UN review of the Madrid International Plan of Action on Ageing -

major obstacles to older people’s “participation, inclusion & social integration”, including discrimination and abuse

Care in old age

A sense of crisis -

growing numbers of oldest old

growing numbers living with dementia

reduction in family-based care

challenges to division of health care & social care

rising costs

the great majority of care will continue to be given & received in older people’s own homes and communities

care will be provided informally, by family, friends and neighbours,

and in an ideal world...

supported by formal local services - community health & care care workers, in community centres etc.

Working with family caregivers

Problem

HIV pandemic in Africa and SE Asia - older people caring for family members living with HIV, and orphans and vulnerable children

many older carers have care needs themselves

Response

a training program for older carers

They trained others - basic nursing care, counselling, pain control

Information on HIV and available services, nutritional advice for people with HIV, drug administration, referrals

Support groups to combat the stigma felt by families

Older carers increasingly offer a wider community resource

Utilising community resources

Problem

Increasing isolation, family separation due to migration, work requirements

Lack of community-based facilities – health and community centers

Response

Village-based older people's associations - foster social bonds and help older people to support each other

training on older people's health

“age-friendly” health consultations

training on home-based care

home care volunteers for frail older people

In Cambodia, “National Guidelines on Home Based Care” endorsed by government...

...a model for care at home for the most vulnerable older people

Key need – to be closely linked to public service provision –

family/community care also needs formal care service support

Care in emergencies

Problem

Older people are especially vulnerable to

natural disasters

conflict

long-term crisis – drought, food shortages

Response

In Colombia, Peru & Bolivia...

Representatives from older people’s associations trained in emergency preparedness

Teams of older people (“White Brigades”) have been set up for

disaster preparedness (awareness, training)

disaster response (rescue, rehabilitation)

Working together?

“to create a peer network so that providers around the world can learn from one another and have a forum to share innovations and best practices.”

Thank you

Photo credits

Haiti: F. Dupoux/HelpAge International 2011

Bangladesh: Antonio Olmos/HelpAge International 2013

Singapore: Jerry Wong/Flickr 2013

Tanzania: Jeff Williams/HelpAge International 2011

Cambodia: Joanne Hill/HelpAge International 2010

Tanzania: Jeff Williams/HelpAge International 2011

Cambodia: Nile Sprague/HelpAge International 2007

Bolivia: HelpAge International 2012