wargawarga emaswarga emas in malaysia - …apacph2015.fkm.ui.ac.id/ppt/21 october 2015/4. symposium...

SymposiumSymposium: : Enhancing Enhancing quality of life of the quality of life of the elderlyelderly

Problems, Policies and Program to Problems, Policies and Program to Improve Quality of Life of theImprove Quality of Life of the

Problems, Policies and Program to Problems, Policies and Program to Improve Quality of Life of theImprove Quality of Life of theImprove Quality of Life of the Improve Quality of Life of the

WargaWarga EmasEmas in Malaysiain MalaysiaImprove Quality of Life of the Improve Quality of Life of the

WargaWarga EmasEmas in Malaysiain Malaysia

Associate Professor Dr Farizah Mohd HairiAssociate Professor Dr Farizah Mohd Hairi

University of Malaya

farizah@ummc edu [email protected]

Outline Outline

• I. Challenges • II. Policies• III. Programs

*Also would like to acknowledge that some *Also would like to acknowledge that some slides are shared by Dr Mohmad Bin Salleh, Senior Principal Assistant Director, Sector of Elderly Health, Division of Family Health Development

slides are shared by Dr Mohmad Bin Salleh, Senior Principal Assistant Director, Sector of Elderly Health, Division of Family Health DevelopmentDivision of Family Health Development, Ministry of Health, Malaysia.Division of Family Health Development, Ministry of Health, Malaysia.

ChallengesChallenges wargawarga emasemasChallenges Challenges –– wargawarga emasemas

•Demographic changes•Health challenges among warga emasHealth challenges among warga emas• ImplicationsSocialSocialEconomicHealthHealth

3

DemographyDemographyDemographyDemographyDemographyDemographyDemographyDemography

Number of Elderly in the WorldNumber of Elderly in the WorldNumber of Elderly in the WorldNumber of Elderly in the WorldNumber of Elderly in the World Number of Elderly in the World

and % in Developing Countriesand % in Developing Countries

Number of Elderly in the World Number of Elderly in the World

and % in Developing Countriesand % in Developing Countries

Year Population 60 yr old and above (million)

% in developing countries

2000 614 62

2025 1,200 72

2050 2,000 80

Source: United Nations, 2001

Rate of general population growth ~ 50 % Rate of general population growth ~ 50 % Rate of general population growth 50 %

BUT growth rate for the elderly ~75 %

Rate of general population growth 50 %

BUT growth rate for the elderly ~75 %

Countries with 10 million population or almost (in the year 2002) with the highest number of elderly

2002 2025

Italy 24.5% Japan 35.1%

Japan 24.3% Italy 34.0%

Germany 24.0% Germany 33.2%

Greece 23.9% Greece 31.6%

Belgium 22.3% Spain 31.4%

Spain 22.1% Belgium 31.2%

Portugal 21 1% United Kingdom 29 4%Portugal 21.1% United Kingdom 29.4%

United Kingdom 20.8& Netherlands 29.4%

Ukraine 20.7% France 28.7%% %

France 20.5% Canada 27.9%

Source: United Nations, 2001,

PendudukPenduduk WargaWarga EmasEmas (60+(60+ tahuntahun) di Malaysia, 1947) di Malaysia, 1947‐‐20502050PendudukPenduduk WargaWarga EmasEmas (60+(60+ tahuntahun) di Malaysia, 1947) di Malaysia, 1947‐‐20502050PendudukPenduduk WargaWarga EmasEmas (60 (60 tahuntahun) di Malaysia, 1947) di Malaysia, 1947 20502050PendudukPenduduk WargaWarga EmasEmas (60 (60 tahuntahun) di Malaysia, 1947) di Malaysia, 1947 20502050

2022

15

1617

16

18

20

“Negara tua” (aged nation) apabila w. emas > 60 = 15% jumlah penduduk

10

12

14

Perc

enta

ge (%

)

2

4

6

8P

0

2

1947 1957 1970 1980 1991 2000 2010 2020 2030 2035 2040 2050

Total population (60+) Male (60+) Female (60+)

Sources:Sources:1. Department of Statistics,2006 & 20112. United Nations, 2010 World Population Prospects: The 2010 Revision. Retrieved from web Population Division, Department of Economic and Social Affairs, http://esa.un.org/unpp/

Number and Percentage of Number and Percentage of WargaWarga EmasEmas by States, 2010by States, 2010

MALAYSIA, 2010 [60+; N = 2067.0, % = 7.7]

7.98.4

7.6

9.0 8.67.7

9.410.7

10.1

8.1 7.78 0

10.0

12.0

240 0

280.0

320.0

t 60+

(%

)

r 60+

('00

0)

N %

6.6 6.3 5.85.0

4.0

6.0

8.0

80.0

120.0

160.0

200.0

240.0

Perc

ent

Num

ber

252.7 167.0 123.9 67.1 85.1 114.2 140.8 252.9 24.4 326.3 71.0 200.0 141.9 3.5 118.70.0

2.0

0.0

40.0

State

High percentage of older persons 60+ / rapidly ageing states

Speed of Population Ageing (Doubling of 65+ Population from 7% to 14%)(Doubling of 65+ Population from 7% to 14%)

85

115France (1865 - 1980)

Developed Countries

53

69

73

85Sweden (1890 - 1975)

Australia (1938 - 2011)

United States (1944 - 2013)

Hungary (1941 - 1994)

26

45

53Hungary (1941 1994)

United Kingdom (1930 - 1975)

Japan (1970 - 1996)

26

33Azerbaijian (2004 - 2037)

China (2000 2026)

Developing Countries

22

23

24

26China (2000 - 2026)

Sri Lanka (2002 - 2026)

Malaysia (2020 - 2043)

Thailand (2002 - 2024)

Source: Kinsella and He, 2009; and U.S. Census Bureau, International Data Base, accessed on October 20, 2010.

18

19

19Thailand (2002 2024)

Columbia (2017 - 2036)

Singapore (2000 - 2019)

South Korea (2000 - 2018)

Population PyramidsPopulation Pyramidsp yp y

Slide : Prof. Gary Andrews Aust.Slide : Prof. Gary Andrews Aust.

…….factors contribute to…….factors contribute to

…….factors contribute to…….factors contribute to

increase ratio of increase ratio of wargawarga emasemas …………increase ratio of increase ratio of wargawarga emasemas …………

‐ increase life expectancy ‐ increase life expectancy

‐ decrease birth rate

‐ decrease death rate

‐ decrease birth rate

‐ decrease death rate

‐migration

l

‐migration

l‐ internal‐ external‐ internal‐ external

Life Expectancy At Birth, Malaysia, 1957 Life Expectancy At Birth, Malaysia, 1957 ‐‐ 20122012Life Expectancy At Birth, Malaysia, 1957 Life Expectancy At Birth, Malaysia, 1957 ‐‐ 20122012

YearsAge

YearsMale Female

1957 55.8 58.2

1985 67.0 72.5

1990 69.0 74.0

199 69 4 41997 69.5 74.4

2000 70.2 75.0

2003 71.0 75.52003 71.0 75.5

2006 71.8 76.3

2007 71.7 76.4

2011 72.2 76.8

2013 * 72.6 77.2

Source: Health Facts 2014, MOH, June 2014Source: Health Facts 2014, MOH, June 2014

Population agingPopulation aging

• Population aging was first observed in developed countries, but more recently this phenomenon has extensively occurred in developing countriescountries.

• In Malaysia, mortality rates among the elderly group are on theIn Malaysia, mortality rates among the elderly group are on the decrease, which means there will be more elderly group in the coming decades.

Health Challenges Among Health Challenges Among WargaWarga EmasEmas

Health Challenges Among Health Challenges Among WargaWarga EmasEmasWargaWarga EmasEmasWargaWarga EmasEmas

B 2020B 2020B 2020B 2020By 2020By 2020;

• it is projected that three‐quarters of all deaths

By 2020By 2020;

• it is projected that three‐quarters of all deathsp j ee qua e s o a dea sin developing countries could be ageing‐related,

th l t h f th d th ill b

p j ee qua e s o a dea sin developing countries could be ageing‐related,

th l t h f th d th ill b• the largest share of these deaths will be caused by non‐communicable diseases, such as di f th di l t

• the largest share of these deaths will be caused by non‐communicable diseases, such as di f th di l tdiseases of the cardiovascular system, cancers and diabetes,diseases of the cardiovascular system, cancers and diabetes,

• the number of people affected by senile dementia in Africa, Asia and Latin America may • the number of people affected by senile dementia in Africa, Asia and Latin America may , yexceed 55 million

, yexceed 55 million

Active Ageing: A Policy FrameworkActive Ageing: A Policy Framework‐ Active Ageing: A Policy Framework (WHO/NMH/NPH/02.8)

‐ Active Ageing: A Policy Framework (WHO/NMH/NPH/02.8)

….. Malaysia…….….. Malaysia…….….. Malaysia…….….. Malaysia…….

•Study by MOH (1995), among rural elderly:‐

‐ 77.1% elderly able to move independently.

•Study by MOH (1995), among rural elderly:‐

‐ 77.1% elderly able to move independently.

‐ 1.3% bedridden.

16 5% id d th l i “ d”

‐ 1.3% bedridden.

16 5% id d th l i “ d”‐ 16.5% considered themselves as in “good” health condition (Urban ‐ 6% ‐ study by ISIS & LPPKN, 1991).

‐ 16.5% considered themselves as in “good” health condition (Urban ‐ 6% ‐ study by ISIS & LPPKN, 1991).

‐ 69.7% considered themselves as in “fair” health condition (Urban ‐ 65% ‐ study by ISIS & LPPKN, 1991).

‐ 69.7% considered themselves as in “fair” health condition (Urban ‐ 65% ‐ study by ISIS & LPPKN, 1991).

(Urban ‐ 29% “poor” health – study by ISIS & LPPKN, 1991).(Urban ‐ 29% “poor” health – study by ISIS & LPPKN, 1991).

Malaysia Malaysia Malaysia Malaysia

•The study also showed:‐


‐ 81.4% suffered from at least from one chronic medical illness.

‐ 12.7% had 3 or more chronic diseases.

Th t di l ill•The commonest medical illness:‐‐ joint paint 50.1%

i ht bl 40%‐ eyesight problem 40%‐ hearing problem 21%hypertension 26%‐ hypertension 26%

‐ heart diseases 16.3%‐ diabetes 11 6%diabetes 11.6%


• Study by ISIS & LPPKN (1991), among urban elderly:‐

• The commonest medical illness:‐The commonest medical illness:‐ weakness in arms and legs 35.8% ‐ poor vision 19.3%p‐ respiratory problem 13.8%‐ urinary tract 11.9%‐ heart problem 11.0%‐ digestive tract 5.5%back bone 1 8%‐ back bone 1.8%

‐ others 0.9%

11stst Five Morbidities Among Malaysian Five Morbidities Among Malaysian WargaWarga EmasEmas (Return BPKK)(Return BPKK)11stst Five Morbidities Among Malaysian Five Morbidities Among Malaysian WargaWarga EmasEmas (Return BPKK)(Return BPKK)

30

20

25

ge Hipertension

10

15

Perc

enta

g pDiabetesJoint ProblemHeart Problem

5

10Repiratory ProblemEye

0

2004

2005

2006

2007

2008

2009

2010

2011

2013

YearYear

Morbidities Among MalaysianMorbidities Among MalaysianWargaWarga EmasEmas (NHMS III)(NHMS III)Morbidities Among MalaysianMorbidities Among MalaysianWargaWarga EmasEmas (NHMS III)(NHMS III)Morbidities Among Malaysian Morbidities Among Malaysian WargaWarga EmasEmas (NHMS III)(NHMS III)Morbidities Among Malaysian Morbidities Among Malaysian WargaWarga EmasEmas (NHMS III)(NHMS III)

Prevalence 95% CI

(%) Lower UpperHypertension 73.7 72.3 75.1Hypercholesterolemia 37.9 36.3 39.5Diabetes Mellitus 23 6 22 3 24 8Diabetes Mellitus 23.6 22.3 24.8Asthma Adult 6.2 5.5 6.9Physical Disability 2.4 2.0 2.9Nutritional Status

- BMI- Underweight 11.0 10.1 12.0- Normal 48.4 46.9 49.9- Overweight 29 8 28 4 31 2- Overweight 29.8 28.4 31.2- Obese 10.8 9.9 11.7

PrevalencePrevalence of chronic diseases amongof chronic diseases among wargawargaPrevalence Prevalence of chronic diseases among of chronic diseases among warga warga emas emas in Malaysiain Malaysia• Increasing in life expectancy and number of elderly result in increased cases of chronic diseases.

• The most common prevalence of chronic diseases among elderly in Malaysia wereMalaysia were

• cardiovascular diseases (21.1%), • neoplasms (16.8%), • urinary diseases (13 9%)• urinary diseases (13.9%), • respiratory diseases (7.7%) and • metabolic diseases (7.1).

Implications/issues due to population ageingImplications/issues due to population ageingImplications/issues due to population ageingImplications/issues due to population ageing

• Social Implication‐ dependency ratio/aged dependency‐ labour source ‐ availability of care givers ‐ feminization ageing ‐ lebih ramai warga emas wanita yang hidupg g g y g p

bersendirian (kerana jangka hayat merekalebih panjang daripada lelaki).

‐ living arrangements – penyediaan tempat kediaman yang sesuailiving arrangements penyediaan tempat kediaman yang sesuaiuntuk warga emas bersesuaian dengankebolehan fizikal serta mental mereka.

public facilities kemudahan awam sesuai dengan‐ public facilities – kemudahan awam sesuai denganwarga emas seperti tempat rekreasi/riadah,pengangkutan awam, keselematan jalanraya, t d lif t ( ) d b itandas, lif, susur tangan (ramps) dan sebagainya.

• Economic implication• Health implication

Beban Penduduk Kumpulan Umur Bekerja Beban Penduduk Kumpulan Umur Bekerja Beban Penduduk Kumpulan Umur Bekerja Beban Penduduk Kumpulan Umur Bekerja (I5 (I5 ‐‐ 64 Tahun) Menanggung Seorang Warga Emas64 Tahun) Menanggung Seorang Warga Emas(I5 (I5 ‐‐ 64 Tahun) Menanggung Seorang Warga Emas64 Tahun) Menanggung Seorang Warga Emas

Tahun 2004 = 11 pekerja*

Source: Statistical Department, Malaysia

Dependency RatioDependency RatioDependency RatioDependency Ratio

90

100

Youth Dependence Ratio (0-14)

70

80

Rat

io

Old Age Dependency Ratio (65+) There is a decrease in the youth dependency ratio, but an increase in

40

50

60

epen

denc

y ,old age dependency ratio.

20

30

40

Tota

l De

The falling birth rate results in a lowering total dependency ratio,

0

10

1970* 1980 1990 2000 2010 2020 2030 2040 2050

but as population ageing continues, the overall ratio rises again.

1970 1980 1990 2000 2010 2020 2030 2040 2050

Year

PoliciesPoliciesPoliciesPolicies

•Malaysia’s Vision 2020•Health VisionHealth Vision•Goals of health care systemN ti l P li f Old P 1995 ( 2010)•National Policy for Older Persons, 1995 (rev 2010)

•National Health Policy for Older Persons, 2008

27

MALAYSIA’S VISION 2020MALAYSIA’S VISION 2020

By The Year 2020, Malaysia Is To Be A United Nation With A Confident Malaysia Society:a ays a Soc e y

• Infused By Strong Moral & Ethical Values

• Living In Society That Is Democratic, Liberal, Tolerant & Caring

• Economically Just & Equitable Progressive & Prosperous• Economically Just & Equitable, Progressive & Prosperous

• In Full Possession Of An Economy That Is Competitive, Dynamic, b d lRobust And Resilient

HEALTH VISIONHEALTH VISION

Malaysia is to be a nation of healthy individuals, families and

communities

Characteristics of future healthcare system

Emphasis of future healthcare systemhealthcare system system

•Equitable•Affordable•Equitable•Affordable

•Quality•Innovation•Quality•Innovation•Affordable

•Efficient•Technologically appropriate•Environmentally adaptable

•Affordable•Efficient•Technologically appropriate•Environmentally adaptable

Innovation•Health promotion•Respect for human dignity•Promotion of individual

Innovation•Health promotion•Respect for human dignity•Promotion of individual y p

•Consumer friendlyy p

•Consumer friendly responsibility•Promotion of community

participation

responsibility•Promotion of community

participation

GOALS OF HEALTH CARE SYSTEMGOALS OF HEALTH CARE SYSTEMGOALS OF HEALTH CARE SYSTEMGOALS OF HEALTH CARE SYSTEM

•Wellness Focus (tumpuan kepada kesejahteraan)•Person Focus (tumpuan kepada individu)•Person Focus (tumpuan kepada individu)• Informed Person (individu berpengetahuan) •Self Help (kendiri)•Care Provided At Home Or Close To Home•Seamless, Continuous Care•Services Tailored To Individual Or Group NeedServices Tailored To Individual Or Group Need•Effective, Efficient And Affordable Services

GOVERNMENT’S RESPONSEGOVERNMENT’S RESPONSE• Establishment of National

Policy for Older Persons (1995, revised 2010) and Action Plan ofrevised 2010) and Action Plan of National Policy for Older Persons (1999, revised 2010)

– A unified, holistic, inter-sectoral national policy.

– Formation of National Advisory and Consultative Council for the OlderConsultative Council for the Older Persons with the Department of Social Welfare as the national secretariat.

• National Plan of Action for• National Plan of Action for Health Care of Older Persons(1997) - MOH.N i l T h i l C i f• National Technical Committee for Health of the Older Persons (1998) - MOH.

• National Health Policy for Older Persons (2008) - MOH.

National Policy for Older PersonsNational Policy for Older Persons

National Policy for Older Persons is a government commitment to create a

i t f i iti hsociety of senior citizens who are independent, contented and possess a high sense of self‐worth and dignity, by g g y y

optimizing their potential through healthy, positive, active and productive ageing to improve their well being alongageing to improve their well‐being along

with national development.

Improvement inImprovement in National Policy for OlderNational Policy for OlderImprovement in Improvement in National Policy for Older National Policy for Older PersonsPersons

Giving priority for preparation during old age;

Giving priority on strengthening relationship among the older persons as well as inter‐generation; and

I h i f i l t ti d Improve mechanism of implementation and monitoring by formation of committee at the

ti l t t t di t i t l lnational, state at district level.

Pengerusi: Y.B. Menteri

Urus setia: Jabatan Kebajikan Masyarakat

Majlis Penasihat dan Perundingan Warga Emas Negara

Pengerusi: Ketua Setiausaha

Urus setia: Bahagian Dasar, KPWKM Jawatankuasa Teknikal

Dasar Warga Emas NegaraARAR g g

7 JAWATANKUASA KECIL1 J t k K il k ih t

DASA

DASA

1. Jawatankuasa Kecil kesihatan2. Jawatankuasa Kecil Sosial dan

Rekreasi3. Jawatankuasa Kecil Pendidikan

d K h iAAN

AAN

dan Kerohanian4. Jawatankuasa Kecil Perumahan

dan Persekitaran5. Jawatankuasa Kecil Ekonomi6 J t k K il P k jKS

ANKSAN

6. Jawatankuasa Kecil Pekerjaan7. Jawatankuasa Kecil Penyelidikan

dan Pembangunan

NEGERIPELA

PELA

Majlis Tindakan Negeri Jawatankuasa Pembangunan Warga Emas Negeri

NEGERIPengerusi: Timbalan SUK

Urus setia: JKM Negeri

Jawatankuasa Pembangunan Warga Emas Daerah/ Pihak Berkuasa Tempatan

Majlis Tindakan Daerah/ Pihak Berkuasa Tempatan

10

Pengerusi: Ketua Penolong Pegawai Daerah

Urus setia: PKMD

National Health Policy for the National Health Policy for the

Older Person (2008)Older Person (2008)

To ensure healthy, active and

productive ageing byproductive ageing by

empowering the older

persons, family and community

with knowledge, skills, an

enabling environment; and the

provision of optimal health care

services at all levels and by all

sectors.sectors.

The Rationale of the PolicyThe Rationale of the Policy

• Seven rationales;• Seven rationales;

• Among it:

A t l d d i t tt ti t t t

• Among it:

A t l d d i t tt ti t t t Are not always accorded appropriate attention or treatment because their ailments are considered to be the result of age itself.

Are not always accorded appropriate attention or treatment because their ailments are considered to be the result of age itself.

Financially disadvantaged compared to when they were employed.

Financially disadvantaged compared to when they were employed.

Principles For Service Provision (stated in the Policy)Principles For Service Provision (stated in the Policy)

• Six principles;• Six principles;Six principles;

• Among it:

Six principles;

• Among it:

Recognising the Distinctive Needs of Older Person ‐ Health services should provide older person with choices. This should include choice between types of service methods and quality of service delivery as

Recognising the Distinctive Needs of Older Person ‐ Health services should provide older person with choices. This should include choice between types of service methods and quality of service delivery asbetween types of service, methods and quality of service delivery as well as the provision of services

Promoting Healthy Ageing ‐ All services for older person should

between types of service, methods and quality of service delivery as well as the provision of services

Promoting Healthy Ageing ‐ All services for older person should optimize their opportunities for healthy ageing through the life course perspective on ageing and the encouragement of planning for a healthy old age.

optimize their opportunities for healthy ageing through the life course perspective on ageing and the encouragement of planning for a healthy old age.a healthy old age.

Providing Continuity of Care ‐ Older persons who are ill or who have a disability require continuity of care. Their access to support

a healthy old age.

Providing Continuity of Care ‐ Older persons who are ill or who have a disability require continuity of care. Their access to support services and the standard of care available to them should be maintained services and the standard of care available to them should be maintained

Goal Goal

• to achieve optimal health through• to achieve optimal health through

integrated and comprehensive health

and health related services.

ObjectivesObjectives

• Four objectives outlined;• Four objectives outlined;

• Among it:To improve the health status of older persons.

• Among it:To improve the health status of older persons.

To provide age friendly, affordable, equitable, accessible, cultural acceptable, gender sensitive,

To provide age friendly, affordable, equitable, accessible, cultural acceptable, gender sensitive,accessible, cultural acceptable, gender sensitive, seamless health care services in a holistic manner at all levels.

accessible, cultural acceptable, gender sensitive, seamless health care services in a holistic manner at all levels.

Strategies:Strategies:1. Development of a continuum of health care services

2. Interagency / intersectoral collaboration

1. Development of a continuum of health care services

2. Interagency / intersectoral collaboration2. Interagency / intersectoral collaboration

3. Research and development

2. Interagency / intersectoral collaboration

3. Research and development

4. Human resource planning and development

5. Health promotion

4. Human resource planning and development

5. Health promotion

6. Legislation

7 I f i

6. Legislation

7 I f i7. Information system7. Information system

Plan of ActionPlan of Action

Primary Care Secondary and Tertiary Carey y Health education and promotionp

R & D Inter‐sectoral collaborationInter sectoral collaboration Legislative

ProgramsProgramsProgramsPrograms

•Services

I / C t i t• Issues / Constraints what works and what doesn’t?

42

Ministry Of HealthMinistry Of Health

http://www2.moh.gov.my/images/gallery/carta_org/carta_besar_bm‐100713.png

Public Health Public Health DevisionDevision at Federal Levelat Federal Level

The ServicesThe ServicesThe ServicesThe Services

ServicesServicesThree main services:Three main services:

• medical ( hospital )

• health ( health clinic )

• ‘institution’institution

Health Care Services Health Care Services

for for WargaWarga EmasEmas

1996

Pilot project: Health Care Services for Pilot project: Health Care Services for WargaWarga EmasEmas

• year 1996

• 4 health clinics:4 health clinics:

‐ H.C. Kuala Kedah (Kota Setar)

‐ H.C. Parit Baru (Sabak Bernam)

‐ H.C. Sungai Mati (Muar)

‐ H.C. Karak (Bentong)

• 1 hospital – Hospital Seremban

…. …. medical and health servicesmedical and health services…..…..…. …. medical and health servicesmedical and health services…..…..

a) Medical ( hospital )a). Medical ( hospital )

i. Acute medical cares

ii. Long term care

iii. Discharge plan

iv. Psychogeriatric care

v. Physiotherapy

vi. Occupational therapy

vii. Clinical pharmacy

viii. Counselling

ix. Medico social / welfare

…. medical and health services…..

b). Health services (at health clinics):‐

i. Health education and promotion.

ii. Screening and assessment ‐memory status, ADL, IADL, fall, incontinence, etc.

iii. Medical examination, counseling, treatment and referral.

iv. Home visits and home nursing.

h b lv. Rehabilitation.

vi. Recreation, social and welfare.


b). health services (at health clinics.):‐

i. Health education and promotion.p

…. activities at health clinics ………. activities at health clinics ……

ii. Health screening and assessment.


ii. …. health screening and assessment……

…..


iii. Medical examination, treatment and counseling.

iii. …medical examination,


,treatment and counseling …..

Counseling by trained g yAhli Panel Penasihatfor their colleague.


iv. Home visiting and home nursing.


v. Physiotherapy and Occupational Therapy.


v. ….physiotherapy and occupational therapy …..


vi. Social, recreation and welfare.


c). Institutional Services

i. Long‐term residential careii Respite careii. Respite careiii. Day care

• Currently, the Social Welfare Department, Non‐Government Organisations and private nursing homesare providing institutional services.

Services for elderlyServices for elderlyServices for elderlyServices for elderly

h i i i i i emphasize on community participation.

‘ id ’ h i l t l i l d i it l ll ‘provide’ physical, mental, social and spiritual well‐being.

caring concept.

involvement of NGOs private sectors and involvement of NGOs, private sectors and communities – indicate the success of the programs.programs.

effort to make hospitals and health clinics elderly‐friendly.

AchievementsAchievements

- Hospital that provide the services (9)- Hospital that provide the services (9)

- Geriatricians (10 MOH – 7 univ. – 6 private)

- Psychogeriatricians (8 MOH – 3 univ.)

- Geriatricians (10 MOH – 7 univ. – 6 private)

- Psychogeriatricians (8 MOH – 3 univ.)y g ( )

- No. of health clinics provide the services

y g ( )

- No. of health clinics provide the services

• ~ 300 health personals (AMO and nurses) undergone post‐basic training in “Gerontology Nursing” upgraded to “Advance Diploma in Gerontology

• ~ 300 health personals (AMO and nurses) undergone post‐basic training in “Gerontology Nursing” upgraded to “Advance Diploma in Gerontologyupgraded to Advance Diploma in Gerontology Nursing” upgraded to Advance Diploma in Gerontology Nursing”

• > 27k health personals had been trained in “Healthcare for the Elderly” (in‐service training)

• > 27k health personals had been trained in “Healthcare for the Elderly” (in‐service training)

• ~ 23k carers had been trained• ~ 23k carers had been trained

Trained OverseasTrained OverseasTrained OverseasTrained Overseas• 4 Medical Gerontologists (doctor with master in

gerontology)• 4 Medical Gerontologists (doctor with master in

gerontology)gerontology).

• 4 did attachment in Australia – Community Geriatric

• 5 attended Short Course in Gerontology (in Singapore)

gerontology).

• 4 did attachment in Australia – Community Geriatric

• 5 attended Short Course in Gerontology (in Singapore)• 5 attended Short Course in Gerontology (in Singapore) organised by International Institute on Ageing, United Nation, Malta and NGO in S’pore.

• 5 attended Short Course in Gerontology (in Singapore) organised by International Institute on Ageing, United Nation, Malta and NGO in S’pore.

• 1 attended Short Course in Gerontology in Malta.

• 2 did attachment in Hong Kong in community paticipation(elderly care)

• 1 attended Short Course in Gerontology in Malta.

• 2 did attachment in Hong Kong in community paticipation(elderly care)(elderly care).

• 2 did attachment in Japan (JICA Program ).

• 2 Dr 2 PPP 2 Nurses 2 OTs 2 PTs did attachment in

(elderly care).

• 2 did attachment in Japan (JICA Program ).

• 2 Dr 2 PPP 2 Nurses 2 OTs 2 PTs did attachment in2 Dr, 2 PPP, 2 Nurses, 2 OTs, 2 PTs did attachment in Australia.

• 1 nurses did study visit to England.

2 Dr, 2 PPP, 2 Nurses, 2 OTs, 2 PTs did attachment in Australia.

• 1 nurses did study visit to England.

Health education materialsHealth education materials

1. Proses Penuaan. Phamplet

2. Panduan Pemakanan Untuk Warga Tua. Phamplet

3. Panduan Kearah Penjagaan Kesihatan Mulut Warga Tua. Phamplet

4. Apakah Masalah Pergigian Yang Dihadapi Oleh Warga Tua? Phamplet

5 Penjagaan Dentur Phamplet5. Penjagaan Dentur Phamplet

6. Pemeriksaan Kesihatan Untuk Warga Tua. Phamplet

7. Osteoporosis (Kerapuhan Tulang). Phamplet

8. Insomnia (Kesukaran Tidur). Phamplet

…………bahanbahan‐‐bahanbahan pendidikanpendidikan kesihatankesihatan….….

9. Arthritis (Sakit Sendi). Phamplet

10. Keusiaan dan Kasih Sayang Phamplet10. Keusiaan dan Kasih Sayang Phamplet

11. Menyesuaikan Diri Anda Di Usia Tua Phamplet

12 S K h W C h l12. Senaman Kearah Warga Tua Cergas. Phamplet

13. Panduan Pemakanan Warga Tua Di Institusi. Booklet

14. Panduan Untuk Penjaga Warga Tua Manual

15. Senaman Warga Tua CD & Tape

16. Teknik Mengangkat dan Mengalih Warga Emas CD & Buku, booklet

…………bahanbahan‐‐bahanbahan pendidikanpendidikan kesihatankesihatan….….

17. Osteoarthritis Lutut. Phamplet

18. Jatuh. Phampletp

19. Senaman Aerobik Warga Emas. Phamplet

20 W E d S Ph l t20. Warga Emas dan Senaman. Phamplet

21. Penuaan Sihat Phamplet.

22. Dementia Phamplet

MyHealth @ http://www.myhealth.gov.my

Bahagian Pembangunan Kesihatan Keluargahttp://fh.moh.gov.my

The ElderlyThe ElderlyThe ElderlyThe ElderlyThe Elderly …. The Elderly ….

inin

The Elderly …. The Elderly ….

ininin in

the Health Clinicthe Health Clinic

in in

the Health Clinicthe Health Clinic

Guideline toGuideline toGuideline to Guideline to

Implement Implement pp

Healthcare Healthcare

Service for the Service for the

ElderlyElderlyElderlyElderly

Guideline to Guideline to

ImplementImplementImplement Implement

Healthcare Healthcare

Service for the Service for the

ElderlyElderlyElderlyElderly

• S.O.PS.O.P• Activities• Elderly friendly facilities• Targets/indicators• Targets/indicators• Committees

Issues / Constraints Issues / Constraints

(what works and what doesn’t?)(what works and what doesn’t?)

‐manpower, manpower, manpower

( )‐ (money) ???

lack of interagency collaboration:‐ lack of interagency collaboration:e.g. multiple agencies do training

KKM – carers

JKM volunteersJKM – volunteers

other NGOs – carers

‐ Stigma for the older person:

• are not always accorded appropriate attention or treatment because their ailments are considered to be the result of age itself.

‐ Older persons often described in terms of:• cost factors,cost factors,• burden of the future d d t i di id l• dependent individuals,

• lacking social autonomy, neglected, and a burden to the producing world.

O di t f h i ld l h th i‐ One coordinator for research in elderly heath issues

‐ Issue on old folk home which have nursing gactivities

C tl t t Currently two acts

‐ Laws to protect elderly (Child Law)p y ( )

‐ Power of Attorney, elderly abuse issues, work di i i ti /di i i ti t k ldiscrimination/discrimination at work place, driving, etc.

Global Global CommitmentCommitment

•Vienna International POA on Ageing 1982g g•Health of Elderly Report 1989•Brasilia Declaration on Ageing and Health 1996•Brasilia Declaration on Ageing and Health 1996•Madrid International POA on Ageing 2002A ti A i A P li F k 2002•Active Ageing – A Policy Framework 2002

•Beijing Declaration•Asia Pacific International POA on Ageing•……………… Note: POA = Plan of Action

Having said so ……..Having said so ……..g g

* * * * *• Healthy Ageing / Successful Ageing /

Active Ageing*

• Ageing Process and Process Of*

• Ageing Process and Process Of Ageing *

• Add Years to Life and Add Life*

• Add Years to Life and Add Life to Years*

International Day of Older PersonsInternational Day of Older PersonsInternational Day of Older PersonsInternational Day of Older Persons

•1st October 1991

2015 Th•2015: ThemeSustainability and Age Inclusiveness in the Urban Environment

82

When she is 18 ‐ She is a football, 22 men going after her.

WOMANWOMAN

, g gWhen she is 28 ‐ She is a hockey ball, 8 men going after her. When she is 38 ‐ She is a golf ball, 1 man hitting on her. When she is 48 ‐ >She is a pingpong ball, 2 men pushing to each other. At the age of 60?

MANMANMANMANAt 20 ‐ A man is like a coconut, so much to offer, so little to give. At 30 ‐ He is like a durian dangerous but deliciousAt 30 He is like a durian, dangerous but delicious. At 40 ‐ He is like a watermelon, big, round and juicy. At 50 ‐ He is like a mandarin orange, the season comes once in a year. At 60 ‐ He is just like a raisin dried out wrinkles and cheapAt 60 ‐ He is just like a raisin, dried out, wrinkles and cheap.

S h t ld lik t b ?So what would you like to be?

Ageing is a privilege and a societal achievement. It is also a challenge, which will impact on all aspects of 21st century society. It is a challenge that cannot be

addressed by the public or private sectors in isolation: itaddressed by the public or private sectors in isolation: it requires joint approaches and strategies.

Take HomeMessageTake HomeMessageTake Home MessageTake Home Message

•• If you want to go fast, If you want to go fast, go alone. •• If you want to go far,If you want to go far, go together.If you want to go far, If you want to go far, go together.

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