By Huda NV
Decades of growing processes cease with ageing — an inevitable phase of life if you live long. Thanks to enhanced healthcare available today, people are living longer. The World Health Organisation has announced that the world will have more people who will live to see their 80s or 90s, now, more than ever before.
The ageing of the world’s population — in developing and developed countries — is an indicator of improving global health. However, WHO still stresses that the healthcare should go beyond therapeutic care and should include complete well being of the elderly. The focus should be to add life to years, rather than adding years to life.
Ageing is not a disease; it is the accumulation of changes in a person over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline. Reaction time, for example, may slow with age, while knowledge of world events and wisdom may expand.
The world’s population of people 60 years of age and older has doubled since 1980 and is forecast to reach 2 billion by 2050, according to WHO data. Between 2000 and 2050, the proportion of the world’s population over 60 years will double from about 11 percent to 22 percent.
In many traditional societies, the elderly population is respected as “wise old men.” In Eastern societies, the old population is respected and is taken care of by the family, and hence does not pose a major social problem. These people are still able to play a crucial role in social life, especially in light of religious teachings, customs and traditions that calls for respect for this section of the society.
However, older people in other societies may not enjoy the same amount of respect. They can be marginalised, forced to retire at a certain age or potential employers can stereotype the older people as being less active and less valuable.
Even changes in the society as migration of rural population to urban areas, inflation, the associated changes in the customs and traditions, and the disintegration of family ties, can lead old people to be marginalised within society or families. Generation gap, strained relationships and retirement age, that effect financial situation, have major impact on the physical, psychological and social conditions of the elderly.
Demographic changes and new challenges
The main health burden for older people is non-communicable diseases. Already, even in the poorest countries the biggest killers are heart disease, stroke and chronic lung disease, while the greatest causes of disability are visual impairment, dementia, hearing loss and osteoarthritis. Disabilities and chronic health problems carry high risk in old age.
About 65 percent of the total number of people who are visually impaired are 50 and above, and this age group includes approximately 20 percent of the world population. With increasing number of elderly people in many countries, there will be more people at risk of visual impairment due to ageing.
Some even believe that senior citizens do not deserve health care. This notion is brought about by the intuition that all problems in old people are normal part of ageing. However, they should understand that age does not cause, for example joint pains; the effects of ageing are restricted to physiology/ body functions.
Furthermore, many of them have developed a non- communicable disease which causes the onset of other non- communicable diseases and its complications leaving them either blind or with one limb or no limb at all to allow them to move around freely and protect themselves.
Senior people have the same right to enjoy the best possible health care, which includes rehabilitative and preventative care, apart from treatments.
Added to this, elderly population is at risk of abuse at a global level. Some four to six percent of the elderly in developed countries faces some form of abuse at home. This includes restricting the elderly physically, and depriving them of dignity and care. There are a lot of stories of elderly people neglected by their family members, loneliness after the death of a spouse or child and depression because they are excluded from everyday decisions in life. This can lead to long-term psychological effects.
The need for long-term care is rising, according to experts. The number of older people who are no longer able to look after themselves in developing countries is forecast to quadruple by 2050. Many of the very old lose their ability to live independently because of limited mobility, frailty or other physical or mental health problems. Many require long-term care, including home-based nursing, community, residential and hospital-based care.
According to data released by Qatar Statistics Authority (QSA), there are 33 Qatari senior citizens who are aged 100 or more. They are part of the 7,347 citizens aged 65 years and above — 3,506 men and 3,841 women. There are 13,817 senior citizens in Qatar. Of them 6,470 are non-Qataris — 4,643 men and 1,827 women.
Some 12 citizens and 11 expatriates are at the Qatar Foundation for Elderly Care. Another 64 Qataris and 38 non-Qataris are admitted in Rumailah Hospital and 64 Qataris and 38 expatriates are at the Hamad Medical City.
Qatar through its laws ensures protection and support for the elderly population. The senior population is also given special emphasis in all aspects of the National development Strategy.
“Within the Qatari society, the same respect and care is given to the elder members of the family as before,” said Dr Moza Al Malki, noted Qatari psychologist.
“Elders are rarely put in care centres. They are in hospital only in case of medical need, and are rarely separted from families,” she said.
According to her, a proposal to have an old age home established here was rejected by number of Qataris, as they did not want new trend of discarding elders in these centres to develop here.
“There are very few cases of families abandoning their elder members these days. Most of them are here because they need to have medical attention. Families are becoming aware of old people and their role in the community, and their need to live in the community,” said Dr Hanadi Al Hamad, Geriatric Consultant, HMC.
However, there are instances when it is better to keep people here than sending them back home. There are situations when all the member s of the family are working, and there is no one to help them. In some cases, there is only one maid to look after the elder member, and it is a difficult situation to handle. So we often study the background of patients to see if they are fit to be at home,” she said.
Experts call for more education on elderly needs and training on elderly care, in Qatar. Often, lack of any training and regulations to take care of an elder person in a society, is seen as an indictment of the low priority society places on the needs of the elderly.
Most of the families do not know how to look after the vulnerable elderly and given the busy work schedules, families are finding it difficult to keep the old ones at home, according
Caring for older adults requires specific caregiver training to protect the care recipient’s functional abilities and health. For example, there is always the risk of being injured by using poor body mechanics when lifting or positioning a person, so training in the correct lifting techniques is especially important.
“Make it safe for our seniors as we do for our babies. Both age ranges are more vulnerable than most adults. Care provided by the family attempts to satisfy the needs of older persons. But with changing social and economic configurations, older persons are most of the time left in the care of strangers i e people who are not properly trained to be caregivers,” said Dr Al Hamad.
There are medical reasons for placing a special focus on the elderly, as their condition is often complicated by their being on many medications, having more than one sickness and being unable to express what is wrong with them clearly. The reason why seniors are asking for help is because they are more vulnerable.
“There is need for more education and training in taking care of elders. Every aspect of an elder person is different from a normal adult. There is difference in the cognitive power, dietary need and also psychological needs. Caring for elderly and dealing with them is something that needs more training. Often they should be considered as babies,” she said.
The Qatari government gives the elder population much protection and rights. Also there are number of organisations supporting old people in
“At HMC there are various rehabilitative and therapeutic facilities especially for elders. However, most of the people are not aware of these facilities. The government also gives monetary support to these people. There is need to educate the public about the options before them,” said Dr Al Hamad.
“People should know about the rights of the elderly and help them demand these rights when needed. They should also know about the various support mechanisms the government and other organisations offer to the older people,” Dr Al Malki said.
Added to this, modern technology should be utilised more to help seniors in the community. However, with people becoming addicted to the Internet and other digital media, elders are becoming more and more isolated from the society.
“In Qatar, one of the most common problems the senior people have is the new technology. People are addicted to chatting and other Internet preoccupations, and hence there is lack of social contact with the close family, especially the elders. What happens to the elder people is that they are ignorant of these technologies and so are isolated. This leads to social withdrawal, which further leads to other psychological problems like depression and anxiety,” said Dr Rida Taha Ahmed Abon Elazab, Senior Specialist, health Programme, Communication and Media Department, Health Education Programme
However, these innovative technologies can be used to integrate elders into the society.
“The elders should be trained in using Internet so that they can communicate and spend their time. There are options like skype and social media sites which help them communicate with their peers in different parts of the world. This can help do away with loneliness,” said Dr Al Malki.
“Added to these, families and relatives should treat seniors kindly, give them moral and psychological support, which is more needed than material support. Children should also be taught the value of old people and taught to respect them,” she said.
The reason why seniors are asking for help is because they are more vulnerable. People spend an inordinate amount of time stimulating the imagination of children, allowing them to experience seeing, hearing, smelling, touching and tasting. The elder people also should be given some of that stimulation; perhaps then their sense of isolation could be eased and some of the anger and frustration they feel could dissipate, with this support the society gives.