Are we ready for an ageing population?
by Peter Tan. Posted on January 4, 2015, Sunday
WE will all grow old someday. That is a given. When we are young and working hard to build a career and family, we seldom think about preparing comprehensively for that stage of life other than trying to grow a sizeable nest egg through the EPF, investments and savings.
With better living standards and modern healthcare, we are living longer than before. But comfort in old age requires more than being financially sound although having the means makes it easier. There are age-related issues that cannot be avoided even though we may have led a healthy lifestyle.
With age, vision and hearing declines. Mobility and agility decreases. Bones become more brittle and are prone to fracture easily. Cognitive abilities deteriorate. These are all issues that affect us one way or another as we grow older.
In Malaysia, the Ministry of Women, Family and Community Development defines those above 60 years of age as senior citizens as agreed on subsequent to the United Nations World Assembly on Ageing 1982 in Vienna. A country is said to have become an ageing nation when 15 per cent of the population falls into this group. Recent projections estimate Malaysia will achieve that status in 2035.
With only 20 years to go, how prepared are we in handling issues related to growing old? Two decades may seem like a long time still but going by past records, our complacency in the preceding years will come back to haunt us when we pass that threshold without having put the necessary measures in place.
This article looks at the state of public amenities that allows the independence and mobility of senior citizens to access other critical services such as healthcare, social life and other aspects of living.
An ageing population needs better public facilities, services and social support than are currently available. Facilities and services must be easy to use, safe and convenient. These values which are all encapsulated in the Principles of Universal Design cover the designing of products and facilities so that they can be used by the broadest spectrum of people. Social support like emotional and financial assistance must be easily accessible and not buried under layers of bureaucracy.
In many ways, the requirements of senior citizens are similar to what disabled people need. It was pointed out by disability experts that accessible public facilities in developed countries in Asia like Japan and Singapore were put in place because of the ageing population rather than for disabled people specifically. With that in mind and seeing that disabled people are facing great difficulty in society, we are currently not ready to cater to the needs of senior citizens by any measure.
We have two laws that regulate facilities for disabled people. Senior citizens and the general public can benefit from them as well. What is good for disabled people is good for everyone else. They are By-law 34A of the Uniform Building By-laws covering all states in the peninsula and By-law 110A of Buildings By-laws in Sarawak.
Both mandate all public buildings must provide access to disabled people. The by-laws have been around for more than 20 years and 14 years respectively. It is a crying shame many new buildings and the majority of old buildings within the jurisdiction of the by-laws are still not in compliance with the requirements due to the lack of implementation and enforcement.
Therefore, it is not insolent to cast doubts on the determination of the government in preparing the country for an aged population. Like disabled people, senior citizens needing the convenience of accessible facilities are facing difficulties now. If the situation remains unchanged, many more will experience exclusion 20 years down the road.
The image of the elderly lady getting down from a bus with great difficulty illustrates the many problems senior citizens face. Their desire to lead an active and productive life are restricted by barriers in the public transport system and built environment.
As always, public infrastructure is constructed in a way that does not take into account the diverse make-up of society and the declining faculties of senior citizens. They are also usually poorly maintained, making them unusable and dangerous.
One example is broken pavements with debris that may cause a senior citizen with poor eyesight and unsteady gait to trip and fall, and risk sustaining fractures and other serious injuries. Another example is the lack of connectivity of buses from their homes to places they want to go, rendering them homebound.
According to the Department of Statistics, there is an estimated 2.7 million senior citizens as of 2014. That is a sizeable 8.9 per cent out of the total population of 30.3 million. The World Health Organisation also noted that the world will have more people who will live into their 80s and 90s. As they age, they lose their ability to live independently due to increasingly limited mobility, frailty or other physical or mental health problems. Many need long-term care either at their own home, in institutions or hospitals.
With families becoming smaller, the responsibility of caring for aged and ailing parents may be challenging, especially when children are working and living in another city. This situation is made more difficult and financially demanding when both sides of the family have elderly parents requiring constant care and medical treatments or having to be put up in nursing homes.
And what about married couples with no children and people who opt for singlehood? When they reach the stage of needing care, the options are limited to employing a personal carer or stay in a nursing home. Personal carers are usually domestic helpers from neighbouring countries trained to assist in the activities of daily living.
Rates for private nursing homes start from RM1,200 per month excluding medical treatments and other recurring expenses. The total monthly expenditure can amount to more than RM3,000. This is beyond the means of many senior citizens. There is an urgent need for a better support system that is affordable and one they can fall back on in times of need.
Support extended to senior citizens must ensure that their dignity is preserved and a reasonable quality of life assured. After all, they contributed to nation in their prime. It is not too much to ask that the nation properly provides for them in their golden years should they require it.
A lot can be done in 20 years as we head towards that point in time. But if we wait until then to do something, a large proportion of the population will face difficulties in being independent in the meantime. Now is as good as any other time to start building for a future we may all need to depend on one day. We can still make it.
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