It’s important to future-proof care of our elderly
From：The National View：694 Date：2015-02-02
Traditionally, Emirati families take care of their elderly. It’s a social value driven by our religion, which obliges us to be good to our parents, particularly as they grow older and require attention. Since most families are extended, the elderly find the attention and company they need at home among their own relatives as they grow infirm or suffer health problems.
But modernity and rapid social change has affected the UAE’s social structure. Nowadays, the nuclear family has become the dominant family structure and women are joining the workforce in ever larger numbers. Such social change has, in many cases, weakened the bonds that once united the extended family.
Caring for an ageing family member can be a very stressful task and sometimes entails a big financial burden as well. Office-workers may sometimes find it difficult to properly care for elderly relatives – all those hospital appointments, meal times, medication schedules.
Even though we can all agree that adult children should bear some responsibility for their elderly parents or at least ensure that they have home nursing, we need to acknowledge that there will be gaps in care.
If we take an idealised view of the situation, we won’t be able to see there is a growing problem in our society.
This is why remarks made by Princess Haya bint Al Hussein during the recent Leaders in Health Care conference are important. This year, the conference focused on geriatric care in the region. The wife of the ruler of Dubai said that this is one of the most significant health challenges facing our country. She said that “the current local system will be unsustainable if not changed over the next 20 years”.
She is right because the demographics of the UAE are changing. Currently, 61.5 per cent of the population is between 25 and 54 years old; 3.1 per cent is between 55 and 64 and only 1 per cent of the population is over 65. By 2050, the picture changes substantially and 34 per cent of the population will over 65 years.
Another factor to consider is the decreasing fertility rate. People in the UAE, as in some other countries, are having fewer children. The fertility rate here, according to the CIA’s World Factbook, is now 2.36 children per woman. This means a responsibility that was traditionally divided between many adult children will increasingly fall to fewer people. This is where nursing homes could come in. They are frowned upon in our culture but they might be a better option than leaving elderly people at home without proper care.
We could probably learn from Japan, a country that has one of the most elderly populations in the world. Traditionally, it relied on individual and familial support to care for the elderly. In fact, Japan had no publicly-funded social care until 2000. But the traditional approach started to fail when many more cases of neglect and abuse of old people started to come to light. Many elderly people were subject to what was called “social hospitalisation”, which meant that they were being admitted to hospital for long periods even if they didn’t really need medical care. This was simply because they could not find the care they needed anywhere else.
As a result, the Japanese government made radical changes to its policy of caring for the elderly. Instead of depending on family members, long-term care insurance was introduced. It provided care to those over 65, depending on their own needs, funded partly through compulsory premiums for people over 40. Users are required to contribute only 10 per cent of the cost of the service.
This seemingly simple move resulted in a massive cultural shift. Like in the UAE, there was great social stigma attached to putting elderly parents in a care home but no stigma attached to admitting them to hospital. Nowadays, more people accept the fact that sometimes community care could be better for the elderly than neglect or non-professional care from a stranger at home.
It’s good that health authorities are working on expanding medical infrastructure and improving geriatric care in hospitals by attracting more trained specialist doctors and trained nurses. But just as important is social care, which should be as accessible as health care.
The country has to start planning more care facilities before it faces greater pressure a few decades from now. More rehab facilities and day care centres, as well as home services, are needed to accommodate those in need. Even if most of our elderly don’t need this now, many might need it in the future.