Problems associated with the aged & Measures
Economic Problems :
1) Higher Dependency ratio to meet the retirement and medical needs of the elderly
· Singapore: the cost of running services for the elderly is about a million dollars a year and their lifelong learning programme costs another half a million dollars.
· By 2030, only 3.5 persons will be supporting one elderly in Singapore
· Canada's publicly-funded universal health care system is already creaking at the seams amid increased demand.
· Increasing demands on pension systems.
· Spain's low birth rate and ageing population means it may face problems meeting future pension needs.
· France: Tax take is likely to fall by more than €500 million a year by 2030 due to the state’s ageing population; officials at the Department of Finance have warned the government --> additional pressure on public finances.
· Exchequer revenues would slide.
· State pensions systems face difficulties now, when there are four people of working age to each retired person. By 2030, Japan and Italy will have only two per retiree; by 2050, the ratio will be three to two.
· By 2030 it seems there will be only two Japanese of working age for every pensioner, which means that he will be working all the hours God sends to keep his parents and grandparents in pensions.
"By 2030, one in five Singaporeans will be at least 60 years old. With families getting smaller, we will have fewer children around to support us in our old age. "Part of the answer is to get workers to work longer and retire later. But another part is to ensure that Singaporeans have enough savings to continue enjoying financial security and good medical care throughout our lives.....” Mr Lee Hsien Loong (PM of Singapore)
Measures
· The Central Provident Fund Scheme. Every worker and employer puts in a percentage of the worker’s salary into the worker’s CPF. The CPF can be withdrawn at the age of 55 to meet the individuals’s retirement needs.
· The Medisave Scheme was introduced in April 1984 as a national savings scheme to help CPF members put aside part of their income in their Medisave Accounts to meet their personal or immediate family’s hospitalization expenses, especially after retirement.
· MediShield is a catastrophic medical insurance scheme that enables the individual to \ settle part of the expenses arising from prolonged hospitalisation and certain outpatient treatments for serious illnesses. It complements Medisave savings, which may be greatly strained in the event of prolonged illnesses which require longer-term medical treatment.
· The ElderShield, the disability insurance cover for Singaporeans aged 40 years and older, will kick off on Sept 30 2007. Under the scheme, they will get S$300 a month for five years, as long as they cannot do any of these activities without help - eating, bathing, walking, getting out of bed or going to the toilet. Premiums, payable from Medisave in their CPF accounts, start from S$146 a year for a 40-year-old man. Women pay premiums that are 28 to 41 per cent higher. This is because women live longer, and as a result more of them are expected to suffer from disabilities for a longer period, said Mr Moses LEE, Permanent Secretary at the Health Ministry. ElderShield is an opt-out scheme, so those who do nothing will automatically be covered. (Straits Times 16 Apr 2002)
· in the USA, Florida, there is the Health Savings Programme.
· Medical insurance such as Medicaid (United States), Medical Cards (Ireland)
· In Singapore, the government has also introduced the Tribunal for Maintenance of Parents which empowers the parents to bring their children to court for failure to provide them with financial support.
2) Shrinking Workforce
Paradoxically, despite the labour shortage, older workers often experience economic discrimination, both in the form of mandatory retirement and when they seek new employment. due to the general perception that the old are physically unfit, not agile, less ambitious, less vibrant and not dynamic, less flexible and more resistant to changes and technology
· Canada's population is ageing so quickly that in a decade, there could be more people leaving the work force than entering it, a factor which will pose major challenges for employers.
· Workforce will shrink by a fifth in the next decade—a considerable loss of knowledge and skills.
· The Russian army has had to tighten up conscription because there are not enough young men around.
Measures
· Encourage people to work for longer, and remove the barriers that prevent them from doing so by
§ Increasing retirement age
§ changing the mindsets of the people;
§ Changing workplace policies
§ Providing re-training and upgrading of skills for older workers to ensure they stay relevant economically
Ø Bank of Canada Governor David Dodge urged policymakers to knock down barriers to labour mobility and allow senior citizens to work longer.
Ø A larger pool of volunteers created, given the tendency of older people to donate their time to worthy causes.
Ø Companies should use performance, rather than age, as a criterion for employing people. Rigid salary structures in which pay rises with seniority (as in Japan) should also be replaced with more flexible ones.
Ø Gail Jackson, director of business development for skillsmatch.ca, a job site aimed at matching employers and mature workers, said "flexibility" is the ticket to retaining ageing workers, on grounds many want to stay active and work, as long as they are not confined to a 9-to-5, 40-hour-a-week job.
Ø A long-term solution rests with increasing the productivity of each worker.
Ø Redesigning of jobs to better suit the older workers, Workfare Bonus (for low wage workers) in Singapore
Ø Finland, which has the most rapidly ageing population in Europe has succeeded in raising retirement age from 60.1 years in 2004 to 60.7 years in 2006 with a pension reform introduced in 2005 to ease pressure on the state pension system to support the growing number of retirees. Up till 2005, the legal retirement age was 65 and early retirement was popular. Under the new rules, full retirement is allowed any time between 63 and 68 years of age and early retirement is penalized with a lower pension. The reform also made provisions for more flexible work schemes and work conditions for older workers.
· Tax exemption could be considered for the aged who can run some private businesses after retirement.
· Increase birth rates by providing incentives
Ø The family of every child born in Spain will get €2500 ($3,980) to help raise the country's low birth rate and support the fast growing economy, Prime Minister Jose Luis Rodriguez Zapatero said.
Ø Policies to encourage women into the workplace, through better provisions for child care and parental leave
· Use of medical technology such as ivf to increase fertility. In Denmark it is the large number of artificial conceptions - nearly 4% of all births - that is keeping up the population.
· Increased use of technology and automation to alleviate labour shortage problems e.g. e-banking and commerce, cashless card transactions for transportation and other services; more high-technology military equipment; more automation in industries
· Open doors to foreign talent and ease immigration laws
Ø Spain’s birth rate would be lower if it were not for the arrival of nearly four million mainly Latin American and North African immigrants since 2000 who tend to have larger families.
Unfortunately, high levels of immigration over the past decade have been a contributory factor in driving up house prices and the cost of the social infrastructure. Foreign labour and immigrants also often perceived as taking away jobs from locals.
Inadequate care for the elderly
The elderly often suffers
Ø physically from old age diseases such as osteoporosis, arthritis, heart problems, hypertension, diabetes, cancer, Alzheimer’s disease; loss of bodily functions e.g. incontinence; ;loss of use of senses especially sight (cataracts) and hearing (deafness)
Ø socially as their social circle decreases upon retirement and upon the death of their spouse and friends causing them to feel the burden of loneliness. Their children, if they have any may also be too busy to look after their emotional welfare. Can result in depression.
Ø financially and psychologically as they lose much of their economic independence upon retirement causing them to have low self-worth
Ø This low self worth stems largely from the fact that the new status of the elderly is often poorly defined, and they therefore tend to accept the negative labels that are applied to them. Pejorative terms used to describe the aged (geezer, biddy, chronologically challenged) show the lack of respect and consideration for the elderly due to stereotypes. For eg, it is widely believed that intellectual ability declines with age, but this belief is incorrect. Intellectual capacity remains unchanged until very late in life, and senility affects only 1% of elderly people.
· Yutaka Sakai, head of a local group that reaches out to at-risk residents said that “In Tokiwadaira, go into the men’s after they die and you can see straight away that most can't cook, clean or do laundry. They don't even throw out their rubbish. They have no idea how to look after themselves."
· There are fewer than 200 geriatricians across Canada, yet the need for them is increasing. One of the reasons that is that geriatricians are paid relatively poorly because the standard fee-for-service remuneration system favours doctors who see a large number of patients and perform procedures.
Measures
1) Provision of facilities and recreational activities as well as campaigns to educate and encourage the elderly to lead active lifestyles to remain healthy and to intellectually stimulate their brains to keep Alzheimer’s at bay. Being involved in social and economic activities will also increase their social circle, increase their financial independence and improve their self-worth as contributing citizens.
§ Provide more learning opportunities to seniors. The courses should be short and non-examinable, and on topics that may be of interest to seniors.
§ Printing more large print books and more audio-visual materials that appeal to the elderly.
§ Marine Parade's "Young At Heart" lifelong learning programme is two years old and has already seen more than 500 seniors graduating.
§ Singapore’s The Good Life Wellness Centre, an elderly wellness centre aim at promoting productive ageing, has a membership of more than 650 people and the membership size could increase in number.
2) The aged need affordable elderly friendly housing that is safe, accessible, adaptable and barrier-free. Singapore has constructed flats especially built to cater to needs of the old. E.g. hand rails in toiiets, carpeted floors
3) Increased health benefits and services.
§ More funds directed for geriatric health care services and research into gerontology and how to help to help the elderly suffering from chronic old-age diseases.
§ Subsidised rates for healthcare, wards down-grading, medical fees competition, costs of medicines and alternatives, healthcare spending.
§ Singapore implemented the National community health screening programme for the elderly in July 2000
4) Educate more people to be volunteers to help befriend the elderly by joining organizations such as
Ø The Singapore Action Group of Elders (SAGE), a nonprofit organisation that supports the aged population including employment placement and counselling.
Ø Lions Befrienders, a volunteer welfare organisation that cares for and assists the elderly in coping with the demands of daily living
Ø The Buddhist Welfare Society, a welfare organisation serving the poor and the destitute by providing relief funds and medical care to the aged sick.
Ø SN Home Volunteer, a nonprofit volunteer group offering residential and institutional care for the aged sick and destitute.
Ø Retired and Senior Volunteer Programme (RSVP)
Ø Fei Yue Community Services has a community involvement partnership programme
Ø Realm of Tranquility that provides encouragement of good deeds via a local charity organisation supporting the aged and poor.
Ø Habitat for Humanity in Singapore and Hong Kong have embarked on Operation Homeworks.
§ In Singapore, Operation Homeworks saw important improvements in the quality of the residents’ lives. When volunteers made the premises safer by trunking loose wiring and repairing toilets. Bug infested beds were changed and unwanted clutter removed. Led by HFH Singapore patron S Dhanabalan, some 300 volunteers converged at two blocks of one-room apartments where the poor elderly live in Bukit Merah and Geylang Bahru. The volunteers, including staff of Citigroup, Timberland and Ikea, cleaned up the apartments, painted doors and grilles, replaced damaged furniture as well as removed bed bugs, among other tasks.
· Over in Hong Kong, HFH China is no stranger to the Homeworks idea, given its experiences in two similar programs. In April 2006, HFH China launched a home safety and improvement program to repair 50 run-down apartments for elderly people in Hong Kong. The target was exceeded four months later when a total of 69 apartments for the elderly were repaired in Lower Ngau Tau Kok estate, near to Kowloon Bay. HFH China’s partner was the Hong Kong Sheng Kung Hui (Hong Kong Anglican Church (Episcopal) whose community development center in Ngau Tau Kok implemented the project. Lower Ngau Tau Kok is an old public rental housing estate with more than 37 years’ history and over one-third of its 4,000 residents are the elderly people who live alone. The work done included plumbing and electrical jobs carried out by skilled technicians. Works completed included fixing of peeling ceiling paint, repairs of rickety windows, replacement of faulty sockets, installation of hand rails and new door grilles. The Aberdeen project was completed in December 2006.
In Japan, Tokiwadaira’s residents formed a taskforce to put in place a range of measures
§ E.g. free counselling, a hotline for concerned neighbours and an agreement from newspaper-delivery workers to alert them when papers remain uncollected from mailboxes.
§ Japan: gadgets available for people who are worried about elderly relatives.
§ E.g. "online" kettle that automatically sends emails to up to three recipients when it is switched on, and internet-linked sensors that can be attached to everyday items such as fridge doors and bathroom mats. This enables the support volunteers to sense something is wrong if these gadgets are not activated for a couple of days
5) Promoting close ties within families and community (social network) and changing the stereotyped perceptions about the elderly
§ Annual Senior Citizens Award
§ Public education, reading programmes for senior volunteers to conduct story telling sessions in libraries, campaigns
The Aged
1 million people cross the 60-year mark every month, and of them 80% are in the developing world. There are 70 million people in the world in the age group of 80 years or more in age, and the figure is projected to grow to 5 times its present size over the next 50 years.The reasons for greying population…
Decline in fertility, falling birth rates
o Increasing education opportunities for woman in both the developed and developing countries have increased the number of woman joining the workforce.
o Women are now more career-minded and places career ahead of marriage and giving birth. They marry at a later age or do not marry at all.
o Family planning and contraception is found to be more common.
o Eg. According to UN, the average fertility in the developing world dipped below 3 children per woman to 2.9 and in 20 of the developing nations. There was a steeper decline to only 2.1 children per woman.
o Eg. Feritility rates in Brazil have fallen from 6.15 per woman to 2.27 now.
Population bust following after population boom
o Many countries experienced a population boom in the 1960s to 1970s, but as countries became more developed and advanced, birth rates have decline rapidly, resulting in population bust.
o The number of births is not enough to replace the number.
o Number of aged is greater than the number of young people.
o Eg. In Singapore, the number of births per female fell to 1.24 in 2005, compared to 4.66 in 1965 - meaning population growth is not fast enough to even replace both parents.
Rising life expectancy, decline in mortality rates, increased longetivity
o With advancement in science and technology, improvements has been made and medicines and technologies are now able to prolonged the life expectancy of people and decrease the mortality rates.
o People are now able to live longer with cures and treatment available for almost all illnesses and diseases.
o Eg. According to the WHO, Japan is the country with the highest life expectancy of 74.5 years among 191 countries and Australia follows after with a high life expectancy of 73.2 years.
Better nutrition, higher quality and better healthcare services and facilities
o With improvements made in technology, food is now made more available and thus there is better nutrition for the people. With affluence, people are also able to afford higher quality food and genetically modified food which contains more nutrients for the body.
o Better healthcare services and facilities are available to people and illnesses and diseases can be cured with improvement made in medical equipments and medicines.
o In countries like Singapore, subsidies for the medical fees are applicable for the lower income group to allow them to enjoy the healthcare services.
o With a higher possibility to receive healthcare treatments today, people are able to enjoy longetivity.
o Eg. In Singapore, the public healthcare systems began restructuring in the mid 1980s to provide better healthcare to the people of Singapore through higher quality services, greater medical expertise and increased cost effectiveness.
o Good and affordable basic healthcare are made available at the public hospitals and polyclinics to all Singaporeans through the provision of heavy subsidies by the government. The Singapore healthcare financing system is based on individual responsibility, coupled with the government subsidies to keep basic healthcare affordable.
Increased awareness of the importance of a healthy lifestyle
o Health education are provided in schools today to teach people how to take good care of their health and encourage them to maintain a healthy lifestyle by eating healthily and exercising regularly.
o Eg. Organisations such as the Health Promotion Board (HPB) set up in Singapore aims to build a nation of fit and healthy Singaporeans. HPB assumes the role of the main driver for national health promotion and disease prevention programmes that reach out to the population. Specifically children, adults and the elderly.
Improved standard of living and quality of life
o With improvements made over the years, there is now better sanitation, hygiene, healthcare, food. In addition, the increasing affluence has also allowed people to improve their quality of life in a way such that they enjoy better food and nutrition, and they are able to afford good medical services.
o These have helped to improve life and thus increase life expectancy of people, especially in the developed countries.
Changing profile of the elderly in the developed world.
1) Better educated and have more enlightened views of the world, keeping abreast of world affairs. Hence, able to look beyond parochial interests.
2) More economically independent since they have more income to save, have made wise investments for their old age and often have multiple insurance coverage. In fact, ironically, there is an increasing social trend of the elderly supporting their financially able children well into adulthood e.g. paying for their children’s home mortgages, insurance, education fees of their grandchildren.
3) Lead more active lifestyles as they exercise regularly and have better nutrition. They are actively involved in sports, travel a lot and often volunteer their services to the community. No longer seen as merely useful as nannies to look after their grandchildren.
4) In the US, the elderly take a very active interest in politics and are more likely to vote relative to young people and government policies have been geared to capture the senior citizens’ vote.
5) Businesses have also been set up to cater to this growing consumer market such as health spas, skin care products, travel agencies, recreational centres, retirement communities
6) Legally, the elderly are empowered to make decisions about life and death issues such as the living will.
7) Traditional perspectives on old age as a phase of dependency, sickness and lack of productivity have today been overturned. With better standards of health awareness and nutrition, the elderly are making vital contributions to their societies. The U.N. has put forward the concept of "active ageing" and has called for governments to put in place policies that will keep aged people active for as long as possible, with more opportunities, a supportive environment and a better life.
· The U.N.'s Second World Conference on Ageing was held in Madrid, from April 8 to 12, 2002. The First World Conference on Ageing was held in Vienna 20 years ago. At that conference, an International Plan of Action focusing on the economic, psychosocial and health needs of the aged was prepared, and it called upon governments to approach the issue of ageing with a new sensitivity.
Numerous examples of active senior citizens in politics, business. entertainment industries and community service.
Related essay questions
1) Does the government of your country pay enough attention to the needs of the sick and the disadvantaged?
(in this case, the aged could also form a group under the disadvantaged.)
2) Should we look forward to growing old?
3) Assess Singapore’s success in tackling its population problems.
4) How far should citizens of your country rely on the government rely on the government to solve their problems?
5) The aged are a class to be feared in society. Comment.
6) The older, the better. Comment.
7) To what extent are the young in Singapore favoured at the expense of the elderly?
Compiled primarily by Kiang Pin and Karyn (12/05) with input from Melissa and Shu Yi (07/06) and Li Shean and Fanny (22/06)
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Lishean =))
Sorry for hogging up so much space! hahas
22/06 Forever!
9:35 PM