New Age Challenges

Published: Sunday | December 9, 2012 Comments 0

Denise Eldemire-Shearer, Contributor

IN 1962 when Jamaica got Independence, persons had a life expectancy of 65 years. For many, the idea of retirement was unheard of and persons expected to do what they were doing until they died. For the few who had been employed and who did retire, it was a time of rest and relaxation. This has changed.

Today, for most people, the concept of 'the later years' - and to a few persons, the concept of 'old age' - is not one of resting for a couple of years. Today's older persons are more independent, physically and otherwise, than they were 50 years ago. The perception of old age has changed. Once considered a time of frailty and of being in need of care, it is now a time to do the things one never got to do.

Today, at 60, a person going into retirement can expect to live another 20 to 25 years as life expectancy has increased significantly. Improvements in the health and social services have contributed to this. As persons talk about getting older, they refer to 50 as the new 40 and 70 as the new 60. Even scientists have recognised the change. The World Health Organisation has divided older persons into three groups: the young elderly between 65 and 70; the elderly - between 70 and 80; and the old elderly - over 80.

Today's older persons are very active, able to start second careers, and continue as major contributors to family and community. Many grandparents pick up children at school, provide childcare services, and are the backbone of community groups.

gains and challenges

The ageing of the population has come with both gains and new challenges. As persons have aged, the family has changed. In the early years, older persons referred to children as their 'old-age pension' - and it worked. If one had six to eight children, there was usually one, often a daughter, who could stay home 'to look after the parent'. Persons usually lived near each other, making providing care easier. Development has changed this. Many persons only have two or three children; some have none. This is especially true as more and more females are becoming professionals. The work and social environments have changed, so no longer is there a child left at home to care for the elderly.

Perhaps the most important change is how families stay connected. The telephone, especially the mobile, and the Internet keep families close over great distances. The person closest to an older person may live in another country. There are times, especially if there is an acute illness, when an older person needs physical help and the closest relative is simply not available. This is an area of great concern , but at the same time, one that creates an opportunity for the development of affordable, accessible community-support services to help older persons stay at home and function independently as long as possible. Such services can be expensive to develop and maintain, so it is a challenge for the next 50 years.

Perhaps one of the greatest changes in 50 years of Independence is the increasing importance, and the challenge, of maintaining financial independence. The increase in years of life after retirement has caused many to think about how to maintain a good quality of life for their remaining years. While many children want to help parents, they do not necessarily want the help, preferring to maintain their independence.

In the economic climate of the last 20 years, there have been many challenges, beginning with the financial problems of the '90s. Many of today's older persons lost savings then and because this occurred towards the end of their working years, they did not have enough time to regroup. The value of money is not the same today. The returns from investments are lower - but prices are higher. Many older persons live on the edge financially.

As a country, we have not dealt adequately with pension issues. Pension coverage is low for today's seniors - less than 50 per cent, including NIS coverage. Contribution to pension coverage other than the compulsory NIS remains at the same level in 2012 as it was in the late '60s - and the population has almost doubled.The current discussion about financial security after retirement will still be around when the 100th anniversary of Independence is celebrated.

Pension reform - including matters of compulsory contribution and portability - needs Government intervention. Decisions are needed - as unpopular as they may appear.

The pattern of the family has not only been affected by technology, but by development, overall. Jamaica has seen a drift from rural to urban areas. Eating habits have changed with urbanisation and exposure to the lifestyle of others overseas. Fast foods high in fats and cholesterol have replaced the 'root foods' - yam, banana, and home-grown vegetables - of rural living. This has contributed to changes in the health of older persons.

less physical activity

Changes in modes of transportation have had a negative impact on health. There has been a decrease in physical activity, accompanied by an increase in obesity as people walk less.

One of the biggest health challenges is how to reduce the increasing level of chronic diseases as the population gets older. There is a markedly higher incidence of chronic diseases - especially hypertension and diabetes, and the related illnesses of stroke, heart attack and loss of limbs - in older people today. This leads many to ask the question, does the increase in years have to be accompanied by all the health issues? The answer is no. There may be some health issues, but if everyone recognises early what contributes to poor health and takes responsibility to ensure a healthy lifestyle, health issues would be reduced. How can we get the message across to younger persons at a time when old age seems so far away?

The Government has been responsive to the need to provide additional services for older persons. They can access health care at clinics and hospitals across the island without cost. There have been specific programmes to supply medications - the Jamaica Drugs for the Elderly, the National Health Fund, and the Drug Serv pharmacies. Some older persons, however, do not always take advantage of what is available. The ideas of a check-up and practising prevention are not understood by persons born before these services were developed in the '60s and '70s.

More has to be done to inform older persons - in fact, all ages - of the importance of adopting a life-course perspective to ageing, that is, taking responsibility early in life to make choices, which will contribute to good health in the later years. As we move into the next 50 years, more is needed to ensure that older persons are viewed as important in the development of the country. We need to ensure that a growing older population consolidates the gains achieved. There will be challenges as the growing increase in chronic diseases can cause an increase in health-care needs and chronic-care services. Family and other support relationships will need community support services to be able to maintain older persons - especially the very old - in the family unit. Pensions and finance issues will need to be addressed at the national level.

Professor Denise Eldemire-Shearer is senior lecturer in the UWI's Department of Community Health and Psychiatry. Email feedback to editor@gleanerjm.com and denise.eldemireshearer@uwimona.edu.jm.

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