Over the past century, life expectancy has increased dramatically and the world will soon have more old people than children. This social transformation represents both challenges and opportunities. The theme of World Health Day 2012, April 7, 2012, was “Ageing and Health.”
Countries and health care systems will need to find innovative and sustainable ways to cope with the demographic shift. John Beard, director of the WHO Department of Ageing and Life Course, says that “with the rapid ageing of populations, finding the right model for long-term care becomes more and more urgent.” anniversary of the adoption of the Madrid International Plan of Action on Ageing (MIPAA). The plan is a resource for policy-makers, suggesting ways for governments, non-governmental organisations and other stakeholders to reorient the ways in which their societies perceive, interact with and care for their older citizens, as two billion people will be aged 60 and above by 2050.
Old age consists of ages nearing or surpassing the average life span of human beings. The United Nations World Assembly on Ageing, held in Vienna in 1982, formulated a package of recommendations which gives high priority to research related to developmental and humanitarian aspects of ageing (United Nations, 1987). The plan of action specifically recommends that “international exchange and research cooperation as well as data collection should be promoted in all the fields having a bearing on ageing, in order to provide a rational basis for future social policies and action. Special emphasis should be placed on comparative and cross cultural studies in ageing.”
Many people develop disabilities in later life related to the wear and tear of ageing (e.g., arthritis) or the onset of a chronic disease, (e.g., lung cancer, diabetes and peripheral vascular disease) or a degenerative illness (e.g., dementia). But disabilities associated with ageing and the onset of chronic disease can be prevented or delayed.
The traditional Indian society and the age-old joint family system have been instrumental in safeguarding the social and economic security of the elderly people. However, with rapid changes in society and the emergence of nuclear families in India in recent years, the elderly are likely to be exposed to emotional, physical and financial insecurity in the years to come.
National policy
In view of the increasing need for intervention in area of old age welfare, the Ministry of Social Justice and Empowerment, Government of India, adopted a ‘National Policy on Older Persons' in January 1999. The policy provides broad guidelines to the State governments for taking action for the welfare of older persons in a proactive manner. It defines ‘senior citizen' as a person who is 60 years or above and strives to ensure their well-being and improve the quality of their lives by providing specific facilities, concessions, relief and services and helping them cope with problems associated with old age. It proposes affirmative action on the part of government departments for ensuring that the existing public services for senior citizens are user-friendly and sensitive to their needs.
If ageing is to be a positive experience, longer life must be accompanied by continuing opportunities for health, participation and security. The World Health Organisation has adopted the term “active ageing” to express the process for achieving this vision
During the International Year of Older Persons in 1999, WHO launched a new campaign, Active Ageing, which highlights the importance of social integration and health throughout the life course. Active ageing aims to extend healthy life expectancy and the quality of life for all people as they age, including those who are frail, disabled and in need of care.
Active ageing depends on a variety of influences or “determinants” that surround individuals, families and nations. These apply to the health of all age groups, although the emphasis is on the health and quality of life of older persons. Attaining the goal of active ageing will require action in a variety of sectors, including education, employment and labour, finance, social security, housing, transportation, justice and rural and urban development.
WHO has recognised the need to develop a global strategy for the prevention of the abuse of older people. This strategy is being developed within the framework of a working partnership between the WHO Ageing and Life Course unit of the Department of Chronic Diseases and Health Promotion, the WHO Department of Injuries and Violence Prevention, the International Network for the Prevention of Elder Abuse (INPEA), HelpAge International and partners from academic institutions in a range of countries.
Recommendations of WHO
Promote and live a healthy lifestyle across the life-course. Create age-friendly environments and policies to engage older men and women. Make primary health care age-friendly. Ensure access to health care and rehabilitation services for older people. Adapt physical environments to existing disabilities
Lifestyle choices for Active Ageing should start early in life and include participating in family and community life, eating a balanced, healthy diet, maintaining adequate physical activity, avoiding smoking and excessive alcohol consumption.
It is time for a new paradigm, one that views older people as active participants in an age-integrated society and as active contributors as well as beneficiaries of development.
Dr. Gro Harlem Brundtland, Director General of WHO, says that “there is much the individual can do to remain active and healthy in later life. The right lifestyle, involvement in family and society and a supportive environment for old age — all preserve well-being. Policies that reduce social inequalities and poverty are essential to complement individual efforts towards Active Ageing.”
(The writer is Medical Director & CEO Kalra Hospital. His email ID is dr_rnk@hotmail.com)
