Challenges of the twilight years

Old age can be a boon or a bane. In later life, people become particularly vulnerable to inevitable changes. These changes affect their health, income and independence, their economic situation and a series of combined challenges that could determine the outcome and quality of life associated with old age.

Sadly, many older people could and do become susceptible to exclusion from a number of determining elements that could relatively cushion some of the discomforts associated with growing old.

These factors could be anything from material resources to social relations, civic activities and sometimes even basic services.

Europe is an ageing continent. Its population is decreasing rapidly as a percentage of the world population, due mainly to falling fertility rates and longer life expectancy.

Forecasts predict that the median age of a European will increase from 37.7 years (2003) to a staggering 52.3 years by 2050. Just to make a comparison, the median age of Americans will rise to 35.4 years in the same time frame.

The situation is by and large replicated throughout the continent with some countries experiencing greater declines than others. Some of the worst hit are Italy, Spain and Russia.

A number of factors have resulted in this new reality, which has social, economical and political implications that are slowly but surely transforming the fabric of European society.

Facing up to the combined challenges of demographic change, globalised market economies and an ever-changing family lifestyle puts to task even the most efficient and forward-looking social welfare policy plan and, evidently, threatens the infrastructure of any healthcare system with the best of intentions.

One accepts that policies are specific to cultural, historical and political contexts. In this sense, each nation confronts the issue of old age in a particular way. What works well in one country does not necessarily do so in another.

Nevertheless, almost all European nations share similarities in institutional structures. Grappling with this reality highlights the necessity of putting in systems that cope with such challenges. Malta is no exception!

As in other countries, Malta is experiencing the double whammy of declining birth rate and the phenomenon of the retiring "baby boomers". As the fertility rate decreased from 3.0 children per mother to 2.6 in the space of 10 years (1995-2005) the average age in Malta rose from 35.7 years to 38.5 years in the same period with noticeable increases in the 50 to 80 years-plus brackets. Hence, it is projected that by 2015 the overall population growth will slow down with over 18 per cent of the population being over 65 years, a percentage that will apparently rise further to 22 per cent by 2025. That is almost one in every five.

Here again, the implications on this tiny country are amply clear. The most pressing challenges are the dependency of the welfare system on a dwindling workforce as opposed to rising costs for caring for the old. A further imminent consideration is the ever-expanding need for healthcare services and housing of our elderly. One should only look at the inevitable waiting lists for housing for the elderly to understand the present conditions. All this in view of the fact that the state and the private sector are forking out millions of euros to develop and extend old people's homes.

Coping with this financial and social burden will not be a mean feat. In a sense we are still reacting to the problem rather than setting down specific ground rules that will alleviate the problems ahead.

So what is the way forward? Clearly, maintaining a status quo is a non-starter. It is abundantly evident that for this challenge to be overcome it will require the joint responsibility and participation of the welfare state, the family, the market and the voluntary sector. It would be foolish if any of these participants were to abduct their duty. The thrust of the current reforms and developments can only mitigate the present problems and one hopes that the dumping of relatives at Mater Dei Hospital will not continue to be a reflection of a society ignoring its responsibilities.

In the case of state aid, one could safely say that these resources are pretty stretched to the limit. Telecare, home help, transportation services, day care centres and programmes such as meals on wheels promote the concept of independent living. So do tailor-made schemes that encourage the elderly to remain as much as possible within their community. In my regular visits to old people in their households, it is evident that many of them would prefer to remain in their surroundings. Make no mistake, a fair number of them have an immeasurable fear of the night and the accompanying sense of insecurity. In this sense, the idea of night shelters needs to be evolved much quicker. Local councils could be pivotal in making these programmes a success.

Yet, it is possible that all this is still not enough. In this context, the collective responsibility remains paramount. If we wish to maintain and improve the quality of living of the elderly, then, the effort must be carried by all of us. The elderly deserve nothing less than a comfortable, content life where peace of mind reigns supreme.

info@carolinegalea.com