The realisation that our social services and pensions systems may soon become unsustainable and inadequate for our aging society has brought about a package of measures aimed at managing the cost of aging by reducing benefits, increasing contributions by those still in employment and extending the retirement age. While this has understandably caused resentment in those who have to pay for this cost, the more negative aspect of this approach is that it prevents innovative ideas on active aging from being accepted.
An aging population will increase pressure on health services- John Cassar White
The concept of “active aging” is relatively new, but it is much more than a buzzword coined by organisations that deal with socio-political issues. The World Health Organisation defines active aging as: “The process of optimising opportunities for healthy participation and security in order to enhance quality of life as people age. It applies to both individuals and population groups”. Contrary to the “productive aging” paradigm that looks at the challenge of an aging society as an issue of cost management and benefits rationing, active aging promotes the integration of older people in the economic and social life of their country in a way that they actively contribute to their own an society’s wellbeing.
If active aging is to be embedded in our social policy, it needs to be ingrained in our labour market practices, in our health care system, and in our pensions system. We also need to learn from the mistakes that have already been committed in some countries that pioneered changes to promote active aging. I am referring in particular to the liberalisation of the labour market through measures that rather than encourage new employment have been used to shed workers, especially older ones.
A major reform in labour market practice that is bound to encourage the concept of active aging is the insistence on more “activation” – giving older workers, whether employed or not, a chance to upgrade their skills in an effective way to make them employable. Despite legislation against age-discrimination, we need far more “activation” measures targeting older workers who should be given more opportunities to retrain and improve their skills thereby becoming more employable. Opening up training possibilities to older workers is not just good for employees. Employers can benefit as it may avoid them losing experienced employees who can help to train and mentor younger colleagues.
Another reform that could help older workers to continue to contribute in the labour market is the promotion of the concept of gradual retirement whereby older workers who wish to continue working, but work fewer hours, will be encouraged to do so. Flexible working does not just refer to working hours, but to opportunities for older people to adapt their work to their stage in life through job-redesign and lifelong learning. Job-redesign means adapting a person’s role to their capabilities, for example an older person may want a similar role, but one that is less physically demanding.
Quality housing is a health determinant. Older people’s health and wellbeing can be negatively impacted by their housing because it is too difficult or expensive to heath properly in winter, is difficult to navigate due to lots of stairs or inconvenient layout or is badly situated for public amenities. As people age, housing modifications may be needed to compensate for declining functional capabilities.
On the health care front, health care management should move away from the present focus on cost-containment through cutting budgets or rationing services as these measures are designed to manage the rising cost of health care today, but not necessarily deal with the health care demands of tomorrow that will arise because of demographic change. The focus of active aging based health care should be “to reset priorities from curative medicine to prevention and promotion of public health”.
An aging population will increase pressure on health services. We need to create a right mix of care services aimed at helping people out of hospitals and in the community through the use of tele-care, tele-health, and home adaptation, supporting healthy aging through diet, exercise and fall prevention. There is also a need to create effective care pathways – aiming for a smooth pathway for frail older people including anticipatory care plans, managed care networks, and implementation of a dementia strategy.
But active aging will only materialise if society tackles the prime issue of discrimination where older people face pervasive and ubiquitous discrimination in almost all spheres in society: in the labour market, out of work and in the social services system.
jcassarwhite@yahoo.com