Presentation given at International Association Homes and Services for the Aged (IAHSA) conference, Shanghai, 2013

1. International Association of Homes and Services for the Aged
conference
“Connecting our Global Community”
Shanghai
18th October 2013
Mark Gorman
Director of Strategic Development
HelpAge International

3. The 21st century is the century of aging
“The new millennium closes the first chapter in human history:
when we were young” (Paul Wallace: “Agequake”)
Life expectancy is extending worldwide, fertility rates are
falling, and demographic ageing is accelerating “The ageing of humanity across the world is a defining stage in
history. It will change everything from business and finance to
society and culture”

4. Global ageing is a triumph of human development
Twentieth Century advances...
Health and sanitation
Education
Poverty reduction

5. Development progress...
more people are surviving childhood
more women are surviving childbirth
fewer children are being born...
...and people are living longer

6. Scale and rate of global population ageing

7. The deficit approach to ageing
strained pension & social security
systems
increasing demand for acute & primary
care services
increased need for long-term and social
care
Reduced family care and support

8. A global aging crisis?
Many low- and middle-income countries are said to
be “growing old before they grow rich”
Media headlines on aging...
“Aging population may explode global economy by
2050”
“Silver Tsunami”
“World faces ageing population time bomb says UN”

10. The “burden” of old age
For the state - fiscal load of income support and health and social
care costs
For individuals - care-giving effort and stress.
The “burden”…
“tends to simplify relationships... between age-groups ...or
between a carer and an older person, and communicates senses
of a nuisance and an excessive charge”

11. Ageing is largely ignored as a global challenge...
a lack of preparedness (governments and societies)
fear of old age & a wish to avoid it
a reaction against older people
fear-mongering today reinforces a fatalist approach to the
future

12. Old age is seen as a disease
older people frequently report this attitude among health staff
Older people are seen as a problem
economic pressures are challenging traditional caregiving
Older people are seen as a threat
destabilising economies and societies

14. A new view of old age
Attitudes to ageing formed when there were far fewer old people
Changing social structures over the last century In “developed” world education, work & retirement - the normal
life-course
For the majority in developing countries lifetimes of work, a short
“old” age in poor health, & an early death

15. Life-courses are changing dramatically
Longer working lives in the developed world
A long old age is increasingly expected in the developing world
Many older people remain connected to family & community...
...And play active roles in community life

17. A new view of old age
Focus on the individual and not the age – her/his capabilities and
assets, not deficits
Old age is not the problem...
...Societies need to adjust– social structures, physical
environments, attitudes

18. The Millennium Development Goals
Poverty
Education
Gender equality
Child mortality
Maternal health
HIV & AIDS
Sustainability
Global development partnership

19. After the Millennium Development Goals – what next?
From 2015 Sustainable Development Goals
Not just developing countries - collective responsibility for global
future
Aim - raise living standards and control the global burden on
natural resources

20. “… As the international community embarks on...the post-2015
development agenda, it is clear that the issue of population
ageing should be fully addressed as part of this process”.
Ban Ki-moon, UN Secretary-General

21. Ageing in the “post-2015” agenda
a forward-looking global agenda on health, poverty, rights, the
environment -
must recognize demographic change and global ageing
needs a life-course based, inclusive approach

23. A UN Convention on the rights of older people?
Growing concern over challenges to older people’s rights…
…and abuses – physical, social, financial
UN review of the Madrid International Plan of Action on Ageing -
major obstacles to older people’s “participation, inclusion & social
integration”, including discrimination and abuse

24. Care in old age
A sense of crisis growing numbers of oldest old
growing numbers living with dementia
reduction in family-based care
challenges to division of health care & social care
rising costs

26. the great majority of care will continue to be given & received in
older people’s own homes and communities
care will be provided informally, by family, friends and
neighbours,
and in an ideal world...
supported by formal local services - community health & care
care workers, in community centres etc.

27. Working with family caregivers
Problem
HIV pandemic in Africa and SE Asia - older people caring for
family members living with HIV, and orphans and vulnerable
children
many older carers have care needs themselves

29. Response
a training program for older carers
They trained others - basic nursing care, counselling, pain
control
Information on HIV and available services, nutritional advice
for people with HIV, drug administration, referrals
Support groups to combat the stigma felt by families
Older carers increasingly offer a wider community resource

30. Utilising community resources
Problem
Increasing isolation, family separation due to migration, work
requirements
Lack of community-based facilities – health and community
centers

32. Response
Village-based older people's associations - foster social bonds
and help older people to support each other
training on older people's health
“age-friendly” health consultations
training on home-based care
home care volunteers for frail older people

33. In Cambodia, “National Guidelines on Home Based Care”
endorsed by government...
...a model for care at home for the most vulnerable older
people
Key need – to be closely linked to public service provision –
family/community care also needs formal care service support

34. Care in emergencies
Problem
Older people are especially vulnerable to
natural disasters
conflict
long-term crisis – drought, food shortages

37. Response
In Colombia, Peru & Bolivia...
Representatives from older people’s associations trained in
emergency preparedness
Teams of older people (“White Brigades”) have been set up for
disaster preparedness (awareness, training)
disaster response (rescue, rehabilitation)

38. Working together?
“to create a peer network so that providers around the world
can learn from one another and have a forum to share
innovations and best practices.”

39. Thank you

40. Photo credits
Haiti: F. Dupoux/HelpAge International 2011
Bangladesh: Antonio Olmos/HelpAge International 2013
Singapore: Jerry Wong/Flickr 2013
Tanzania: Jeff Williams/HelpAge International 2011
Cambodia: Joanne Hill/HelpAge International 2010
Tanzania: Jeff Williams/HelpAge International 2011
Cambodia: Nile Sprague/HelpAge International 2007
Bolivia: HelpAge International 2012