KUALA LUMPUR, Oct 9 – Care is a basic human right that everyone will need at some point in their life so caring should be a shared responsibility, said associate professor Dr Rahimah Ibrahim, director of the Malaysian Institute on Ageing (MyAgeing) at Universiti Putra Malaysia (UPM).
Speaking on a panel for a special broadcast by Asto Awani in conjunction with the International Day of Older Persons last October 1, Dr Rahimah said that when it comes to addressing the long-term care needs of the country’s ageing population, a comprehensive approach was needed, involving cross-sectoral collaboration.
“And for this, we need integrated health and social services. And we should look at care as something needed across our lifespan.”
Strain On Low-Income Families
Dr Rahimah said the majority of Malaysians are cared for by family members, which can put a strain on the family, especially in low income households that are struggling to make ends meet.
“If you need any form of formal services or help or support at home, most of these are coming out of pocket by older persons themselves or the family members. So this is commodification, meaning that families have to pay for services that are beyond their ability to provide. So it’s not a viable solution for everyone,” she said.
“Of course, for those who can afford care or can purchase care from the market, it shouldn’t be a problem. But for everyone else who can’t afford basic quality care, it could mean that we are also pressuring the families to provide beyond their means of doing so. And that is why we need good community-based care that can help support families to play their role.”
Lily Fu, gerontologist and founder of Seniors Aloud, an online community for senior citizens with over 16,000 followers on Facebook, said while everything begins from the home, “the core family unit is no longer existing to the extent that it formerly was. It is kind of breaking up and because of that, we need to focus on where to get external care for seniors.”
She said in Singapore, domestic helpers are afforded training as caregivers because they’re the ones who are going to be at home looking after elderly parents while the children are working.
In Malaysia, she said the focus will be on NGOs and foundations to provide external care for the elderly. However, Fu pointed out that there was still an accessibility issue with many people not aware of what resources are available and which organisations to turn to for affordable care.
Practise Universal Design For Age-Friendly Infrastructures
While studies have shown that the elderly in Malaysia prefer to age at home, this also raises questions about whether the infrastructures currently available can accommodate their needs.
Fu said developers have to take the lead on this by practising universal design. Universal Design is an inclusive design philosophy aiming to create products, services, and environments accessible and usable by as many people as possible, regardless of their age, ability, or status in life.
“Simple things like the width of the bathroom door for wheelchair accessibility, non-slip flooring. So all this comes into place. But for the average family household, it’s something maybe beyond their ability to afford,” she said.
“So the government has to start with the low cost houses, PPPR, upgrading what is already existing as infrastructure. And I think we need more companies to come in.”
Dr Rahimah added: “Additionally, we need support for home retrofitting or modification of existing homes that are not built to support ageing in place, especially for split-level homes.
“The way that we design homes in the past is based on a more youthful idea, not taking into consideration the functional impairment or decline that we may face as we grow older. So these kinds of situations, for example, changing from a squatting toilet to a sitting toilet.”
Increasing Number Of Elderly Suffering From NCDs
While the average life expectancy of Malaysians have risen to 76 years, the increasing number of older people suffering from non-communicable diseases (NCDs) means that the elderly are projected to live with poor health, typically at the end stage, for about 10 years of the average life expectancy.
According to the Alzheimer’s Disease Foundation Malaysia (ADFM) in 2020, the population of persons living with dementia is estimated to be at 204,000 to 264,000. This number is expected to increase by 312 per cent to between 637,500 to 825,000 cases by 2050.
“Dealing with NCDs per se is not going to be sustainable over the long run,” Dr Rahimah said. “It costs a lot. As people age, and with additional issues like the burden of disease and also the risks for disability, there will be a burden of health care and also the need for long-term care.
“So that is why at MyAgeing, we tend to promote policies that look into how to ensure older persons remain active and also healthy as long as possible, so that we will have a better healthy life expectancy.”
Be Responsible For Your Own Health
Fu echoed this sentiment. “Our (Seniors Aloud) motto is actually: be responsible for your own health. Start now, as early as possible. Because that will prevent being very, very sick and spending the last few years of your life in hospitals requiring nursing care and so forth.
“Why not focus on being healthy? Engage in activities. For example, in our community, in just one month alone – just talking about exercising and outdoors – we have more than 50 activities.
And that’s only outdoors. We have others (for) mental stimulation. We’ve got board games, bridge, scrabble, all that. The whole package is there to help seniors.
“And I’m also happy to say that right now, there’s a lot of awareness being built to take care of yourself, grow old well, age well, all that.
“This is, compared to maybe 10, 20 years ago, (when there was) nothing. So we are, I think, on the right path now, finally.”
