THE population of Malaysia has been projected to increase from 18.4 million to 33.3 million between 1990 and 2020, an increase of 80%. The aged population (people 60 years and above) is expected to increase from 1.05 million in 1990 to 3.26 million over the same period, an increase of 210%.
For us, there are serious problems and challenges ahead given that the absolute and relative number of our elderly is increasing. Nur Syahidah Abdul Jalil in her article “The need for a strong ageing support system” (The Star, Jan 3) rightly stressed that our increasingly elderly population challenges not only our nation’s economy but also, and most importantly, our humanity.
The physical and social changes associated with ageing are combined with the debilitating effects of acute and chronic diseases. For carers at home or outside, such as hospitals, it is a time-consuming and sometimes frustrating task to care for patients with Alzheimer’s and dementia, which is estimated to affect at least 5% of our population aged 65 years and above. The increasing number of these patients has important implications on the country’s resources, including budget pressures to build more hospitals.
Our healthcare system is mainly geared towards short-term care and hospitalisation. The elderly with their chronic diseases and problems require long-term care. Thus, our present healthcare system is somewhat inadequate to service the elderly with their chronic diseases and disabilities. While we have quite comprehensive medical and healthcare services for the general population, special programmes for the aged are lacking. This is in part due to lack of trained personnel in geriatric healthcare.
Healthy ageing depends on maintaining good health from young via a healthy lifestyle. Sound health and nutrition education and counselling must be properly targeted.
But ageing is not a disease and early intervention is intended mainly to enhance self care and self respect. It is important to be effective (doing the right things) and also efficient (doing things right) to properly help the elderly and also to contain rising health and medical costs.
The main aim in caring for the elderly is to help them have a full life for as long as possible. To achieve this, quality of life issues such as work, retirement, housing, family, community and leisure activities have to be proactively addressed. Continued casual or part-time employment for the elderly would result in higher morale, keep them healthier and reduce the burden on healthcare.
Increasing participation of females in our labour force also means the traditional expectation of women looking after their elderly may need to change. Allowing women casual or flexible work arrangements would help in this case.
Services that enable the elderly to remain in the community, which include day-care centres and day hospitals, social clubs, rehabilitation, counselling and advice centres, volunteer schemes and home nursing, have to be properly coordinated to keep costs reasonable while ensuring sound delivery outcomes. It is useful to note that Malaysia, spent about 2% of its GDP for healthcare (1994) while G7 countries spent between 5% and 8%. Hence, the Malaysian healthcare delivery service must improve as we progress into developed nation status.
No doubt our aged population will have its own unique problems and challenges, and addressing them would require the sharing of responsibilities among all stakeholders including the Government, private sector, non-governmental agencies and the community. Remember, we will all become old and vulnerable and will require geriatric healthcare at some point in time! We have a good reputation for helping worthy causes and we have to extend this to properly looking after our ageing folk. In this regard, it helps to heed Nelson Mandela’s words that a society is judged not by how it treats its highest citizens but how it treats its most vulnerable people.
NGEOW SZE LOONG