Dec 17, 2014 10:05:37 AM
According to the World Health Organization (WHO), there will be over two billion people aged 60 or older, worldwide, by 2050. That's a staggering number of people who will need additional care and it represents, as the WHO noted, both a challenge and an opportunity.
Senior care in the United States is approached in a very different manner than it is in other countries.
In fact, the United States and other developed, Western countries lag behind other nations in some respects when it comes to providing future care. Here's a look at some of the lessons we can learn from abroad.
A high national GDP doesn't equate to better senior care.
Per the WHO, an estimated four to six percent of older people in developed, high per capita-income countries have experienced some form of abuse or mistreatment at home. Maltreatment is not just limited to physical abuse— financial misappropriation by loved ones or friends, as well as psychological and emotional abuse, are major contributors to depression, mood disorders and other psychiatric illnesses experienced disproportionately by the elderly.
Unfortunately, this percentage is expected to rise as high-income countries— the United States included— experience an overall aging of their population (due to stabilized or decreasing birth rates) relative to developing nations. The problem may be even more widespread in US nursing homes (where seniors should arguably feel safest and most cared for).
"Rates [of elder abuse in nursing homes] may be high," the WHO stated, as among nursing home staffers, "36% witnessed at least one incident of physical abuse of an elderly patient in the previous year; 10% committed at least one act of physical abuse towards an elderly patient; 40% admitted to psychologically abusing patients."
The problem is undoubtedly worsened by limited resources— the USA's healthcare system is overburdened and this creates gaps in vigorous monitoring and enforcement of the lowest-tier nursing homes.
The quality of care in accredited, well-funded retirement communities is, on the whole, much better. But that sort of disparity shouldn't exist, and it represents an area for national improvement. It also speaks to a critical necessity facing seniors and loved ones today: planning for, and paying for, better care than basic Medicaid will provide.
A society's perception of "old" has a lot of bearing on how much respect it gives its elders.
According to Elizabeth Jacobs, reporting on anthropologist Jared Diamond's 2013 TED Talk lecture about the differences in elder care across nations, "the perceived value of the elderly is an important factor in determining whether seniors are respected or not."
And the threshold age for "elderly" in a given culture may be the determining factor of that perceived value.
"In the United States a senior citizen is defined as someone who is 65+," Jacobs wrote. "But in other parts of the world, like New Guinea, anyone 50 or over is considered lapun, or an old man. As Diamond points out in his book, The World Until Yesterday, this difference has wide implications, as the two age groups tend to have a different set of physical and mental abilities."
The younger "old" people in New Guinea are thus afforded reverence and respect, whereas in the United States, "old" people are often seen as frail and senile, and are commonly lampooned in pop culture.
Unfortunately, that lampooning may have harmful consequences. As younger people ingest those lines of satire and comedic thought, they can all too easily begin to believe them, and come to disrespect, or even despise, their elders.
The interesting case of Japan.
In Japan, there are expected to be nearly double the number of persons aged 80 or older than in the US by 2020. Adult diapers already outsell baby diapers there. Like America, Japan faces a crisis in funding and caring for its elderly population; its national pension system has been on the brink of insolvency for years.
Yet, even with more Japanese seniors living among younger family members in extended family arrangements than their American counterparts, elder abuse and neglect is less frequent. Why?
Like the United States, Japan has a high per capita income and an aging population. Unlike in the US, however, there is an endemic cultural reverence for the elderly that has withstood economic development.
The Japanese celebrate their elderly.
In fact, the third Monday in September is celebrated there as National Respect for the Aged Day— a paid holiday from work even for young adults— on which families gather for meals and to give gifts to grandparents and great-grandparents. In the United States, by contrast, the flow seems to operate the other way, with many holidays (like Christmas, Halloween and Easter) focused on making children happy.
This may be due, said The Week's Karina Martinez-Carter, to Western religions. Whereas the traditional Shinto belief system in Japan reveres ancestors, Western youth-centricism, "relates back to the Protestant work ethic, which ties an individual's value to his or her ability to work— something that diminishes in old age."
So is the United States getting anything right when it comes to providing future care?
Of course. We're by far not the worst off among all nations. But there are clearly areas for improvement that we need to address, and other countries customs and practices warrant examination.
The issues associated with an aging population aren't going to diminish in the near future; they're going to increase. The Baby Boom, the largest generation in US history, is nearing peak retirement. We need more solutions for providing quality, affordable senior life care, and we need them fast. Good care is available to most in the United States, but it should be available to all.