Old age is a stage in which new needs appear. Are we taking good care of them?
Caring for the elderly is a practice that has generated important debates in recent decades. This is because, in the face of social transformations and the most recent economic crises, aging has begun to be recognized as one of the stages most exposed to different conditions of vulnerability around the world.
Due to this, political and theoretical debates on care practices have become fundamental in the creation of strategies to mitigate the vulnerability of older adults and to strengthen both support networks and social policies.
Is caring for the elderly a problem?
The term to care comes from the Latin cogitare, which means to think; so it can be understood as “thinking”, but also as “having a concern.” Hence, its meaning can be transferred to having a concern that something unwanted will happen, a concern that translates into a specific practice: protecting someone from an unwanted event, because that someone has difficulty doing it himself.
Care is then a rational activity that connects with an emotional dimension (Izquierdo, 2003): it is centered on fear due to the awareness of the other’s vulnerability, a question that human beings satisfy among ourselves through interpersonal relationships.
For this reason, care is currently one of the central issues in the development of our societies. For example, a large part of social and health policies are organized around asking who is being cared for, who can or should meet that need, and what options are available to do so.
Given this, many challenges have been detected. Among others, there is a question that has recently concerned the world population, especially those who have lived through the “baby-boom” after the Second World War: who is going to take care of us in our aging process?
Changes and challenges of caregiving in old age
Old age is often understood as a problem, or at best, a challenge or a challenge. Far from old age itself having intrinsic conflicting qualities, the challenges have been the social and economic changes themselves, which often leave some people on the fringes of strategies designed to meet basic needs; which in turn, generates passive positions and little participation in social affairs.
For example, health in old age is a challenge, but not because of old age itself, but because health is becoming more and more expensive, there is a greater shortage of professionals and material or economic resources, its distribution and access are inequitable; In addition, there have been important changes in the social and productive roles of those who have been the main caregivers over time: direct families.
As one of the alternatives to cushion this, the concept of “active aging” has emerged, which refers to the optimization of physical, social and intellectual opportunities focused on the autonomy and rights of the elderly.
This concept has made it possible to develop some strategies; however, in some cases it has also served to hold the elderly person responsible for a problem that is social, political and economic; which makes us see that this is a more complex issue than it might seem.
Despite this, in many contexts aging is ceasing to be seen as a problem. There is a tendency to promote the social participation of older adults, and to rethink the concept and practices of care, more specifically those related to health and illness.
The family support network (the family support ratio), which is the direct family, has constituted the vast majority of caregivers. However, due to socioeconomic changes in recent decades, family support ratios are drastically changing.
For example, in Spain it is estimated that the number of caregivers will go from being 6 caregivers for every 80-year-old adult, to only three people by the year 2034. The consequence of this has been a considerable increase in the care needs of older people, as well as groups or people who are responsible for meeting them.
In addition, the practice of care has a very important gender dimension : being something that has been understood especially in relation to the private space, we have also been women who have socialized in a greater identification with these values and tasks.
Consequently, a large part of care practices are led by women, and the belief that caregiving is a ‘female task’ has even become widespread. For this reason, another of the great topics discussed has been the ‘feminization of care’.
Likewise, in many populations, the same political and socioeconomic conditions have promoted that care is also a semi-professional task aimed at the migrant population, a population that has contained a large part of the problem of the lack of care.
In other words, an important lack of care for the elderly and other populations that are in contexts of vulnerability, as well as the need to generate new political and socio-educational strategies at both family and professional level, has been put on the table. In this context, the strengthening of intra-family solidarity strategies in connection with social policies becomes relevant .
5 proposals from the World Health Organization (WHO)
Although caring for the elderly is not a practice that is limited solely to health, it is in this sector where some specific challenges have arisen. In light of this, WHO has begun to develop a program called the Global Strategy and Plan of Action on Aging and Health.
In this way, an important part of care practices begins to be the responsibility of public organizations, beyond being focused on private spaces and families. Some of the proposals that make up this plan are the following:
1. Commitment to healthy aging
Closely related to the concept of active aging, it refers to an awareness-raising process to create sustainable measures and scientifically-based policies that can promote the abilities of older adults and their autonomy.
2. Alignment of health systems with the needs of older people
It is about not underestimating the need for the health system to organize itself around the diversity of old age, towards detecting the preferences of the elderly and towards consolidating a good network of professional assistance.
3. Establishing systems to provide chronic care
The relevance of promoting the timely detection of chronic and long-term care needs, including palliative care, and especially from the strengthening of infrastructures and staff capacity is discussed.
4. Create environments adapted to the elderly
Due to the relationship between care and vulnerability, one of the most important issues on the subject is to extend the necessary measures to avoid stigma and discrimination, as well as to enhance autonomy and empowerment from the most basic and everyday levels.
5. Improve measurement, monitoring and understanding
Finally, the WHO recognizes the need to promote research focused on aging, as well as to create new measurement and analysis mechanisms that are diverse, and that allow understanding and addressing the complexity of care in old age.
- World Health Organization (2018). Aging and health. Key facts. Retrieved April 30, 2018.Available at http://www.who.int/es/news-room/fact-sheets/detail/envejecimiento-y-salud.
- Alfama, E., Ezquerra, S. & Cruells, M. (2014). Aging in times of crisis. Retrieved April 30, 2018.Available at https://www.academia.edu/10729630/Envejecer_en_tiempos_de_crisis.
- Abellán, A. & Pujol. R. (2013). Who will take care of us when we are octagenarians? Retrieved April 30, 2018.Available at https://envejecimientoenred.wordpress.com/2013/09/02/quien-cuidara-de-nosotros-cuando-seamos-octogenarios/.
- Izquierdo, MJ (2003). Caring for individuals and groups: who cares for himself. Social organization and gender. Paper presented at the Catalan Mental Health Congress. Working group on identity, gender and mental health. Retrieved April 30, 2018.Available at http://www.debatefeminista.cieg.unam.mx/wp-content/uploads/2016/03/articulos/030_08.pdf.