Ageing and development

Older Peoples CareOlder People

by Alison Tarrant.

Wherever in the world a person lives, the process of ageing is likely to raise challenges. Most people wish to remain independent as they grow older and to continue to contribute to their families and communities – but the ageing process may bring difficulties with it. In particular, older people are more likely to face financial insecurity, ill health or disability. In many countries most people move into old age after a lifetime of poverty, poor nutrition and healthcare and, frequently, years of hard physical labour.

People often think that ageing is not an issue in Third World countries because life expectancies are shorter, but this is not true. Currently the majority (61%) of the world’s population over 60 years of age lives in Third World countries. This proportion will increase to 70% by 2025. These populations are ageing much faster than they are in industrialised countries. In 1995 the world’s population aged over 60 increased by about 1 million people each month. Nearly 80% of this increase took place in the Third World.

The idea that many older people are passive recipients of aid and support is inaccurate. In its work with older people, HelpAge International has found that they are extremely resourceful, frequently undertaking many different activities to provide for themselves. Around the world, most people continue to work well into old age. This contribution usually goes unseen because most of this work is unpaid work in the family or is in the informal sector, so is not recorded.

Two of the issues most commonly mentioned by older people as being of great importance to them are financial security and good health. In many of the world’s poorer countries very few older people receive any kind of pension and those who do receive a pension may often find it inadequate for even the most basic needs. Where pensions are not available or are insufficient, older people either have to rely on the support of their family or community, or they have to work to bring in their own income. The traditional security of family support for older family members may be lacking if their children have moved away to work in cities or other countries, if children have died from AIDS or if government initiatives have relocated family members to other parts of the country.

Good health is of vital importance to older people, not only because this generally improves the quality of life, but because it enables people to continue to work and contribute to their communities. However, older people who need healthcare may find it very difficult to obtain, particularly if they live in rural areas. There may be very limited health facilities available, and what care does exist may well be beyond the reach of older people – either because they cannot afford to pay for it, or because they are unable to travel to it. It is also common for older people to assume that many conditions associated with ageing are an inevitable part of growing old and that there is nothing which can be done. In fact many of these conditions – such as cataracts – are treatable.

Through experience of working with older people around the world, HelpAge International has found that the most effective way of supporting older people is to work with them on projects they have identified as meeting their needs. These are usually community based initiatives. In Sri Lanka, for example, a minibus was stocked with primary healthcare equipment and basic drugs and now visits communities in plantation areas, where older people previously had no access to healthcare. In Manila in the Philippines, older people are training to become community health workers, providing basic healthcare and education for other older people in their area. In Uganda, an older women’s group used a grant to purchase some pigs. The pigs are breeding and the income the women gain from them is being shared among the group members who use it to help pay for school fees for their grandchildren (in this area, many children have lost one or both parents to AIDS) and to buy basic foodstuffs. A fund has also been established to help meet the cost of some of the house repairs for the poorest members of the group.

Women are important in our ageing world. In nearly every country in the world women outlive men, so more older people are female. Ageing also raises particular challenges for women. In many places girls and women receive less education, have fewer work opportunities and receive less healthcare and nutrition than boys and men. This affects their health, economic status and earning potential in later life. Older women may also have particular health problems as a result of repeated pregnancies and childbirth earlier in their lives.

Women are much more likely to live alone in later life than men. In many places women are likely to marry men who are older than themselves, and are less likely than men to marry again if they are widowed or divorced. As well as the social and emotional impact of living alone, older women are more likely to live in poverty, as it can be much more difficult for a woman on her own to earn a living, especially if she lacks family support. Our experiences in credit schemes with older people have shown that older women are generally an excellent credit risk, establishing small businesses which are at least as successful, and often more so, than those established by men.

1999 is the UN International Year of Older Persons. This offers a special opportunity for us all to look beyond the typical view of their needs and instead to value their knowledge, resourcefulness and experience and to include them in work which will benefit not only themselves, but also the wider community.

Alison Tarrant is the Communications Officer at the Secretariat of HelpAge International, a global network of organisations working with and for older people: 67–74 Saffron Hill, London, EC1N 8QX, UK.

Helping older people without spending money

  • Give up your seat to an older person on a crowded bus or train.
  • Let older people into a queue in front of you, if you’re waiting in a shop or clinic.
  • Invite them to join in celebrations or cook a little extra food and share with an older person.
  • If you can sew, help repair their clothes or help with other practical repairs or cleaning.
  • Help with their heavy work, like carrying water or shopping or working in their gardens or fields.
  • Together, a community could repair their homes or even build them new ones.
  • Help them with reading and filling in bills and forms.
  • Young people could visit older people and talk with them.
  • A lot of older people have led very interesting lives. School children could interview them and write down their histories.
  • Be aware of lonely older people and visit them. Include all older people in the life of the community.

Adapted from Ageways 49