The Current Situation of Global Aging and The Increasing Requirement of Health Care Services
The world’s population is ageing. Almost every country in the world is experiencing growth in the number and proportion of senior citizens. Population ageing is poised to become one of the most significant social transformations of the twenty-first century, with implications for nearly all sectors of society, including labor and financial markets, the demand for goods and services, such as housing, transportation and social protection, as well as family structures and inter-generational ties. Older persons are increasingly seen as contributors to development, since their capacity to take action to improve conditions for communities should be incorporated into policies and programs at all levels. In the coming decades, many countries are likely to face fiscal and political pressures related to public health care systems, pensions and social protections for a growing older population. Population size and age structure are jointly determined by three demographic processes: fertility, mortality and migration rates. Life expectancy has increased significantly in all regions since 1950. As the life expectancy at birth increases, improvements in survival at older ages account for a growing proportion of the overall improvement in longevity. Declining fertility rates and increasing longevity are key factors affecting global population aging, and in some countries and regions, international migration has also contributed to changes in population age structure. In countries experiencing large migration flows, international migration slows the ageing process at least temporarily, since migrants tend to be young people of working age. However, migrants who remain in the country eventually will age into the older population.
Health Systems That are Suitable for The Elderly in Need
In order to meet the requirements of an aging population, both the way that health systems are structured and the approach that health care is provided need to change significantly. In many regions, particularly in low-income and middle-income countries, accessibility and affordability of health care are major barriers. Governments in these places should establish new types and methods of service. Globally, however, the health services available to older persons are often not commensurate with their needs. Therefore, the system should be redesigned to provide more age-friendly and efficient integrated health care system. The improvement requires attention to the unique demands and preferences of older persons; hence they would actively participate in health care plans. In addition, health systems should make the necessary reforms to better integrate all levels of health services and specialists, with strengthening coordination and collaboration with long-term care systems.
Moreover, all changes should be affordable and sustainable. Much of the debate about aging is associated with uncontrollable increases in demand for health services. But the evidence suggests that aging has a much smaller impact on the surge in health care costs than changes in emerging technologies and clinical applications. In fact, health care services have been shown not only to make older people’s lives better, but also to cost no more than traditional health services. While health system reform requires multiple actions, the following themes are top priorities. First, officials should shift the clinical focus from treating diseases to improving intrinsic ability. Second, civil servants should rebuild health systems to provide more integrated health care for older people. Furthermore, the health workforce is transformed to better deliver the health care services required by the new system.
Provision of Daily Care for The Aged
Actually, formal long-term care services do not exist in many low-income and middle-income countries. Then, the task of assist the care-dependent elderly often falls on female relatives, most of whom are untrained and free of charge. Some high-income countries can provide comprehensive public services, but the sustainability is concerning as their populations age. The quality of care is often inadequate; thus, it is required to optimize the trajectory of change in internal capabilities and avoid ignorance of supporting autonomy and dignity. What’s more, measures should be moved ahead on several fronts.
First, countries could establish full equipped long-term care systems. Governments can bring together stakeholders to discuss and decide what needs to be done and who is responsible for what. The program should at least briefly describe what services are provided, how universal access to services is promoted, and how the system is coordinated to ensure the provision of integrated long-term integrated care services.
The second priority is to find ways to build and maintain a workforce willing to provide long-term care. This can be achieved by adequately preparing paid workers for their roles, paying reasonable wages and creating suitable working conditions. Giving care workers meaningful decision-making power and career paths is also a way to facilitate recruitment and retention. Most critically, support must be provided for family caregivers, with training and legislation to support flexible working arrangements and leave systems, as well as payment of remuneration for services provided.
Third, authorities should strengthen the rights of both older persons and their nursing workers. Disregarding, demeaning or abusive treatment of care-dependent older persons will not be tolerated. Instead, long-term care should be designed to facilitate older people’s dignity and personal aspirations while maintaining their connections to communities and social networks. Similarly, the predominantly female care workforces must be treated fairly and reasonably.
Finally, there is considerable scope for countries to develop diversity, innovation and flexibility in deciding how to act in these areas. While a wide range of stakeholders in each country may be involved in this process, in general, only governments can establish and manage long-term care systems as a whole.
Various Preferences of Senior Citizens Require Diversified Pension Models
Since the elderly have a great difference in education level, income, personal hobbies, the elderly hope for the diverse pension models. For example, the old people in good health might hope to find jobs, senior citizens who value the living quality want to enjoy comfortable life, and the disable would hope to get long term care. Therefore, we should build a diversified pension model system to meet the demands of each elderly person.
In European and North American countries, the development of transnational pension industry gradually become a trend. Organizations in Norway’s Oslo, Belum and other cities have built large retirement apartments in southern Spain, where low real estate prices and plenty of sunshine are attracting a growing number of businesses and the elderly. Senior citizens from other Nordic countries go to Spain for retirement because of not only the natural environment but also the fully-functional endowment facilities, good public health services, insurance services and so on. As for service sector relating to the ageing society, more than 90 percent of elderly people live alone in Norway, the Netherlands and Denmark, so there is a huge demand for home care services. In Britain, home care is one of the most active factors in the ageing industry; in Germany, there are more than 10,000 nursing homes providing home care for the frail, and the amount of rest home has been increased for 23% in eight years.
Among Asian countries, Japan and Singapore have also gradually entered the ranks of elderly countries. Because of their strong economic strength, these countries, on the one hand, have absorbed the characteristics of western social welfare pension, and fully endowed the elderly with generous social security. On the other hand, based on the continuation of the traditional Eastern family concept, they are also committed to developing the function of family pension, advocating and encouraging ‘multi-generation cohabitation’.
