Managing an ageing population
More caregivers will need to be trained to provide support to the elderly.

Interestingly, matters deserving of our attention and scrutiny surface but seem forgotten days later. I am now thinking of the number of beds in hospitals that healthy people occupy and what this is signalling.

Years ago, as a young social worker, I visited the home of a child that was assigned to me by the court. As I entered the home I heard shouting and screaming. It turned out to be the mother. She was livid. To bring some peace to the household, I took her aside and asked her to tell me the problem.

She started by telling me what she knew I already knew: She was a sickly mother of nine children who worked every day but made her way home to prepare the main daily meal.

Her main problem was that she had an awful relationship with her mother-in-law. Her husband "worked out something with his link at the hospital to deal with the situation, and she was admitted". The understanding was that she would be a permanent patient. The arrangement worked swimmingly for four years until recently when her husband lost his job. This seemed to coincide with a breakdown in the hospital arrangement.

The Jamaican population is getting older, and its citizens are living longer.

That day, she arrived home to find the mother-in-law regally nestled in the best bed in the house. She opened the bedroom door to reveal a much-healthier-looking woman than herself. Upon seeing each other, and as if on cue, they started screaming at each other. The mother-in-law was having the better of each exchange. Then came the "unkindest cut of all". The mother said to me, clearly expecting her to hear, "You hear her? You see how she look hearty? She na dead fi now. How mi ago manage?" she said before breaking into tears. The mother-in-law, who seemed seriously affected by this statement, soon had tears in her eyes, too.

The Jamaican population is getting older, and its citizens are living longer. Many of those who were saving are realising that those savings are no longer sufficient. Many others have never saved and they have never worked towards permanent housing arrangements. Fewer people are shocked that one bout of illness emptied their savings account.

There is the general expectation that our children will grow up to protect us from the vicissitudes of old age. Many are discovering — belatedly — that while some are unwilling, others cannot shoulder that burden. This is despite the fact that the final few dollars were spent on their education.

More than anything else, everybody has been robbed by the monster of inflation. The inflation rate in Jamaica averaged 8.50 per cent from 2002 until 2023, reaching an all-time high of 26.49 per cent in August of 2008 and a record low of 1.60 per cent in November of 2016. Inflation is like going to bed with $1,000 in your pocket and waking up to find only $975. Over time, this is devastating.

Some older people find that they are outliving their savings.

The combined effect of all this is that some harsh decisions are being considered regarding the welfare of family members who are no longer making a useful contribution to the home. Some are hair-raising.

This is not peculiar to Jamaica. The world is experiencing a seismic demographic shift, and no country is immune to the consequences. While increasing life expectancy and declining birth rates are considered significant achievements in modern science and health care, they will significantly impact future generations. The less prepared countries will suffer earliest.

By 2050 there will be 10 billion people on Earth, compared to 7.7 billion today. Many of them will be living longer. So the number of elderly per 100 working-age people will nearly triple — from 20 in 1980 to 58 in 2060.

Populations are getting older in all Organisation for Economic Co-operation and Development (OECD) countries, yet there are clear differences in the pace of ageing. Japan, for example, has the most senior population, with 33 per cent of its population already over 65. By 2030, the country's workforce is expected to fall by 8 million. This will result in a major labour shortage. On the other hand, South Korea boasts a younger-than-average population, but it will age rapidly and end up with the highest old-to-young ratio among developed countries.

Globally, the working-age population will fall by 10 per cent by 2060. But workforce shortages are just one of the impacts that ageing populations already feel. For example:

*With more people claiming pension benefits but fewer people paying income taxes, a shrinking workforce may be required to pay higher taxes.

* Longer lives do not necessarily mean healthier lives. Those over 65 are more likely to have at least one chronic disease and require expensive long-term care.

* Changing workforces may lead capital to flow away from rapidly ageing countries to younger countries, shifting the global distribution of economic power.

Parking relatives on hospital beds is not sustainable. The shift in population will require drastic changes and new integrated models of health care, community services, and home-based support to provide holistic care for the well-being of a rapidly growing number of unproductive individuals. The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care system. Addressing these unmet needs will, I predict, be the most urgent public health priority facing the Government. If I am asked for suggestions, I would start here:

*Increase the age of retirement.

*Increase the level of savings — both inside and outside pension funds.

*Increase the coverage of private pensions across the labour force, including self-employed and contract employees, to provide improved integration between various pillars.

*Preserve retirement funds by limiting access to benefits before retirement age.

*Providing people with better options to make working at an older age more accessible could be crucial for ensuring continued economic growth.

*Increase living facilities for older people, home care, and training of caregivers.

*Follow the World Health Organization (WHO) guidelines on Integrated Care for Older People (ICOPE).

Glenn Tucker is an educator and a sociologist. Send comments to

Glenn Tucker

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