Challenges Of Promoting Healthy Ageing

We have been very successful in adding several years to life worldwide. However, rising global life expectancy is both a success story and a significant challenge for countries. While many people are enjoying good health even in their old age, others are finding that they are living longer with multiple chronic diseases, such as cancer, diabetes, cardiovascular diseases and other age-related conditions. In such a situation, the potential costs will be higher and then the opportunities are much more limited to work for the retired aged people. Increasing life expectancy raises important questions regarding the role of older adults as individuals and their role in society. It highlights that the healthy aging has become an important agenda for governments and societies in both developed and developing countries.

The World Health Organisation (WHO) defines ‘healthy ageing’ as the process of developing and maintaining the functional ability that enables wellbeing in older age and to value what they do”. By the end of this Decade of Healthy Ageing, the global population of older people will be more than double (2.1 billion). This policy stresses inter-sectoral coordination to enable older adults to remain a resource, and not a burden for their families, communities and the economy.

Geriatric care

There are many challenges of healthy ageing in Nepal The population is ageing at such a speed that the existing health care system and economy might fail to mitigate the challenges of ageing. The 60-plus population currently constitutes around nine per cent of the total population, which is expected to rise to 11 per cent by 2030. Despite this, the health sector has received just 69.38 billion for the current fiscal year. Moreover, with the concentration of health-related infrastructure, as well as less human resource in terms of geriatric care, the situation is pitiful. The country, despite having a geriatric population of nearly nine per cent, has only had nine geriatricians till date (one geriatrician for every 100,000 older adults).

Among various health institutions, only eight of them have started geriatric services. Despite the government’s policy to establish geriatric wards in every hospital with more than 100-bed capacities, is a serious issue that needs to be addressed immediately. Other challenges of healthy ageing are lack of long-term care services and institutions. However, the number of care homes is increasing but professionalism is still missing. Integrated long-term community services have always been inadequate. So, the emergence of the concept of active and healthy ageing can be seen as part of a wider change in the way the meanings of ageing are constructed and how the position of old age in an individual biography is interpreted.

New generations are less aware of the older population’s issues. Multiple sectors and stakeholders need to take up collective strategies and efforts to meet WHO’s goals for the healthy ageing decade. Relevant research should be promoted in the field of gerontology, among academics and universities. Growing attention to social ties has led to a renewed interest in intergenerational research. The involvement of younger people is essential to achieving healthy aging for all. They advocate for innovative intergenerational programmes, education about ageing to disrupt aging stereotypes, and participatory involvement of youth.

This new vision will help create a new social contract between the young and the old to address the four action areas of Decade of Healthy aging: changing perceptions of age-friendly environments, combating ageism, integrated care and long-term care. Active ageing will not be guaranteed until people are fully visualised and interacted within their surroundings, involving biologically, psychologically, and in socio and political domains. In a developing country like Nepal, the government should focus on cultural events, adaption of conceptual approach, and in-depth exploration of older adult’s needs and preferences. Culture is recognised as the concept related to living the best possible life, with profound effects on the ways in which people view, experience, and respond to their health-related circumstances.

In course of my research study in Devghat of Chitwan district, people’s engagement in spiritualism has been found as a kind of healing therapy and also key to active and healthy aging. The suggested the holistic model of health consisting of five elements: body, mind, and spirit, as well as family and their environment. In this context, there is the need to develop skills and the environment that make older adults able to age in the best possible way. 

Digital health

Recognition of community-based approach, development of skilled human resources (geriatricians as well paramedic) and delivering integrated long-term care, health insurance policy should be adopted. Similarly, digital health is increasingly playing an important role in the transformation of the health system towards ageing societies, with the rising use of digital tools such as electronic health records and predictive technology to manage multiple conditions.

Collaboration between provinces, local governments and communities to create geriatric-friendly communities such as that of the yoga centres, libraries, meditation hall, exchanging cultures or learning new languages and encouraging their abilities in digital education is also essential. It can help to cope with adversities in older adults who are encountering loneliness, isolations, and depressions. We should remember that ‘older adults might be retired, but they are not expired or tired’. 

(Pun is an MA in Social Work, with specialisation in gerontology.)