Age International is part of the Age UK group and works to help older people in low and middle income countries, as the UK member of the HelpAge International Global Network. It supports older people in developing countries by improving livelihoods, health and healthcare; providing age-friendly emergency relief; and by challenging attitudes, influencing decision makers and changing policies. Age International is a member of the Disasters Emergency Committee (DEC).
We talked to Head of Policy and Influencing Ken Bluestone about the changing experience of ageing in the developing world– and the importance of accurate data for raising the visibility of older populations and their needs.
What are the biggest issues for older people around the world?
Well, firstly, there is no one experience of ageing around the globe. People come from all sorts of social and cultural backgrounds and economic classes – and even though people might be the same chronological age, what it feels like to be that age and how they are treated by societies can be completely different.
You can be considered older at the age of 40 in Sierra Leone, for example, or you might not consider yourself to be old even if you are 80 in the UK, depending on how fit you are.
So there is a huge breadth of diversity, but what’s interesting, and what we come across time and again with the people that we work with and in the research that we do, is that there is a common experience of expressed desires and needs.
People basically want to have a sufficient income that they can live on, to be in the best health possible and they want to be included in their societies. And underpinning all this fundamentally is that people want to be treated with dignity and to have their rights recognised and respected.
Are ageism and discrimination increasing globally?
The absolute number of older people is increasing exponentially across the globe; by 2050 one-fifth of the world’s population will be over the age of 60.
So looking at just the sheer numbers of people who are older, the incidents of what they are experiencing is, of course, going to increase. And without a doubt, we are seeing increases in experiences of ageism and discrimination.
There are a number of reasons why this may be happening and the World Health Organisation (WHO) has commissioned research to understand what is underpinning this, which is due to be released next year.
It’s part of a strong commitment across the globe now to recognise that ageism exists, and that something needs to be done to tackle it. One challenge is that ageism is often not recognised across many different countries – for example, there isn’t a word for ageism in every language.
We are living in a time of transition in global demographics. Yes, there is a youth bulge taking place in many countries, especially in sub-Saharan Africa. But alongside that population ageing is also happening – basically because we are getting things right.
Population ageing is what happens when you improve economies and you improve people’s health: people live longer and have fewer children.
We’re used to thinking of population ageing as something that only happens in wealthier countries. In fact, the majority of the world’s older people actually live in lower and middle-income countries. In these countries, older people often live in multigenerational settings, but that doesn’t mean they necessarily get the support they need.
Because of better education, children are often seeking employment outside of their village or town – either by moving to a city or outside the country entirely. As a result, traditional networks that provide support to older people are breaking down.
We also see greater reliance on the contributions that older people themselves are making. In East Asia, South Asia and the Pacific, in Latin America and even in Africa, older women and men are increasingly providing backstop support to both younger and older generations – sometimes being primary carers for grandchildren, spouses and parents.
So older people are not able to seek out a quieter life for themselves at a point when they might want to do less. In some cases, they are having to do even more. It’s unfortunate that governments are not recognising the contributions older people are making, and are not valuing them equally in society.
In our work we see that older people are being treated differently by others. They are not being respected. They are sometimes subject to horrific human rights abuses, from violence to not being able to keep their own property. Widowed older women, for example, often have no rights of inheritance and can have everything taken away from them.
And older women and men can be subject to subtler forms of human rights abuses and discrimination, such as not being able to get access to loans, because they are no longer considered “loanable”.
Access to healthcare is also often denied, with older women and men being told that there is no cure for older age. Underpinning all of this is the pervasive ageism that tells people that older people simply don’t count as much in society.
How do you address that?
From a policy perspective, the starting point is to provide the evidence to make these realities visible. Data is at the core. For decades internationally comparable data, the stuff that governments and UN agencies use to see how they’re doing and work out how to do things better, simply hasn’t been capturing data on older people. Data typically stops at the age of 49, or is clumped together in a less than helpful group of 60+.
The lack of data about older women and men sends out a powerful message that ageing and older people aren’t relevant and therefore nothing needs to get done for them.
Thankfully, work is now happening to begin addressing these gaps, helped enormously by the creation of the Sustainable Development Goals (SDGs). For the first time, an international development agreement has explicitly recognised older people as integral to what it is trying to achieve. Strengthening the disaggregation of data by age has also been recognised as core to getting this done.
The UK government is helping with this and has championed the creation of the UN Statistical Commission Titchfield City Group on Ageing, which brings together government officials who work on statistics with experts to answer the question: How can we do data better for older people?
How do we ask the right questions and how can we analyse the data so we can get beyond this very challenging situation at the moment where we don’t have the information we need to help an older woman, for example, when she is experiencing violence and abuse in later life?
Much of your work is humanitarian – does an ageing world have an impact on the way aid relief is distributed?
The starting point in any humanitarian and emergency situation is responding quickly so that vulnerable people’s needs are being met. Where older people are concerned, we need to ask if those who are responding see older women and men and their needs, and whether appropriate relief is being provided.
You might have a person who is older, physically impaired and unable to walk. They may be carried on chairs or on people’s backs to escape as refugees from one place to another. The sheer burden of that for themselves and for the people around them is considerable. But what happens once they find themselves in a situation where assistance is being provided, is it also being made available to them?
We are used to images of aid being unloaded from lorries and queues of people, but if you are 75 years old you’re not going to be the person that’s queuing up. How do we make sure that older people are also receiving what they need? An older person may be living with multiple chronic illnesses such as hypertension or diabetes. Will the medical supplies provide what they require?
Often older refugees living in camps are not able to leave their tents. So when surveys are being done, how often are they counted?
There are many simple, practical things that can be done in emergency settings to make sure older people get counted and get the support they need. This is why we are really pleased that Humanitarian Inclusion Standards for Older People and People with Disabilities have been agreed amongst the humanitarian agencies responding in these very difficult circumstances.
Are there any other areas of growing need among the global ageing population?
Loneliness is common across the world – even in societies where we assume families and the communities provide connections. And when we are talking about dire situations such as humanitarian crises, it is also imperative we find opportunities for older people to come together with others to receive the support that they need.
Dementia too is a growing area of need; it is having a real impact on people’s lives and the global economy. Governments must do much more to put support mechanisms in place, not just for the person experiencing dementia, but also for the people around them.
A lot of good work is happening to raise these issues at a global level. Alzheimer’s Disease International is raising awareness of these issues and the OECD just launched a report a few days ago, looking at the incidence of and responses to dementia across the OECD countries.
Age International is also going to be releasing research that we have commissioned in Pakistan, to better understand the experience of people living with dementia and those looking after them.
Overall, we need to change the way we think about older people and getting older. We need to move away from a ‘welfare’ approach that asks what can we do to older people, to a rights-based approach that recognises older women and men as equal members of society who have aspirations, contributions and needs that need to be valued and met.
This interview was part of a series brought to you by Elder. Whether your are looking for London live-in care or require assistance in another part of the country, Elder will ensure that all of your care needs are taken care of.
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