Grey Crisis: Government and Individuals Must Prepare
United Daily News editorial (Taipei, Taiwan, Republic of China)
February 19, 2014
Summary: "On occasion I venture forth with my staff. At days end I sit behind closed doors. I dare not gaze upon myself in my mirror. I can no longer read books containing fine print." This was Bai Juyi's description of old age. Thirteen hundred years later, elders on Taiwan ought not consider this acceptable.
Full text below:
Within four to five years, Taiwan will become a "grey society." Early retirements in addition to those who are over 65, will account for over one fifth of the population. This means we do not have much time. The average life expectancy has increased. Over the past two decades, many families have experienced tremendous pressure caring for their elders. Baby boomers are now facing old age. Therefore government and society must learn to deal with the problem of aging.
This newspaper's Vision Engineering Department recently published a series of articles on "active aging." They addressed productive aging, care for the elderly, support for the elderly, and end of life care. It depicted what a greying society on Taiwan would look like. It explored what sort of care is required by the elderly. It provided examples of similar experiences from other countries. We hope Taiwan can develop similar elderly care institutions, but with local characteristics.
From a practical perspective, the most pressing issues for Taiwan are support for the elderly and care for the elderly. This is where the concern is the greatest, and the demand is the greatest. But government policies and private industry have failed to meet these needs.
Consider care for the elderly. The public on Taiwan values family. As many as 60 percent of Taiwan's elderly prefer to live with their children. Most people prefer aging in place. Only 20 percent are willing to live in a retirement home. Yet in recent years the government has invested immense resources in institutional care. Support for aging in place within the community or at home remains extremely weak. Substantial changes in policy are necessary to meet the needs of the community. Thankfully, some local governments and non-governmental organizations seem better able to appreciate public needs. The "in place nursing" model is taking root within society. For example, Taichung City has established a "senior citizen academy." New Taipei City has established combined nursery daycare centers that enable the elderly to attend classes along with their grandchildren, and interact with the very young.
Consider support for the elderly. This is where the government has invested the most resources. It has established long-term care services, long-term care insurance planning, and linked it to NHI sick care. The goal is to use one-stop care to ease peoples' concerns. But diseases have different impacts on the elderly, and their ability to age in place. The government must be more flexibile in how it provides care for the elderly. It must relieve the pressure on people who adopt different means of care. The government must be more imaginative. Long-term care planning is proceeding at a snail's pace. Legislation and enforcement cannot meet the needs of the community.
Institutions and systems must be established. But care for the elderly involves other, more important issues. The public must learn how to care for their elders. The elderly are not necessarily people who must be dependent upon society. A UK "White Paper on Social Policy for Senior Citizens" shows that during all periods of life, "self-reliance, opportunity, and choice" are of primary importance. The US has also proposed "self-reliance, opportunity, and " dignity" as a social norm for the elderly. The human lifespan is akin to the four seasons of the year. Ideally one will be able to preserve one's autonomy and dignity between eldership and the end of life. One should make plans. One should continue learning. One should continue working. If one retires, one should do volunteer work to remain active. This makes one's life more meaningful. It also helps one maintain physical and mental health.
In recent years, many advanced nations have been promoting "age friendly" employment policies. They hope to promote the employment of senior citizens. This makes more effective use of the elderly population's accumulated wisdom. It also reduces the impact of an aging society on the nation's finances. Mainstream society on Taiwan has long lacked this age friendly consciousness. For years its "respect for the elderly" policy has merely kept them at arm's length. The labor market imposes mandatory retirement ages. Health clubs impose age restrictions. Such conduct passes off age discrimination as "compassion."
Consider end of life care. Hospice care is the most significant domestic social trend in recent years. The hospice concept is widely accepted. But resources are inadequate. The government has emphasized hospital hospice care. In fact, end of life care should not be limited to the final farewell. Lifelong health planning for autonomy, for combatting unnecessary medical procedures, and for finding a final resting place for one's remaining years, and for avoiding a "lonely death" may be far more important. End of life care is a long road. The individual and the family must cultivate a more positive view of life. Governments need to invest greater resources to help society complete the rites of life.
"On occasion I venture forth with my staff. At days end I sit behind closed doors. I dare not gaze upon myself in my mirror. I can no longer read books containing fine print." This was Bai Juyi's description of old age. Thirteen hundred years later, elders on Taiwan ought not consider this acceptable.
2014.02.19 04:23 am