Introduction
An Ageing Population refers to the phenomenon of increasing percentage of people who are above 65 years. Increased availability of good quality and affordable healthcare has increased the life span of senior citizens and the life expectancy. The rising phenomenon of aging has created new issues such as increased healthcare and rising costs of maintaining the senior citizens and continuation of the social security program has to be reconsidered. This paper examines the pros and cons of ageing and discuses important issues related to ageing. The paper also discuses ‘Ageism’ and the stereotyping and discrimination that the aged undergo.
Statistics on Aging
Gavrilov (et all, 2003) has pointed out that the world is growing older at an alarming rate and by 2050, 20 percent of the global population would be 60 years or older. The author has taken ageing as the retirement age and people who are above 65 years are considered as aged. A society is considered as older when 8 to 10 percent of the population is above 65. In 1900, the percentage of people who were considered as aged was 4.1 %, it was 12.6 percent in 2000 and by 2030 and the percent is expected to rise to 20 percent. Table 1 gives historic statistics and future projections for the ageing population.
Table 1. Ageing Demography and Statistics (Gavrilov, et all, 2003)
Observed and Forecasted Percentages of the Elderly (65+ years) in Selected Areas, Regions, and Countries of the World: 1950, 2000 and 2050.
In Table 1, it can be seen that the developed countries such as USA, Sweden, countries of Europe have high percentages between 21.1 % to 36.4 %. Developing countries such as India and China that had figures lower than 6.9 percent in 2000 will have increased the percentage to more than 15%. The main reason according to Gavrilov is the increasing availability of expensive healthcare facilities and the reduced fertility and birth rate among the younger people.
Pavilion (June 2007) has researched the gender related percentages and he suggests that females form a larger portion of the aged. According to the author, aging is increasingly seen in women and this has created “feminization” phenomenon in aging since females have a lower mortality rates. In US, the number of aged women was 20.6 million while in men it was 14.4 million and this gives a sex ratio of 143. For people who are above 85 years, the sex ratio increases to 243.
Problems Faced by the Aged
Crawford (12 January 2007) has written about the problems faced by the aged in UK and the issues that planners have to consider while planning for them. The author suggests that the growing population of the aged means that planners have to think of housing, convenience stores, healthcare workers and facilities and the increased cost of caring for the aged. Many of the older generation do not have support mechanisms such as children who care for their parents. In such cases, the government needs to provide suitable housing for single and couples. Affordable housing with standard live saving emergency equipment would help to reduce the number of people who wait for admission into healthcare facilities.
Harris (1 September 2007) has argued that caring for the aged has financial impacts on the healthcare system. The author reports that the fire departments in Columbia have increasingly responded to 911 calls and that many of the calls are not for any emergency condition but just that the aged needed transport to long-term care facilities. The author has suggested that such 911 emergency calls tend to divert ambulance services from true emergencies and also waste money.
Mellor (August 2007) has studied the behavior of nurses in long-term care facilities and suggests that though many nurses have a positive attitude towards care for the chronically ill and aged people, they lack gerontic nursing and socioeconomic and understanding of the ageing population. The author suggests that other than financial problems the aged have a problem of discrimination among certain sections who regard the aged as a burden to the society.
Myths of Ageism
According to Todd (2005), elders were regarded with great respect in the biblical times and even in mediaeval times where the life expectancy was less and if anyone lived beyond 50, the person was regarded as chosen by god for a divine purpose and given great respect. Since in olden times, there were no printing presses or writing materials, elders served as the storehouse of knowledge and were frequently consulted for events of the past and they were valued for their wisdom. Family and village history had to be memorized and repeated verbatim back then and the knowledge was passed on to their disciples and so on. The elders could relax, not work, eat drink and keep merry and assist in the education of the village children. With the advent of the printing press, this changed and history could be printed on paper and preserved so there was no need for the old people. Todd suggests that with the advent of the industrial revolution, families needed to be mobile, live and work in tough conditions and do manual repetitive jobs. There was no need for historic knowledge as machines did the work. Older members of the family were regarded as a burden now since extra efforts had to be taken to accommodate them.
Davison (Davison) has researched Ageism in colonial Australia and written that the colonial settlers and immigrants who first came to Australia were the young who had left their parents back in another country. The number of people who could be called as old was less than one person per thousand. When these young couples had children, these children grew up without seeing a really old person and they had no filial feelings or reverence for the old. As the years passed on, the first settlers grew old and their children and later their grandchildren grew up and came to despise these old people who actually did nothing but consumed scarce resources. With increase in medication, the life expectancy in Australia rose and also the percentage of old people. Since there was no tradition of caring for the old, the concept of Ageism grew and now affects almost all people.
Negative Feelings about Ageism
Beth (Beth 2003) has reported that with improved healthcare systems and technology, the life expectancy of senior citizens has considerably increased and this has given rise to a new kind of stereotyping called Ageism, for the old similar to racism and the discrimination and derogatory attitude shown toward African Americans and other race of deprived people. This attitude is not only shown by the general public but also by nurses and the medical fraternity who regard old people as a burden and who enjoy social welfare benefits, at the expense of younger people who pay taxes. Ageism is a very malevolent form of attitude since the older people do not have anywhere else to go and rely on healthcare professionals to meet their basic needs. Todd (2005) has suggested that in US, elders are institutionalized, marginalized, and stripped of dignity, responsibility and power, and were regarded as a burden by their children and the state.
Lindsay (Lindsay 1999) has suggested that ageism and the stereotyping and aloof attitude is present among nurses and senior nursing professionals. The author suggests that these attitudes are inculcated right from their nursing college days and they continue even when the nurses attain seniority. Very little has been done by professional bodies and the nursing institutions to remove this bias and negative attitude and the author has suggested that measures should be taken and counseling provided to remove such harmful attitudes.
Death Denying of the Aged
Ashby (2005) has suggested that death denying is the process where the life of a critically ill patient is prolonged by placing them on life support systems. He has discussed the case of a few patients who could be classified as being in the ‘vegetative state’ where it was medical technology alone that ensured that the patients lived. Zimmermann (2004) has argued that there is a reluctance and reticence on the part of the healthcare community and the society when it comes to palliative care or care for the dying. The author has argued that the society has become a death denying society where prolonging life becomes a test of the machines and technology that is bent on prolonging death. Death is no more regarded as a natural cause but a technological and clinical event and while instances of death in hospitals and institutions have risen, there has been a considerable decline in death at homes. The author has argued that the death denying society which includes pharmaceutical companies and medical professionals with specialized training, have increased the lifespan of human beings. Zimmermann has suggested that the death denying society has created an ‘atmosphere of denial’ where information is withheld from patients and their real condition is not revealed. The society creates a veil of silence and does not reveal such information to patients who want to know the truth about their health. The author has cited the works of some eminent authors and calls this masquerade as the ‘pornography of death’. The research pointed out that while explicit pornography is freely discussed, prudery is practiced while discussing natural death. The death denying society, has turned death into a mere medicalization practice and the funeral practices, display of grief and mourning has become detached and the survivors have become bystanders since there is a taboo on discussing death.
Threats to Social Security Act
The US Office of Management and Budget (OMB 28 June 2007) has raised serious concerns about the risks that the Social Security Act is facing due to the increased cost of caring for the aged. The Social Security Act is under the threat of collapsing from its own burden. The life expectancy of retired Americans has increased to about 72.1 years from the 60.1 years that was present when the act came into force. With increase in the number of retired people, there is a real fiscal danger of the fund being drowned in deficit. There are currently more than 39 million senior citizens who avail of the benefits and it is estimated that the total shortfall in Social Security and Medicare is about USD 18 Trillion. Employed workers are taxed to the extent of 12.4 % for social security and 2.8 % for Medicare and studies show that the inflow amount from taxes is not sufficient to balance the payments. The payments are done by heavily subsidies from the government and it is projected that by 2017, the huge burden of social security and other programs will become unmanageable or put in simple terms, the government will not be able to pay out the money. Attempts have been made by some administrators and presidents to tax the benefits or reduce the outflow of money, but this has been resisted by people.
Conclusion
An ageing population refers to the number of people who are greater than 65 years. By 2005, it is estimated that the 20% of the world’s population will be above 65 years. As a result, there has been increased healthcare costs and infrastructure development costs such as housing. The aged need adequate housing and long term critical care facility. The rise in population of the elderly has created certain negative feelings about the aged and this is called ageism. Certain sections of the population feel that the chronically ill and the aged are made to prolong their lives with advances in medical technology and the phenomenon is called as death denial. The paper suggests that enough care and facilities must be provided to the aged and that they should not be considered as a burden on the society.
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