Hasnat M Alamgir |
February 23, 2022 9:33:10 p.m.
February 28, 2022 9:06:26 p.m.
According to estimates, the proportion of elderly people (over 60 years old) in Bangladesh will be 22% in 2050 with about 36 million people compared to 8% currently with about 13 million people. This suggests that for every five people, one will be an elderly person in Bangladesh. This rapid aging of the country’s population and the large number of elderly people will significantly increase the demand for a number of health and social services. Older people suffer from a wide range of health problems, need frequent access to health care, have lower incomes, need special housing and transportation, and have greater emotional needs. important. Many will develop visual impairment, hearing loss, difficulty walking, bowel and bladder continence. Osteoporosis, arthritis, high blood pressure, diabetes, Parkinson’s and Alzheimer’s disease are common health problems in this age group. Is Bangladesh ready to take care of its elderly population?
In Bangladesh, the hardship of old people will be further compounded as only a third of them (33.4%) over retirement age receive a pension and the current social security schemes in the country are in jeopardy. still in its infancy and in the trial phase and does not cover most people with or without economic insecurity. The trend shows that over time there will be fewer and fewer working-age adults to support their elderly parents and dependents, as the old-age dependency ratio is expected to triple over the next few years. decades. The aging of the population in Bangladesh will have serious implications for individuals, families, society, government, NGOs, the health system, social service providers and private sector organizations, as they all need to find solutions to the problems of housing, social security, retirement, health care, care. , and the affliction of disease and disability. The long-term care (LTC) service delivery system is still at a nascent stage in Bangladesh with only sporadic and largely private individual initiatives on the development of small-scale “old houses” here and there to serve only the elderly people who have no close family. living members, no one is willing or available to care for them or those who no longer have other means or support for them. LTC involves a variety of services designed to meet a person’s needs – both health care and personal care – to help people live as independently and safely as possible when they become dependent on others to perform their daily activities.
LTC is provided in different locations by different caregivers, depending on need. Most LTC is provided in the home by volunteer family members and other relatives. It can also be organized in a facility such as a nursing home or in the community as an adult daycare center. In Bangladesh, it is anticipated that the current level of interest and availability of family members and relatives will decrease over time to provide care to their dependents, which will create enormous challenges for these people to continue to receive care and large-scale initiatives need to be put in place. place to meet their continuing and growing care needs. While a few nursing homes – commonly known as “old houses” have been built in Bangladesh, adult daycare remains a foreign concept and has yet to gain any traction from any side.
The most common among LTC services is personal care assistance with routine activities, including bathing, dressing, grooming, eating, using the toilet, and getting around. LTC also includes delivery of prepared meals and access to adult daycare where seniors can spend the day under supervision in the company of peers, friends and neighbors of similar age ranges (such as children’s daycare centers which are now popular in Bangladesh). Special transport services will be required as conventional vehicles in Bangladesh do not have any accommodation for people with special needs or for the elderly.
Long-term care needs generally increase gradually as people age and become weaker and their illness or disability worsens over time. Several factors predict the type and amount of long-term care needs: the risk almost always increases as people age; women are more at risk than men because they have a longer life expectancy; single people, widows and widowers are more likely than married people to need care; unhealthy eating habits and lack of physical activity can increase a person’s risk; poor health and a family history are also associated with the need for care. Research also suggests that people with low incomes, very old people and people living without a spouse need more LTC.
Bangladesh needs to put in place plans, policies and programs, develop a legal framework and start developing the structure and human resources (care providers) for its growing aging population. A human resources policy should be developed to create a large pool of trained and qualified family caregivers, full-time or part-time, and to ensure an adequate number of health professionals such as geriatricians, gerontologists, dietitians, nutritionists, nurses, nursing aides, home health aides, social workers, nursing aides, physiotherapists, occupational therapists, speech therapists, housekeepers.
Dr Hasnat M Alamgir is Professor of Public Health