Hasnat M Alamgir |
August 05, 2022 20:32:04
Bangladesh needs to find and develop appropriate models to provide care for its growing aging population. Old houses were built here, but the complete residential isolation of elderly parents and living with strangers was not much appreciated by their family members due to the social, cultural and religious norms in the country. . In general, Bangladeshis enjoy socializing with friends and enjoy the company of family members more. Other care delivery models need to be explored that will meet care needs and will also be accepted by care recipients and their offspring. The increase in the elderly population intensifies this need and the country is simply not ready to offer proper options on how to meet their needs.
In 2019, about 13 million people in Bangladesh were 60 years and above, which was about 8% of its total population and it is projected that in 2025, about 37 million people in Bangladesh will be 60 years and above, which actually 21.0% of its total. population. Life expectancy for Bangladeshi men will be 78 years in 2050 (an increase of approximately 7.6 years compared to 2019) and for women it will be 81 years (an increase of approximately 7.3 years compared to 2019). compared to 2019). The old age dependency ratio (65+ people to 15-64 people) will drop from 7.7 to 23.5 during this period. The fact that almost a fifth of the country’s population will be over 60 in the near future should ring alarm bells for all stakeholders including healthcare providers, medical professionals, policy makers , the social welfare system, NGOs and public health experts to work on proposing ways to care for this vulnerable demographic segment and meet their health needs.
Adult daycare is an option where older adults spend time with similar age groups during the day. Providing home care (homecare) is another realistic option, as recent research shows that most people enjoy living and aging in place. The home care services model provides essential health and personal care support services that enable people to live in their own homes. This may be a preferred approach rather than receiving care in a nursing home (commonly referred to as old home in Bangladesh) or other institutional settings.
The demand for home-based care (HC) is increasing across the world because the supply of traditional home-based caregivers (female family members), women between the ages of 15 and 64, are educated or engaged in the labor force formal paid work. For example, in the United States, 67% of women aged 15-64 now work outdoors, while 52% of women worldwide work outdoors. This lack of caregivers is increasingly prevalent around the world, including in Bangladesh, and has highlighted in interesting ways the often invisible, ignored or undervalued care work that women have always done since dawn. of human history.
Home care workers are known for several professional titles; for example, home health aide, certified health aide, nursing aide, orderly, personal care worker, and homemaker. The term “home help” generally refers to all of these professions. While there is also considerable overlap when it comes to duties, there are also differences in job duties, usually related to the degree of medical support they can provide. Home health aides may be employed by a company called an agency or hired directly by care recipients or their families. Home care recipients are referred to as patients, clients or consumers; for brevity, “client” refers to all home care recipients. HC aides typically assist clients in their home with “Activities of Daily Living (ADL)” including walking, moving around the house or outside, eating, dressing, and bathing , toilet, bath and transfer. They also participate in “Instrumental Activities of Daily Living (IADL)” including transportation management, shopping and meal preparation, housekeeping and maintenance, communication management, and medication management .
The convergence of several social, economic and technological changes creates an urgent need for more home care services. The vast majority of those who will need these services are people over the age of 65 and other ill or disabled people. According to a report, nearly 17 million Americans living in the community need help with personal care and other daily tasks for their physical, cognitive, developmental and/or behavioral conditions, and 70% of adults in Ages 65 and older in the United States will need to pay for long-term support services at some point before they die. People are living longer with complex and varied health conditions – for example, 80% of Americans over the age of 65 have one or more chronic health conditions.
Social, demographic and economic changes are driving the provision of home care around the world. The majority of Americans say they would like home care; healthcare professionals, clinicians, government payers and private insurers recognize the medical and economic benefits of keeping clients at home. Another report indicates that Americans now prefer to die at home. In fact, more Americans died at home than in hospitals, nursing homes or any other facility in 2016.
This Covid-19 pandemic has again underlined the importance of home care as an alternative to residential care: the elderly were at high risk of serious Covid-19 infection, and nursing homes reported high infection and mortality rates.
The pandemic has made it clear that a healthy and safe workforce is needed to provide healthy and safe care to millions of people at home when possible.
Some issues or questions that Bangladesh needs to consider or reflect on how to provide care for its aging, chronically ill or disabled population are: (1) Can home care services be an appropriate care delivery model? ; (2) Who will pay for these services? ; (3) How to develop a trained and skilled workforce in home care delivery? ; (4) How can accounting for the safety of helpers and clients improve overall health services? ; And (5) how to make this model popular with care recipients and family caregivers?
Dr. Hasnat M Alamgir is Professor and Chair of Public Health at IUBAT-International University of Business Agriculture and Technology, Uttara, Dhaka. [email protected]