Tri Budi W. Rahardjo CENTRE FOR AGEING STUDIES - PowerPoint Presentation

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Tri Budi W. RahardjoCENTRE FOR AGEING STUDIES Universitas IndonesiaUNIVERSITAS RESPATI INDONESIA

Overview of Healthy Ageing Practice in South East Asia

Presented at ACHA

2017

10th-12th Oct 2017

Hotel Pullman

Kuching

Sarawak, Malaysia

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BACKGROUND

The population of older persons in ASEAN has been increasing consistently due to rising life expectancy.

By 2050, one out of every four older persons will be over the age of 80, and the number of older people over 100 years old centenarians will at least triple in the Southeast Asian region.

Older people in most parts of this Region live in the community where they have spent the best part of their lives. An effective strategy to keep the elderly active and help them age with dignity is to provide most of their care in a community setting.

POPULATION AGEING IN SOUTH EAST ASIA

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Population in South East Asian Countries

Country

Population (2017)

Indonesia

(263,991,379)

Philippines

(104,918,090)

Viet Nam

(95,540,800)

Thailand

(69,037,513)

Myanmar

(53,370,609)

Malaysia

(31,624,264)

Cambodia

(16,005,373)

Laos

(6,858,160)

Singapore

(5,708,844)

Timor-Leste

(1,296,311)

Brunei Darussalam

(428,697)

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Population Ageing

2015

2050

S

ource: WHO World

Report on Ageing and

Health, 2015

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Region or Sub-region

Number of people Percent

Percent

Increase

Age 65 and above (1.000s)

2000

2025

2050

2000-2050

Asia

206,822

456,303

857,040

314

East Asia

114,729

244,082393,802243Southeast Asia24,33557,836128,958430South Asia67,758154,385334,280393

Projected growth of Asia’s elderly population

Source:

United Nations (

2001

).

Notes:

All data are based on the United Nations medium fertility variant.

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HEALTHY AGEING

PRACTICES

Healthy ageing is the process of optimizing opportunity for physical, social and mental health to enable older people to take an active part in society without discrimination and to enjoy an independent and good quality of life (WHO-SEARO, 2012)

To cope with improving health status of older persons, healthy ageing practices in SEA has a

similarity

in term of traditional pattern of family support and community solidarity but there is

diversity

relates to social, economic and political issues

HEALTHY AGEING

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As non communicable diseases become more prevalent among older persons, there is an urgent need to prevent non communicable disease-related disabilities and to plan for long-term care. Ageing is among the major contributory factors to the rising incidence and prevalence of non communicable

diseases, which are leading causes of preventable morbidity and disability.Only view of older persons with good health, such Indonesia ,such as Indonesia, only 13%Health Problem

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A Public-Health Framework for Healthy Ageing (WHO,2016)

Long-term Care

:

Environments

:

High and Stable Capacity

Declining Capacity

Significant Loss of Capacity

Health Service:

Functional

Ability

Intrinsic Capacity

Prevent chronic conditions or ensure early detection and control

Promote capacity-enhancing

Behaviours

Support capacity-enhancing

behavioursManage advanced chronic conditionsRemove barriers to participation, compensate　for loss of capacityEnsure a dignified late life

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Healthy Ageing Issues Intervention All ASEAN countries have established several similar interventions to address these issues although the magnitude and coverage of such interventions show wide diversity and effectiveness such as:

Health Care Older Person Activities ( Active Ageing) Long-term care

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Health Care System Adaptation of the health systems to the challenges of population ageing and to meet the health needs of the elderly

Objective: Design interventions and initiatives that provide a package of preventive, promotive

, curative and rehabilitative measures to ensure active healthy ageing throughout the life-cycle

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Similarity and diversity in Health Service Delivery Healthcare delivery is provided by both the government and private sectors for all ages . The delivery of health care in the rural areas is achieved via a network of health centre and mobile teams, supported by the presence of district hospitals and secondary referral state general hospitals.

Further specialized services are available at the General Hospital and geriatric clinics

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Po

lyclinic

Acute

ward

Chronic ward

Day-care

Hospital-based

Home-care

H

ealth

Center

Instutional

elderly home

Comm

Day-care

Community-basedCompleted the acute phaseDischarge planningCare at home/Home Health NursingPromotive,Preventive rehabilitative activitiesMore limited informal carePaid by local communitySome personal care Domestic assistant Profesional staff involvementGrowing into institutional care and social system-based home careHealth Care System for older personsTransitional care ?

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Indonesia Community Care:

Activities and Services

for Older Persons in Integrated Community

Posts

;

84 000 in 2017

-

PHYSICAL EXERCISE

- ROUTINE CHECK UP

- SEMINAR, ETC.

h

HEA

LTH EDUCATION

8

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Age Friendly Neighborhoods, C

ommunity

care

for elderly

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ACTIVE AGEING

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Colin Milner, 2013

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Intergenerational Program ‘reduce ageism’

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Social activities :

Retirement Group Activities : Faculty of Dentistry UI

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Similarity in Cultural ,Emotional and spiritual Activities

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PHYSICAL ACTIVITY

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LONG TERM CARE

Establish and strengthen programs to ensure that all

older persons in need of care have access to long-term care services regardless

of age, gender, income and other considerations. Such programs should

be carefully shaped to avoid

fragmentation

of

care provision

and constructed for

a seamless

system of

care

(

health and social care

)LONG-TERM CARE OF THE ELDERLY POPULATION

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Diversity of quality in Activity of Daily Living (ADL) in Long Term Care ( traditional to modern way)

Eating: assist feeding, provide nutritious meals and adequate fluids;Bathing: assist bathing, transferring in/out tub/shower, bed bath as needed;Dressing/Grooming: assist dressing, glasses, hearing aides, special orthotics (i.e. braces), hair care, shaving, oral hygiene;Ambulation: assist walking, safe use of assistive devices, range of motion and strengthening exercises;Toileting: assist to bathroom, bedside commode, urine, bed pan usage;

Incontinence: assist changing diapers, undergarments, pads, related skin care.

A D L

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All ASEAN Countries: Similarity of Home Care and Institutional care and diversity in quality

ADL by care giver (informal and formal) Home Nursing Services               Medical Appointment Companion ServicesIn developing countres, providing home and community long term care can enable older persons with care needs to stay at home as long as possible. This can help greatly improve their situation, and it is what most want. Also, supporting an older

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The Ministry of Women, Family and Community Development has established the Home Help Services throughout the country through smart partnership with NGOs to provide care for older persons and persons with disabilities (PWDs) living alone. Among the services provided are bringing the bed ridden older persons and PWDs to hospitals/clinics for health treatment and assisting the older persons and PWDs to clean themselves in the aspect of personal hygiene.

MALAYSIA

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THAILAND LONG TERM CARE NETWORK

Medical

Doctors

Lab

Technicians

Nurse

Dentists

Social Workers

Physical Therapists

Nutritionists

Pharmacists

Socio-

Health Care

Community Health Promotion Hospital

Community-based

Organisations (CBO)

Adult Day Service

(

ADS

)

Programmes

Case managers

/

geriatric care

managers

Home Health

Care (HHC)

/

Home Care

Emergency

response

systems

Home chore

services

Home visit

/

Companion

services

Meals

programmes

Respite Care

Senior Centers

Transportation

services

Transitional Care/

Intermediate Care

THAILAND

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Family and Community Based Long Term Care

Family and Community Based Long Term Care (LTC) For Older People is a family and community support system, Part of community care program which provides assistant to the family in caring older persons, both who are independent and partial or fully dependent( Multi Sector approach)

INDONESIA

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Community Network of Long Term Care (LTC)thers is no LTC Insurance

Field staff

Comm.

leader

Health center

Village- Sub

district

Red cross

Hospital

Instituonal

Care

INDONESIA

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Singapore Long Term Care The model is built on a senior's care continuum, and provides for the health and medical support, social and psychological needs of an elderly, as well as support for the caregivers, provide holistic eldercare services and solutions with

LTC insurance system

SINGAPORE

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Vietnam Long Term care Informal care by family and

community Formal care supported by Long Term care Insurance

VIETNAM

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Maintaining Independency in LTC

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Weakness in promoting and protecting t human rights and fundamental freedoms of elderly personsConcept of healthy ageing is not yet adequately addressed, andNational programmes to promote healthy ageing have not gained optimallyLack of qualified health providers and care givers as well as appropriate facilities Universal coverage and Long Term Care Insurance have not been implemented adequately

Limitation

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Ageing of the population and its impact on the economic, social and health situations have been recognized by all South-East Asia CountriesThere are similarities of community health care and active ageing practices ,but there is a diversity of quality in term of Long Term Care ServicesThere are some limitation in the implementation of Healthy Ageing Practices

CONCLUSION

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Promoting and protecting t human rights and fundamental freedoms of elderly persons to avoid abuse Implementation of healthy ageing concept and programme properly Working together in training and education for health providers and care givers as well as appropriate facilities Exchange experience

each other in this Region in the implementation of Universal coverage and Long Term Care InsuranceCollaborative research in this region on Healthy Ageing Practice

RECOMMENDATION

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Prof. Nathan Vytialingam

Organising Chairman

Dr. Wong Teck WeeScientific Chairman

All Committee Members

ACKNOWLEDGEMENT

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Please join the ACAP 2018 in Hongkong 25 – 28 January, 2018

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Terimakasih

Thankyou