Social Structures
Author: Matthew McKenna, PhD Researcher at Maynooth University’s Assisting Living and Learning Institute (ALL Institute)
The World Health Organisation (WHO) Department of Data and Analytics published a technical report in December of 2020 yielding data which highlights the need for increased global awareness of the importance of healthy ageing in the twenty-first century. The report found that global life expectancy increased by more than six years between 2000 and 2019; from 66.8 years in 2000 to 73.4 years in 2019. However, it was found that increased life expectancy did not entail a corresponding reduction in the number of years lived with a disability among older persons. In addition, the United Nations (UN) Department of Economic and Social Affairs estimates a 56 percent global increase, from 901 million to 1.4 billion, in the number of people aged 60 years or over in the 2015-2030 timeframe; this figure is predicted to rise to almost 2.1 billion by 2050 based on current data.
Human society must adapt to support and engage with older persons so that nobody is left behind in an older society. In that regard, the promotion of active, healthy, engaged and independent living for older persons above the age of 65 is key.
The ongoing Covid-19 pandemic has disproportionately affected older persons, particularly those with disabilities and underlying health conditions. Over the past year and a half, global news media has been frequently awash with stories of nursing homes whose communities were devastated by the pandemic due to the increased numbers of older, medically compromised persons who were in-residence in these institutions. This tragic situation has highlighted the increased health risks and vulnerability of older persons who reside in residential care facilities or who are dependent on caregivers. It is arguable that the disproportionate casualty ratio among older persons during the pandemic may have been mitigated in the case that lower rates of institutionalization and wider supports for independent and autonomous living were available for those over the age of 65.
On June 15th, designated as World Elder Abuse Awareness Day by the UN, it is important to reflect upon the words of UN Secretary General António Guterres, who said in May of 2020 that, ‘No person, young or old, is expendable. Older people have the same right to life as everyone else’. Furthermore, the high infection, illness and death rates among older persons in institutionalized care during the pandemic arguably shows how the medical model approach to disability among the aged comprises a global neglect and abuse of a vulnerable demographic of human society. To ensure that such a tragedy does not repeat itself in the event of future global health crises, it is vital that society moves towards the human rights approach to disability and de-institutionalization in all demographics, including older persons. Independent living, support by enhanced, efficient and progressive community services, is crucial to enabling the active, participatory and healthy living of older persons throughout the ageing process.
Regarding conventional forms of elder abuse witnessed under medical model and institutional approaches to disability, it is foreseeable that the rates and incidences of neglect and maltreatment can arguably only increase as the proportion of the global population aged 65 and over increases. Unless there is substantial progress in de-institutionalization alongside the provision of efficient community care services that also respects the rights of caregivers, then elder abuse is likely to remain a chronic issue well into the twenty-first century and may be greatly exacerbated as the proportion of older persons increases.
Alsaqer (2021) highlights two key risk factors in the relationship between older persons and caregivers. The first adverse interactions in this domain as discussed by Alsaqer relates to caregivers’ abuse, in which a vulnerable older person may be subjected to physical or verbal abuse, neglect, coercive-control, theft or manipulation amongst other forms of abuse. The second risk factor is that a caregiver is likely to suffer from depression and emotional strain due to the demands of their role. Alsaqer highlights that some studies show that many caregivers must devote between 40-100 hours to their task and, two thirds of caregivers suffer from depression with some 90 percent being emotionally affected in their work. He also mentions that this can result in an older person feeling guilty and burdensome upon their family or other respective caregiver; this often leads to depressive tendencies and sometimes even suicidal depression among older persons in receipt of the services of caregivers.
To reduce the risk of elder abuse as the global population of older persons increases into the future, it is essential that aged persons and caregivers can access ‘smart’ Assistive Technologies (AT) that incorporates ‘Artificial Intelligence’ (AI) into modern, universal and accessible design standards. These technologies hold the potential to preserve or restore independence to older persons with disabilities or who are medically compromised. Alsaqer explains that modern AT can maintain, rehabilitate or offset the functionality of impaired limbs or movement, aid balance, rejuvenate bodily mobility, assist vision and hearing, provide important reminders such as timetabled medication dosages for persons with forgetfulness or cognitive degenerative diseases and can even assist in the measurement of dosages to be taken. Smart AT can monitor the health of a user and provide intellectual stimulation through a wide range of activities, as well as connectivity with the wider world, enabling active, engaged, social and participatory ageing.
In conclusion, greater integration, utility and accessibility of AT for older persons with disabilities can help to increase protection, autonomy and engagement for all persons throughout the ageing process. The integration and symbiosis of AT for older persons can also reduce the strain and pressure placed on caregivers and would likely contribute to lower rates of depression and adverse emotional affects for this demographic whilst increasing public health as a complimentary benefit of this process.