Empowering the elderly in Sri Lanka

Sri Lanka boasts of one of the most advanced free health care systems in Asia. Whatever the drawbacks are, our government health system is well standardised and attempts to integrate high tech medical advancements. Our life expectancy at birth is 77 years which is better than Russia (71), India (69), China (76) and even Malaysia (75). We also have one of the fastest growing elderly populations in the world because of better health standards. In the following paragraphs, I will explain some of the concepts that are extremely useful to keep the elderly active and engaged in our Sri Lankan setup.  

What is active ageing?  

Geriatrics is the branch of medicine that deals with elderly patients. The term is usually devoted to people aged 65 or above. With age emerges new health challenges. Rheumatology is the key specialty in medicine that involves geriatric health care in the Sri Lankan setup. As most of the elderly patients have joint diseases, we rheumatologists get an opportunity to evaluate other health problems when they approach us for pain relief.  

The world health organization defined the term “Active ageing” as optimizing opportunities for health, participation and security in order to enhance the quality of life as people age. Simply put, this is enhancing the well-being of elderly patients as they age. But why do we need to enhance their quality of life? And what needs to be done to promote active ageing in Sri Lanka?
Being actively involved in treating the elderly, I have noted that most of the aged patients tend to disengage and mutually withdraw from society at a certain age. The reasons for disengagement vary from one individual to another. A key fact that I have observed is the type of personality seen in the elderly patient. Another very important reason for withdrawal might be on how the society assigns roles to the elderly. In Sri Lanka, there lies a myth on a mandatory resting age, where people are expected to focus on religious activities and indulge in thoughts about the afterlife. Worldwide there is also an accepted scheme of three phases in life, which are learning, working and resting. I believe that in order to promote the active participation of the geriatric age people, we need to counteract these traditional beliefs.  

Our life expectancy at birth is 77 years which is better than Russia (71), India (69), China (76) and even Malaysia (75) We also have one of the fastest growing elderly populations in the world

Why do we have to empower the elderly in Sri Lanka?  

Empowering the elderly gives direct benefits to the person who’s aged as well as the caregiver. I will describe the caregiver’s agony first. Sri Lanka does not have a government sponsored caregiver scheme to look after the needs of elderly patients. This will be an enormous problem in the years to come. As I earlier described with a rapidly expanding geriatric population, we are in need of a well-structured elderly care programme.  

The current situation in rural areas like the north-central province is detrimental, where a young unwilling adult is assigned the task of a daytime caregiver. This young adult who has the capability to contribute to the workforce will remain at home during the daytime to look into the needs of an ailing parent/relative. Not just economical but psychological issues arise as a result of this assignment. Therefore the sole breadwinner of the family is additionally burdened with financial issues.  

The old aged people in Sri Lanka have serious issues affecting their physical, emotional and social well-being. When the elderly are given the power to engage in the community as a useful resource person, this alone will enhance their well-being. Providing a sense of importance boosts the confidence to involve more and play advisory roles in society.  

What are the steps that lead to the empowerment of the elderly?  

There is no universal consensus on how to promote active ageing. Therefore we need to device a feasible method that suits the Sri Lankan context. Firstly identification of the social groups that are most vulnerable to the “side effects” of the expanding elderly population is a must. I feel that devoting more attention to the rural communities is ideal.  

We require at least a few research projects on the four phases of old aged which are pre-retirement, independent living as a retiree, early dependent living and dependent living up until death (Malanowski et al). The pre-retirement group is further subdivided into those who are in good or poor health. Discovering the major problems of each category in the Sri Lankan communities is essential for us to plan on empowerment.  

A media campaign on not to stereotype or discriminate the elderly based purely on their age is another important step. People in their geriatric ages could be given more prominence with tags such as “Older and wiser” or “Older with decades of experience”. In a society where media campaigns easily win the hearts of the majority, this will not be a difficult task.  

The old aged people in Sri Lanka have serious issues affecting their physical, emotional and social well-being

I am also in the process of promoting an eight hour period of freedom within rural communities. If the elderly people could remain independent during the daytime without the aid of a caregiver, a young adult who usually plays the usual role of a caregiver could find employment. This will strengthen the household economy as well as nourish the workforce.  

Independent research should be carried out to find the capabilities of the elderly. Categorizing them according to their strengths and weaknesses is the next step. Getting them involved in voluntary work is also useful. As an essential measure, I propose introducing technology knowledge to people in the geriatric age group.  

I also believe that there should be a government department for the employment of the elderly in Sri Lanka. The Finnish National Programme on Ageing Workers (FINPAW) launched in 1998 overseen by three government ministries: the Ministry for Social Affairs and Health, the Ministry for Labour and the Ministry for Education. Its objective was to promote the employment of those over the age of 45, promotion of practical learning and the development of the links between health, education and working life. The programme is a visionary one and we badly require a similar scheme in our country.  

The author is a member of the American College of Rheumatology and   Consultant in Rheumatology and Rehabilitation