Care for the elderly: how does it happen and what proposals are there?

Old age is a stage in which new needs arise. Are we taking good care of them?

Care for the elderly is a practice that has generated important debates in recent decades. in recent decades. This is because, in the face of social transformations and the most recent economic crises, aging has begun to be recognized as one of the stages most exposed to different conditions of vulnerability around the world.

Because of this, political and theoretical debates on care practices have become fundamental in the creation of strategies to mitigate the vulnerability of older adults and to strengthen both support networks and social policies.

Is elder care a problem?

The term care comes from the Latin cogitare, which means to think; so it can be understood as "to think", but also as "to have a concern". Hence, its meaning can be transferred to that of having a concern that something undesirable will occur, a concern that translates into a concrete practice: to protect someone from an undesirable event, because that someone has difficulties to do it by himself/herself.

Care is then a rational activity that connects with an emotional dimension (Izquierdo, 2003): it is centered on the fear of the other's awareness of vulnerabilityIt is centered on the fear of the other's vulnerability, an issue that we human beings satisfy among ourselves through interpersonal relationships.

For this reason, care is currently one of the central themes in the development of our societies. For example, a large part of social and health policies are organized around the question of who is the object of care, who can or should satisfy this need and what options are available to do so.

Many challenges have been identified. Among others, there is a question that has recently preoccupied the world's population, especially those who have lived through the "baby boom" after World War II: Who will care for us in our aging process?

Changes and challenges of care in old age

Old age is often understood as a problem, or at best as a challenge. Far from old age itself having inherently conflicting qualities, the challenges have been the very social and economic changes that often leave some people on the margins of strategies to meet basic needs; which in turn, generates passive positions and little participation in social affairs..

For example, health in old age is a challenge, but not because of old age itself, but because health is increasingly expensive, there is a greater scarcity of professionals and material or economic resources, their distribution and access are inequitable; in addition, there have been important modifications in the social and productive roles of those who have been the main caregivers over time: the direct families.

As one of the alternatives to cushion this, the concept of "active aging" has emerged, which refers to the optimization of physical, social and intellectual opportunities focused on autonomy and autonomy. focused on the autonomy and rights of the elderly..

This concept has allowed the development of some strategies, however, in some cases it has also served to make the older person responsible for a problem that is social, political and economic, which makes us see that this is a more complex issue than it might seem.

Despite this, in many contexts aging is ceasing to be seen as a problem. There is a trend toward promoting the social participation of older adults, and toward rethinking the concept and practices of care, more specifically those related to health and illness.

Who cares?

The family support network (the family support ratio), which is the direct family, has constituted the vast majority of caregivers. However, due to the socioeconomic changes of recent decades, family support ratios are changing drastically.

For example, in Spain, it is estimated that the number of caregivers will go from 6 caregivers for every 80-year-old adult to only 3 caregivers by the year 2034. The consequence of this has been a considerable increase in the care needs of the elderly, as well as in the groups or individuals who are responsible for meeting them.

In addition, the practice of caregiving has a very important gender dimensionThe practice of caregiving has a very important gender dimension: as something that has been understood especially in relation to private space, it has also been women who have been socialized in a greater identification with these values and tasks.

As a result, a large part of caregiving practices are conducted by women, and there is even a widespread belief that caregiving is a 'female task'. For this reason, another of the major issues discussed has been the 'feminization of care'.

Likewise, in many populations, the same political and socioeconomic conditions have promoted the fact that care is also a semi-professional task for the migrant population. that caregiving is also a semi-professional task for migrant populationsThis population has contained a large part of the problem of the shortage of care.

In other words, a significant lack of care for the elderly and other vulnerable populations is now on the table, as well as the need to generate new political and socio-educational strategies at both the family and professional levels. In this context, it is important to the strengthening of intra-family solidarity strategies in connection with social policies..

5 proposals of the World Health Organization (WHO)

Although the care of the elderly is not a practice that is reduced only to health, it is in this sector where some specific challenges have arisen. In response to this, the WHO has begun to develop a program called the Global Strategy and Plan of Action on Aging and Health.

In this way, an important part of the care practices begin to be the responsibility of public organizations, beyond being centered on private spaces and family members.. Some of the proposals that integrate this plan are the following:

Commitment to healthy aging 2.

Closely related to the concept of active aging, it refers to a process of awareness-raising to create sustainable measures and science-based policies that can foster the abilities of older adults and their autonomy..

2. Alignment of health systems with the needs of older adults.

It is important not to underestimate the need for the health system to organize itself around the diversity of old age, to identify the preferences of the elderly and to consolidate a good professional care network. and towards the consolidation of a good network of professional assistance..

3. Establishment of systems to provide chronic care

The relevance of promoting the timely detection of chronic and long-term care needs, including palliative care, and especially the strengthening of infrastructures and staff capacity, is discussed.

4. Creating age-friendly environments

Because of the relationship between care and vulnerability, one of the most important issues in the field is to extend the necessary measures to avoid stigma and stigmatization. necessary measures to avoid stigma and discrimination, as well as to enhance the autonomy of the elderly.and to enhance autonomy and empowerment from the most basic, everyday levels.

5. Improving measurement, monitoring and understanding

Finally, WHO recognizes the need to enhance research focused on aging, as well as to create new measurement and analysis mechanisms that are diverse, and that allow for understanding and addressing the complexity of care in old age.

Bibliographic references:

• World Health Organization (2018). Aging and health. Key facts. Retrieved April 30, 2018. Available at http://www.who.int/es/news-room/fact-sheets/detail/envejecimiento-y-salud.
• Alfama, E., Ezquerra, S. & Cruells, M. (2014). Aging in times of crisis. Retrieved April 30, 2018. Available at https://www.academia.edu/10729630/Envejecer_en_tiempos_de_crisis.
• Abellán, A. & Pujol. R. (2013). who will take care of us when we are octagenarians? Retrieved April 30, 2018. Available at https://envejecimientoenred.wordpress.com/2013/09/02/quien-cuidara-de-nosotros-cuando-seamos-octogenarios/.
• Izquierdo, M. J. (2003). Caring for individuals and groups: who cares. Social organization and gender. Paper presented at the Catalan Congress of Mental Health. Working group on identity, gender and mental health. Retrieved April 30, 2018. Available at http://www.debatefeminista.cieg.unam.mx/wp-content/uploads/2016/03/articulos/030_08.pdf.