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Healthy ageing
Why healthy ageing?
In order to tackle the acute problem of population ageing, World Health Organization re-affirmed the “healthy ageing” framework in a recent report published in 2015. In this report, WHO recommend countries to provide adequate assistance to older adults, enabling people to be and do what they value throughout their lives.
Healthy Ageing replaces the World Health Organization’s previous Active ageing: a policy framework developed in 2002 and is the focus of WHO’s work on ageing between 2015 – 2030.
The concept
According to the World Health Organization, healthy ageing is the process of developing and maintaining the functional ability that enables well-being in older age.
Functional ability is made up of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. Intrinsic capacity is the composite of all the physical and mental capacities of an individual. Environments comprise all the factors in the extrinsic world that form the context of an individual’s life, such as home, community and society.
So... how does the above translate to health in old age?
- Intrinsic capacity, such as education, can impact older adults' health. More educated older adults may have better job environment, better health care and healthier lifestyle since they were young! So naturally, when they step into old age, they are in a position to exercise healthy ageing.
- Environment has a huge impact on older adults' participation in society as well. Imagine Hong Kong without the $2 transportation scheme, much fewer older adults would go out as often to socialize, volunteer and even work!
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From Our Hong Kong Foundation
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From Our Hong Kong Foundation
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The framework
As older adults experience decreased intrinsic capacity, gradually they lose functional ability, which prevents them from experiencing healthy aging in old age. However, a well-planned supportive environment could compensate for the loss of intrinsic capacity and retain older adults’ functional abilities at an acceptable level even when an individual suffers from substantial loss of intrinsic capacity.
What is a well-planned & supportive environment?
WHO stated that a well-planned civic and health system should be "person-centered", as the capabilities of different older adults could vary a great deal.
Why?
While some may have the physical ability of a 30 year-old, and some may need others to care for in their daily lives.
What should we do?
For those who have higher functional ability, the society should provide them with more opportunities to work, volunteer, socialize and contribute in different ways. For those who have less functional ability, the society should provide them with the most autonomous and dignified care, such as providing transitional support from hospital to homes, and letting them age in place as much as possible.
It would be unwise to think all older adults are the same, and thereby set "one policy for all".
On the individual level, we must remember that no two older adults are the same. Mui, Chi & Chui (2008) stated that some people may think all older adults are 3Ds (Dependent, Depressed and Demented). If that is what you have in mind, you may have fallen into the trap of "ageism"!
References
Mui, A., Chi, I., & Chui, E. W. T. (2008). Gerontological Social Work for the 21st Century.
Healthy Ageing, like Active Ageing, emphasizes the need for action across multiple sectors and enabling older people to remain a resource to their families, communities and economies.
World Health Organization
Healthy ageing & Hong Kong
2018
Innovation and Technology Fund for Application in Elderly and Rehabilitation Care (樂齡及康復創科應用基金)
Subsidizing rehabilitation and older adults service units to procure, rent and trial use technology products, to improve quality of life of service users and reducing burden and pressure of care staff and carers.
2017
"Ageing in place as the core, institutional care as back-up" (居家安老為本，院舍照顧為後援)
Updated policy guideline set by the Government.
2014
Living Allowance for Carers of Elderly Persons from Low-income Families (為低收入家庭護老者提供生活津貼試驗計劃)
Providing carers of older adults from low-income families with a living allowance to help supplement their living expenses so that older adults in need of long-term care services can, under the help of their carers, receive proper care and age in place.
2012
Universal Accessibility Programme (人人暢道通行計劃)
Creating barrier-free access facilities at public walkways, striving to create a “universally accessible” environment in the community to facilitate the access to public walkways by the public.
2012
Government Public Transport Fare Concession Scheme for the Elderly and Eligible Persons with Disabilities (a.k.a. 兩元計劃, $2 Scheme)
Enabling older adults and disabled to travel on designated public transport modes and services at a concessionary fare of $2 per trip.
2007
Elderly Academy (長者學苑)
Offering opportunities for older adults to pursue studies and participate in activities that foster their general well-being, both physically and mentally.
2001
Enhanced Home and Community Care Services (改善家居及社區照顧服務)
Enabling older adults to age in place as well as providing support to carers and strengthening family cohesion.
1997
"Sense of belonging, sense of security and sense of worthiness" (老有所屬 ﹑老有所養﹑老有所為)
Three objectives set by the Government.
2018
The Employment Programme for the Elderly and Middle-aged (中高齡就業計劃)
Encouraging employers to engage unemployed job seekers aged 40 or above and provide them with on-the-job training, through the provision of training allowance to employers.
2017
Elderly Service Program Plan (安老服務計劃方案)
With the help of consultants from the Department of Social Work and Social Administration of HKU, envisioning ten overarching principles in guiding older adults services policies, including "active and productive aging," "age-friendliness," "age-in-place," and "social inclusion and equal opportunity." The plan strives to focus on the contribution side of older adults rather than seeing them as needing help.
2015
Navigation Scheme for Young Persons in Care Services (青年護理服務啓航計劃)
Providing employment to younger adults either in care work for older adults or rehabilitation service units, and training of two-year part-time course under government subsidy, for those interested in working in the care service of the welfare sector.
2014
Community Care Service Voucher for the Elderly (長者社區照顧服務券試驗計劃)
Adopting a new funding mode of 'money-following-the-user' approach (「錢跟人走」模式), eligible older adults may choose community care services using Community Care Service Voucher for the Elderly (Community Voucher).
2012
Strategic Service Framework for Elderly Patients (長者醫療服務策略)
Enhancing well-being of older adults, and contributing to healthy ageing, by raising the standards and quality of healthcare wherever care is given.
2008
Neighborhood Active Ageing Project (左鄰右里積極樂頤年)
Establishing a support network in a neighborhood setting with the older adults playing a leading role.
2003
Integrated Home Care Services (綜合家居照顧服務)
Providing a range of community support services to older adults in the community with experienced and professionally trained staff.
2000
Standardised Care Need Assessment Mechanism for Elderly Services (安老服務統一評估機制)
Using minimum Data Set-Home Care (MDS-HC) to ascertain the care needs of older adults and match them with appropriate services.