Elderly care: how it is produced and what proposals are there

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

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

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Is caring for the elderly a problem?

The term to care comes from the Latin cogitare, which means to think; so it can be understood as "thinking", but also as "having a concern." Hence, its meaning can be transferred to having a concern that something unwanted will happen, concern that translates into a concrete practice: protecting someone from an unwanted event, because that somebody have a hard time doing it on their own.

Care is then a rational activity that connects with an emotional dimension (Izquierdo, 2003): is focused on fear by the awareness of vulnerability of the other, a question that human beings satisfy among ourselves through interpersonal relationships.

For this reason, care is currently one of the central issues in the development of our societies. For example, much of social and health policies are organized around asking who is it? object of care, who can or should meet that need and what are the options available to do it.

Given this, many challenges have been detected. Among others, there is a question that has recently concerned the world's population, especially those who have experienced the “baby-boom” after the Second World War: Who is going to take care of 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 or a challenge. Far from old age itself having intrinsic conflictive qualities, the challenges have been the social changes themselves and economics that often leave some people on the sidelines of strategies designed to meet needs basic; 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 shortage of professionals and material or economic resources, their distribution and access are inequitable; In addition, there have been important changes in the social and productive roles of those who have been the main caregivers over time: 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 the autonomy and rights of the elderly.

This concept has allowed the development of some strategies, however, in some cases it has served also to hold the elderly 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 tendency to promote the social participation of older adults, and towards rethinking the concept and care practices, more specifically those related to health and disease.

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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 socioeconomic changes in recent decades, family support ratios are drastically changing.

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 three people by the year 2034. The consequence of this has been a considerable increase in the care needs of the elderly, as well as the groups or individuals who are responsible for meeting them.

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

Consequently, a large part of care practices are led by women, and the belief that caregiving is a 'female task' has even become widespread. For this reason, another of the great issues discussed has been the ‘feminization of care’.

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

In other words, a significant lack of care for the elderly and other populations that are in need has been put on the table today. contexts of vulnerability, as well as the need to generate new political and socio-educational strategies both at the family and professional level. In this context, it becomes relevant the strengthening of intra-family solidarity strategies in connection with social policies.

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5 proposals from the World Health Organization (WHO)

Although caring for the elderly is not a practice that is limited solely to health, it is in this sector where some specific challenges have arisen. Given 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 care practices begins to be the responsibility of public organizations, beyond being focused on private and family spaces. Some of the proposals that make up this plan are the following:

1. Commitment to healthy aging

Closely related to the concept of active aging, it refers to an awareness-raising process to create sustainable measures and scientifically-based policies that can promote the skills of older adults and their autonomy.

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

The aim is not to underestimate the need for the health system to organize itself around the diversity of old age, towards detect the preferences of the elderly and towards consolidating a good professional assistance network.

3. Establishing systems to provide chronic care

The relevance of promoting the detection of chronic and long-term care needs in a timely manner is discussed. including palliative care, and above all from the strengthening of infrastructures and the capacity of the personal.

4. Create environments adapted to the elderly

Due to the relationship between care and vulnerability, one of the most important issues on the subject is to extend the necessary steps to avoid stigma and discrimination, as well as to enhance autonomy and empowerment from the most basic and everyday levels.

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5. Improve Measurement, Tracking, and Understanding

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

Bibliographic references:

• World Health Organization (2018). Aging and health. Key facts. Retrieved April 30, 2018. Available in 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 in 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 in 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 for himself. Social organization and gender. Paper presented at the Catalan Mental Health Congress. Working group on identity, gender and mental health. Retrieved April 30, 2018. Available in http://www.debatefeminista.cieg.unam.mx/wp-content/uploads/2016/03/articulos/030_08.pdf.