Glimpses of a positive aging strategy

I began this discourse a few weeks ago by indicating that three programmes targeted at the elderly by the Barbados government have been identified as regional best practices. However, here I am not interested in best practices in the delivery of quality services as such: I want to point to some aspects of a practical approach that we could utilise to establish a realistic vision and programme of services for the elderly. The New Zealand approach to drafting of its “Positive Aging Strategy” 2001, has been identified as a best practice by the 2008 “Madrid International Plan of Action on Ageing: Guiding Framework and Toolkit for Practitioners & Policy Makers” and being a developed country, the programme of services it provides may well represent an “ideal type” which could inform our vision.

That said, both New Zealand and Barbados are far better off than Guyana and this important fact must also inform our expectations. The World Development Indicators of the World Bank show New Zealand, Barbados and Guyana as having Gross Domestic Product per capita incomes (at current US$) of US$32,618, US$14,992, and US$2,992 respectively in 2010. Note may also be taken of the fact that in 2009 it was estimated that 9 per cent of older people in New Zealand were living below the low-income threshold compared to 15 per cent for the population as a whole and 22 per cent of children.

Not unusually, the provision of services to the elderly in New Zealand is a combination of private and public support. Briefly, there are: (1) the usual national and private pension payments; (2) A gold card scheme, which gives a wide range of discounts from businesses, government and local government services; (3) accommodation supplements; intended to supplement the cost of renting, boarding or purchasing; (4) residential care subsidies for those needing long-term residential care in rest homes or hospitals; (5) a community services card, which gives family discounts on doctors’ visits and even home insulation cost; (6) a disability allowance; (7) advance payments if one urgently needs financing for items such as essential house repairs or household appliances, which are not immediately affordable; (8) a special needs grant, a one-off payment to help with urgently needed items like food, bedding; (9) temporary additional support if one finds it hard to cope financially; (10) funeral grants to help with the cost of burial; (11) help to care for children if one is the principal caregiver of a dependent child; (12) orphan’s benefit if one is caring for someone else’s child; (13) child disability allowance if one is taking care of a child who has a serious disability, and (14) a childcare subsidy; extra help with childcare costs.

The “Guiding Framework” mentioned above helps countries to develop and implement plans, and many regions (“Regional Strategy for Latin America and the Caribbean in the Implementation the Madrid International Plan of Action on Ageing:” 2003) and countries (New Zealand) have policies that are rooted in its methodology.

The Madrid Plan argued that the lack of political will on the part of governments is one of the reasons for underachievement in the area of elderly provisioning. As such, a necessary first requirement is government commitment which goes beyond the usually platitude of older persons being “important members of society” and identifies specific longitudinal binding obligations to allocate sufficient resources.

The next important step must be the creation, by the government and stakeholders, of adequate institutional mechanisms to devise, implement and monitor the process, and here is where the New Zealand experience may be particularly useful. Much like our National Commission on the Elderly, that country had a cabinet appointed Advisory Council for Senior Citizens which provided the responsible minister with independent advice. For the specific purpose of creating the “Positive Ageing Strategy,” a positive ageing reference group was appointed to give advice on positive ageing issues and volunteer community coordinators to organise consultations within their communities and to identify priority issues for inclusion in the strategy and a Positive Ageing Strategy Project Team, responsible for the day-to-day management of the initiative were also established.

The New Zealand Positive Aging Strategy: 2001 outlined ten priority areas which are sure to find resonance here. It calls for: (1) a review and monitoring of living standards and the enactment of legislation to ensure that the elderly have a adequate and secure income; (2) a health sector with integrated planning, funding and delivery of primary, secondary, residential and community support services; (3) a comprehensive geriatric needs assessment to provide equitable, timely, affordable and accessible health services for older people; (4) ageism to be eliminated in employment and flexible work options developed to suit the aged by the provision of family-friendly workplaces; (5) government to provide assistance for low-income families to purchase their own home, support pensioners’ housing complexes, strengthen the protection of retirement villages and maintain an income relation housing policy for the elderly; (6) affordable, accessible, safe and user friendly transportation options to ensure that the lack of transport is not a barrier to persons accessing health services; (7)  a policy to make elderly feel safe and secure and able to “age in place”, which requires the promotion of safety awareness programmes; (8) services targeted to specific ethnic and marginalized groups such as the Maori; (9) older people living in rural areas not to be disadvantaged when accessing services;  (10) efforts to be made to see that people of all ages have positive attitudes to ageing and older people: government publicity campaigns to carry positive images of aging and intergenerational programmes should be taught in schools.

Finally, the Positive Ageing Strategy contained a two-tier monitoring, review and reporting process. Utilising baseline data, the first level involved the monitoring and reporting on the progress made in relation to the commitments of the various departments of government which are located in the annual Positive Ageing Action Plan. Further, a report was to be published at about three yearly intervals, assessing the current condition of the aged and identifying old and new issues requiring further action by the stakeholders.