Ageing gracefully, and with a purpose

Ageing is really the single most important demographic shift that will affect the future of Malaysia


NOT everyone is as blessed as our Prime Minister Tun Dr Mahathir Mohamad.

At 94, the world’s oldest serving leader is enjoying every bit of his life along with his wife, Tun Dr Siti Hasmah Mohd Ali, who is only a year younger.

From going to the cinema to watch “Star Wars: The Last Jedi” to humming along to a medley of songs with Dr Siti Hasmah playing the piano, the pictures and videos of Dr Mahathir on the Internet say it all.

Not many people enjoy good health at that age. According to data sourced from the World Health Organisation, life expectancy in Malaysia has risen to 75.3 years from 70.73 years in 1990.

By 2040, the country is expected to have three Malaysians aged 65 and above for every 20 people. This also means that we will have nearly equal share of the young and older population at 18.6% and 14.5% respectively.

The Healthcare National Key Economic Area estimated that the country will reach ageing nation status in just 10 years, with more than 15% of the population over the age of 60.

Changes in the size and composition of the population occur with time. The Department of Statistics Malaysia has outlined that lower birth rates and declining Total Fertility Rate (TFR), as well as increasing life expectancy, have contributed to the ageing population.

Birth rates decreased from 32.4 in 1970 to 16.7 per 1,000 population in 2015. In addition, TFR declined from 4.9 in 1970 to 2.0 in 2015.

Falling birth rates and TFR were due to higher education and late marriages.

Late marriages lead to couples having fewer children.

With many women gaining higher education and better employment opportunities, the percentage of unmarried people has risen — a common phenomenon in many industrialised country.

Increasing life expectancy has also led to the increase of older age population, following excellent medical healthcare, good diets and high quality of life.

Ageing is really the single most important demographic shift that will affect the future of Malaysia. It is perhaps the right time for the government to come out with a comprehensive and coordinated approach so that the seniors would continue to age gracefully, while staying in good health.

Seniors are a very diverse group.

They come from various backgrounds, educational levels, preferences, capacities, capabilities and life experiences.

Their individual differences increase with age and this is what our policymakers should look into.

According to Singapore University of Social Sciences senior lecturer Dr Helen Ko, seniors can be classified into three groups — the Go-Go seniors, Go-Slow and the No-Go seniors.

The classification is based on functional age, which is a person’s ability to perform tasks such as bathing, dressing and eating.

“The Go-Go seniors group is likely to be in their 50s and 60s, is healthier, wealthier and more educated compared to their predecessors from 20 years ago.

“In fact, with medical advances and healthy lifestyles, physically, some of these seniors may be as fit as those in their 30s or 40s,” she was quoted as saying in a media report.

Ko said the Go-Slow seniors — who are likely aged between their late 60s and 80s — may be plagued by health conditions or chronic illnesses such as hypertension, diabetics and heart problems, which tend to increase with age.

“Compounded by age-associated sensory decrements such as hearing impairment, as well as changes in posture and balance, various modifications to their environment will be needed so that they can access amenities such as markets, community clubs, clinics, hospitals.

“Public transport must be adapted to accommodate their needs,” she added.

As for the No-Go seniors, the group comprises seniors with multiple care needs, who may be non-ambulant, bed-bound or highly dependent on caregivers.

“They require a suite of support services — home care, meal services, counselling, befriending, transportation, escort services for medical appointments, financial assistance, end-of-life care and other therapeutic interventions — for themselves and their families,” said Ko.

Given these categories of seniors, it is imperative for the government to craft a multi-pronged approach to deal with issues surrounding ageing population and enhance the comfort of the targeted population.

Perhaps, we could start by having a dedicated department to look after the seniors just like how Singapore is running its Ageing Planning Office under the Ministry of Health.

Rahman Daros is the supplement editor of The Malaysian Reserve.