ALLISON LAI and JUNAID IBRAHIM
Care more for home alone elders
PETALING JAYA: In the last few months, there were almost 10 cases of elderly people found dead alone, which is a worrying trend.
Experts are calling for a more structured health and social service through a proper social safety net for the elderly, especially for those living alone.
Universiti Malaya’s professor of geriatric medicine Dr Shahrul Bahyah Kamaruzzaman said the traditional caregiving support system has been altered due to medical advancement, leading to increased longevity and a decline in marriage, among others.
She said this will lead to a possible rise of vulnerable elders without relatives to support them physically and mentally.
“The rising numbers (of lonely deaths) should prompt the relevant stakeholders to provide safety nets for those who are socially isolated, may no longer be able to make their own medical decisions and have no designated surrogates,” she told The Star.
According to the Statistics Department, Malaysia’s ageing population will see the percentage of people aged 60 years and above reaching 15.3% of the total population by 2030.
In the National Health and Morbidity Survey (NHMS) 2018, it was estimated that 7.4% of elderly people lived alone.
A further 31.9% reported themselves as having low social support in terms of social interaction and perceived satisfaction from their subjective support.
Dr Shahrul Bahyah, who is also the president of Malaysian Healthy Ageing Society, recommended both top-down and bottom-up approaches to deal with the issue.
“The bottom-up strategy would be to identify, engage and support older persons, especially those who live alone at home, at the community and neighbourhood level via resident associations, Rukun Tetangga and senior associations to provide social engagement, support and access to healthcare, community services and inclusion to social activities.”
She said the top-down approach would be in the form of policy – the Senior Citizens Bill which is to be tabled next year.
“Inputs to the Bill should involve stakeholders especially health professionals, NGOs and agencies invested in care of older people, especially at the community level.
“This would create a more detailed policy for the appropriate identification, protection, monitoring and deployment of health, social and other services of those who are frail and at risk in any community,” she said.
“Concerns would be if planning of the Bill does not engage all levels of stakeholders and once launched, the implementation and regulatory aspects are not in place.”Malaysian Coalition on Ageing (MCOA) chairman Cheah Tuck Wing said “loneliness can kill” and it is important for the elderly to be socially active to overcome it.
“This trend is expected to increase when more people remain unmarried. In Malaysia, the average fertility rate used to be around 6 or 7 in the 1970s but it has dropped to 1.7 in 2020, and is expected to decline further,” Cheah said, adding that it is important for seniors to remain active in their local community, such as by going for exercise or meals together.
“Doing so creates a support group to help check on their members daily. In Singapore, there are volunteer groups to look out for the underprivileged and elderly. They do door-to-door visits.
“It is also good for seniors to have an alert alarm system at home to call for help in emergencies,” he said, adding that learning initiatives for seniors such as the University of Third Age (U3A) and Pusat Activity Warga Emas (PAWE) are also helpful.
“The government can play an important role by supporting these groups with subsidies and grants. They can build activity centres at every constituency and fund activities for older persons.“When you have a healthy and active senior community, healthcare and other related costs can be reduced significantly.
“The government needs to do more because currently, not much progress has been seen. Most of these activity centres are privately initiated and funded.”
Citing the example of Japan that has a significant number of aged citizens, Cheah said the country had to appoint a “minister of loneliness” to curb social isolation among seniors.
“In Singapore and Hong Kong, innovative new housing models are curated to cater for the ageing population with social, healthcare, commercial and retail facilities. “This encourages healthy communal living by co-locating childcare and elder care service with sport facilities,” he said, adding that steps are also taken to enliven existing estates where many seniors live.
New York-based Global Coalition on Ageing adviser Prof Nathan Vytialingam said the social services must ensure the functional independence of the lone living elderly, where they are able to move around without much issue.
He said some of the risk factors are that many elderly who live alone may not be tech-savvy and do not use a mobile phone.
“Also, some elderly people tend to hoard, causing safety concerns and fall risk at their home,” he said.
Prof Nathan, who is also Perdana University’s School of Occupational Therapy dean, said social isolation reduces lifespan.
“Living alone creates problems on mental and physical health. It increases risks of other ailments such as depression, anxiety and a poor diet.
“That’s where the community can be the eyes and ears, where everyone checks on each other among the elderly who live alone.”
Calling for a comprehensive community care and support system, he suggested public healthcare to engage and send out occupational therapists on home visits to assess, monitor and provide care and referral to the elderly.
He also called on the Health Ministry to emulate Switzerland, which created the “Time Bank” concept as an old-age assistance programme, where people can volunteer to look after the elderly who require assistance, and then, the number of hours they spend with or caring for seniors gets deposited in their individual social security account.