III. Ensuring Enabling and Supportive Environments

10) OLDER PERSONS AND THE FAMILY

There is widespread recognition of the importance of family and community support for older persons across the region. Although the ability of families to care for their older members is under pressure as a result of urban and labour migration, unemployment, and economic restructuring with resulting internal family pressures, families remain the primary carers of the vast majority of older persons. However, the numbers of older persons at higher risk of dependency and disability are increasing at the same time as the ability of families to provide care is decreasing.

While strengthening traditional support systems and multigenerational solidarity and assisting older persons without family support are accorded high importance, the results of the 2002 survey on ageing conducted by ESCAP showed that providing carer support services such as in-home care for homebound older persons and family elder care training are lower priorities amongst some of the countries. However, in order for families and communities to continue to care for older persons, strong support from governments and other actors may be required.

Key actions:

• Undertake measures to strengthen family cohesiveness and multigenerational solidarity;
• Develop and/or strengthen a range of community-based services that support older persons with or without families and family carers in which caring responsibilities can be shared amongst individuals, families, communities, NGOs and the government.

11) SOCIAL SERVICE AND COMMUNITY SUPPORT

Care for older persons in terms of both home care services as well as community support is one of the important emerging concerns of population ageing in the region. The demands in these aspects have called for more effective coordination and cooperation among agencies and government departments providing services. Other equally important aspects include the correct assessment of needs and matching of appropriate services for older persons. Other important factors are the monitoring of standards and quality of services specially targeted for older persons.

Key actions:

• Develop schemes for comprehensive need-based assessment which act as a gate-keeper to enable older persons to receive a comprehensive assessment of their needs from an inter-disciplinary team;
• Establish standards to ensure quality care in formal care settings, as such measures require governments to take a more active role in formulating accreditation and quality assurance systems. However, instead of putting emphasis on setting regulations and enforcement, governments should advocate a shared responsibility for ensuring quality among service providers, user representatives (older persons) and the government itself.

12) HOUSING AND ENABLING ENVIRONMENTS

One of the many challenges posed to the countries in the region is to provide appropriate living environments for older persons which enable their full participation in the community. To this effect, improved housing characterized by barrier-free and age-friendly designs need to be constructed, thereby enabling families to effectively take care of older persons.

Recognizing the rapid development of the technology and knowledge-based economies which have resulted in the digital-divide and widening gap between countries as well as communities, older persons should have the opportunity and facilities to benefit from the technology development.

Key actions:

• Improve the housing and living environments which emphasize barrier-free, age-friendly and integrated designs and communities, thereby ensuring older persons a dignified and independent living;
• Promote equitable allocation of public or affordable housing, which supports "ageing in place" based on individual preference;
• Provide training and learning opportunities for older persons in the use of technology within their communities.

13) CARE AND SUPPORT TO CAREGIVERS

Within the region, relatively lower priority is attached to supporting caregivers through training, information, psychological, economic, social and legislative mechanisms. This may lead to deprivation of services for caregivers, in many cases, elderly women and female spouses. The HIV/AIDS pandemic in several countries in the region has also added to the responsibility of caregivers. More attention is required by governments to render direct care and support to caregivers.

Key actions:

• Promote and provide direct support to family carers, in the form of material aid, tax reduction, subvented housing or training on home care and to develop an integrative model combining both formal and informal care into enhanced community care to help support and relieve the care burden of family members;
• Promote and encourage community-based programmes which assist and act as relief mechanisms for family members and carers;
• Promote support systems to elderly caregivers of people living with HIV/AIDS, AIDS orphans and older persons living with HIV/AIDS.

14) PROTECTION OF THE RIGHTS OF OLDER PERSONS

It is recognized that neglect, abuse and violence against older persons takes many forms- physical, sexual, psychological, emotional and financial.

The rights of older persons as an important consumer group with common needs, interests and preferences, to receive proper goods and services must be recognized.

Key actions:

• Take active measures to ensure that older persons have access to information regarding their rights.
• Take into account the views of older persons on the design of products and delivery of goods and services;
• Place emphasis on the suitability of services and the right of choice by older persons whose specific needs and preferences should be recognized;
• Facilitate and regulate the development of the market by providing appropriate safeguards to prevent exploitation of older persons;
• Take active measures to combat discrimination, abuse and violence against older persons.

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