Taking care of our elders

WITHOUT much fanfare and with virtually no government announcement or publicity from any source, Malaysia had officially attained the ‘Ageing Population’ status as declared by the United Nations (UN) last year, when its population of those aged above 65 years had reached 7.3 per cent.

The threshold figure was seven per cent.

Out of a total population of 32.7 million in 2022, 2.4 million or 7.3 per cent of us are above 65 years of age. Although we are still a long way off from a nation like Japan where one in four of its population are ageing, and in Singapore where it is double that of ours, at 14.1 per cent, we are definitely on the path to a fast ageing population.

According to Forbes, there are four main causes of our increased life expectancy in the past few decades and these are:

• improved healthcare and advances in medicine, where several breakthrough advances in this field have vastly increased our life expectancy;
• improved hygiene and our overall living conditions, especially concerning the environment;
• improved lifestyle and exercises, and;
• improved food, nutrition and emphasis on personal diet.

Conversely, over the past 12 months, the following are the causes for low life expectancy where fatalities and deaths have occurred most frequently:

• Covid-19;
• drug overdoses;
• accidental injuries (these top three account for two-thirds of the total);
• plus others like heart and liver diseases, and suicides.

Solid evidence has shown that the best way to ensure living a long and active life has always been the same old adage passed down the generations from parent to child – to eat well, exercise regularly, get plenty of sleep, stay away from bad habits, and to not stress yourself.

Today, I would like to take a quick look at two nations that have dealt very well and have continued to care for and look after their fast ageing populations – Singapore and Japan.

I’m just wondering if it’s a good time for us here to take a long, good look and to study, contemplate and, perhaps, consider modifying whatever successful policies that these two nations have taken to adapt them for our use here for our own senior population.

As a matter of curiosity, I am not very sure of what investments, healthcare systems or governmental policies have been put in place or implemented so far, which benefit our elderly population in Sarawak and overall throughout Malaysia.

Closer to home, our nearest neighbour Singapore has over the period of four years (2015-2019) invested S$3 billion (RM9.93 billion) to care for elderly Singaporeans in their golden years; with an additional S$14.1 billion (RM46.7 billion) set aside to give what they term ‘Pioneer’ and ‘Merdeka Generation’ seniors greater piece of mind for their healthcare needs.

Since 2015, the Singapore government has added another 3,600 daycare centres, 2,600 home care places, and 3,700 nursing home beds to cater for their seniors’ healthcare needs.
More are to follow.

The government has also made higher CPF (Central Provident Fund, Singapore’s version of our very own Employees Provident Fund, or EPF) contributions for older workers from 2021, and new schemes are being put in place to help increase their retirement income.

As at July 1, 2022, the re-employment age (i.e. the maximum age an employee can be re-employed until) has been increased from 63 to 68, a jump of an extra five years. In 2021, residents aged 65 and above made up 8.7 per cent of the total employed resident population in Singapore. The island nation is currently one of the most rapidly ageing societies, including an ageing workforce, in Asia.

Japan has an even faster ageing workforce than Singapore. Their birth rate has been falling and at present, one in four Japanese are over 65.

This figure is projected to increase to one in three in the next 15 years, which means that Japan’s population is ageing at a rate double that of Germany and four times faster than France’s.

The Japanese love to work. It is not unusual to find offices that are officially open from 9am to 5pm daily, Mondays to Fridays, still fully operational with a full working staff up till 9pm (but by necessity due to the last trains leaving their stations at 11pm; thus, they must be gone from offices by 10pm at the very latest).

Once the average ‘salaryman’ reaches retirement age (64 for men, 62 for women), instead of retiring to relax and enjoy the rest of their lives, many prefer to put their skills and knowledge and have gone back to work – they say it keeps them mentally and physically fit as they still feel useful to their society.

Many opted to forgo the usual retirement hobbies of travelling, gardening, going to get-togethers and looking after the grandchildren, and have returned to work.

For some, the extra income they earn is a consideration although money is not the main motivation. Keeping active socially and being mentally alert and mobile are usually more important for these sunset-years veterans. In turn, it also helps alleviate a worsening shortage of workers in Japan.

Healthcare in Japan is, generally speaking, provided free for all Japanese citizens, expatriates and foreigners. Medical fees, however, are strictly regulated by the government to keep them affordable – depending on the family’s income and the age of the insured, patients are responsible for paying between 10 per cent and 30 per cent of medical fees, with the government footing the balance.

As for Malaysia, I have checked on the website for ‘MyGovernment’ and appearing under the sub-section of ‘Public Service Delivery and Local Government’ and the section called ‘Vulnerable Groups’, it has so defined the senior citizens thus:

• The elderly/senior citizens are defined as individuals aged 60 years and above. This definition is in line with the definition given by the World Assembly on Ageing 1982 in Vienna. The services offered come under the Ministry of Women, Family and Community Development (KPWKM) and agencies under KPWKM such as Welfare Department (JKM). The services provided for this group include amongst them, financial assistance, activity centres for the elderly/senior citizens and ‘We Care’ Elderly Programme.

Then it lists a very short itemised list of four items. Then it lists 12 items of online services provided to civil servants after their retirement.

Finally at the bottom, there are links to four ‘Download Forms’ for online services available to the elderly folks from other ministries, namely:

• Applications Forms For Voluntary Admissions to Welfare Homes (For The Elderly);
• Wills;
• JKM 18 – Application Forms for Financial Aid, and;
• JKM 20 – Review Forms for Financial Aid.

However, when I actually clicked on all four of these online links, none of them worked!

Just wondering…!

While we are on this subject, even after all these years of firstly establishing websites for government departments and ensuring that the information is current and the pages are regularly updated, we are still at the mercy of such occurrences when links do not work, or online forms and documents referred or referenced to are ‘not the latest’ – and so on and so forth.

It would appear that we still cannot seem to get our act together and that there appears to be no pride in one’s skills when it comes to excelling at what one does.

Is there no pride in one’s own personal labour these days?

In my old company at Sebor Sarawak, we once had a company motto and it had said: ‘Do it right the first time’, and another one was ‘Stay Sharp!’

Anyway, I digress. Back to how we should be taking care of our elders.

We have quite a number of good things going. There’s universal free healthcare for all, where seniors do not pay for what they incur when they visit the general hospitals and public polyclinics (provided they are patient to wait in line), and the quality of healthcare is excellent.

Of course, the specialist treatment costs of optional care devices and medical treatments would attract some nominal fees, as to be expected.

There are special homes for the aged; home care health facilities and financial aid for those in need (very nominal) and even centres for recreational activities.

But are these enough? Shouldn’t there be more funds allocated by the government both at state and federal levels to ensure that the welfare of those above the age of 65 are being taken care of?

I know there are many charitable organisations and societies from the various faiths – the many benevolent groups of formal establishments and others who would regularly donate or contribute either in cash or in kind to help out individual cases or during disasters and tragedies and personal losses, but with our fast ageing population, we must seriously form a group of informed community leaders and professionals who can sit down together and format a long-term policy of how best to ensure that the elders in our population are living the remainder of their lives to the full.

We, as a society, owe them at least that much!

God bless us all – the elders, the seniors and the fulfilled ones.