SHAPING THE FUTURE HOW CHANGING DEMOGRAPHICS CAN POWER HUMAN DEVELOPMENT

for older people. Many advanced countries
spend from 0.5 percent to 1 percent of GDP on
health care for the elderly, a level that countries
in Asia-Pacific should over time seek to attain.
Other deterrents to health care for older
people include a lack of access to facilities,
particularly in rural areas, and a shortage of
trained medical staff, including with skills
specifically related to caring for the elderly. By
2030, 5.5 million additional health care workers
will be needed in Asia-Pacific. 116 This provides
an opportunity to institute training of health
workers that explicitly addresses age-related
and geriatric care.
Stronger financial and programmatic commitments
are needed to support prevention,
diagnosis, management and proper care of
non-communicable diseases over the course
of life. Treating these in many cases requires
extending affordable services in poorer communities,
and shifting the focus from a hospital-centric
model to one in which primary care
plays a bigger role, and the treatment of older
patients with chronic conditions is managed
affordably. Closer ties between formal care providers
and informal community health systems
might extend care options for the elderly as a
whole, given, for instance, the growing role of
voluntary and private actors in filling service
gaps in many communities. Information about
services should be widely available.
Increase long-term care facilities. As the proportion
of older people living alone rises, they will
require more long-term care facilities, including
in homes and communities. There is a growing
demand for home-based nurses and care providers,
but these are still largely missing in most
countries in the region. Investments are needed
in integrated, person-centred care tailored to
the needs of individuals. Other priorities are to
increase rehabilitative care, care for disabilities
and mental health services geared to older people.
Promote preventative care. The current rise in
non-communicable diseases underscores the
importance of preventive health care, including
healthy eating and exercise habits that can
minimize common old-age illnesses such as
diabetes and heart disease. Proactive strategies
to foster active and healthy ageing could include
awareness campaigns to cultivate healthy lifestyles.
Health promotion and well-being should
extend throughout life, recognizing that disease
later in life often starts in childhood.
CREATE MORE OPPORTUNITIES
FOR EMPLOYMENT
Opening more employment opportunities for
older women and men requires removing a variety
of barriers. Complementary and coherent
policy measures need to encourage employment
flexibility; promote the employability of older
people, both as an issue of individual prerogative
and to respond to changing labour market
demands; and stop discriminatory attitudes and
practices towards older workers.
Re-think retirement policy. One priority in
many countries, especially those with rapid
ageing, may be raising the retirement age, since it
clearly lags life expectancy. This is likely to have
a positive impact through increases in the labour
supply and savings as well as higher household
income. People will have more latitude to make
choices about when to retire. Government savings
will rise because lifetime benefits paid to
retirees will be smaller, which will create fiscal
space for expanding pension coverage. Similarly,
private savings may increase as people remain
longer in the labour force.
Increased longevity and improved health
around the world have led a number of countries
with ageing populations to remove the
compulsory retirement age or increase it, and
establish a pension-eligible age instead. The
retirement/pension-eligible age for Australia,
the United States and a majority of European
countries is above 65, and in some is expected
to increase to 67 in a few years, to help ensure
that individuals can sustain themselves
financially over a longer lifespan. In most of
these countries, the retirement policy remains
flexible. For instance, people can choose to
work beyond their pension-eligible age, unless
they are in specific categories of employment,
such as the military or government service. By
contrast, in nearly one-fourth of Asia-Pacific
countries, including a majority of Pacific island
states, people tend to retire before reaching 60,
and women even earlier. This pattern needs to
Skills training
improves employability
at older ages
147