Challenge of meeting ageing population's needs

The current median age of the population of Bangladesh is 27.6 yearsand within a decade it will become 31.6 years; this suggests acontinuing demographic shift, and available evidence suggests that it will become more evident in the coming years. Although at present the nation is benefiting from the economic growth resulting from a demographic dividend that comes along with a large number of availableyounger and working-agepopulation, this will slow down over time according to predictions and the number and share of ageing populationwill continue to grow. Less number of young people will be joining the labour force and will be responsible to support the older age bracket population. A similar crisis will appear in Bangladesh that other developed countries have been going through for the last several decades. It will become a critical national issue and it is a good time to start discussing, understanding, and addressing the economic security, health and wellbeing needs and issues of this growing ageingpopulation and the overall impact this changing population dynamicswill have on the society and economy.
Nearly 720 million people in the world are now 65 and older and resembling the trend in the rest of the world, the number of older people in Bangladesh is escalating. According to a study by the Bangladesh Institute of Development Studies titled 'an inclusive approach to the care of the elderly in Bangladesh' published in December 2019, Bangladesh is following a path when 21 per cent of its population will be elderly by 2025, and 40 per cent by the middle of the century. This is largely attributed to increased life expectancy,lower fertility rates, economic prosperity, and better access and delivery of healthcare services. But in an overly populated country, agrowing share of the ageing population can be looked at as a huge burden for its economy and society unless well-crafted policy, plans, programs, and a good number of initiatives catered to this population bracket are in place to support them.
In changing socio-economic circumstances encompassing rapid urbanisation, industrialisation, migration of millions of younger people to other countries, breaking down of joint families intonuclear ones, growing participation of women in the labour force, the traditional family care providing modality that was in place for centuries may collapse. As a result, the care of the elderly- who are until now taken care of by their immediate family members and children- has and will become a major concern. The above-referenced study stated that anger towards the older members of the family wasprevalent in both rural and urban settings with reports being higherby urban dwellers. A more concerning issue is that on the question of assault, that study reported that about 7 percent of rural elderly respondents experienced physical ill-treatment and this percentagedoubled among the urban respondents.
Many countries across the world have been dealing with the needs andissues of the elderly and have developed a well-functioning support mechanism that includes providing specialised care and attention to promote physical and mental health for them while offering free or heavily subsidised housing, meals, and transportation for that population segment. But to pursue similar policy and initiate such programs in a developing country, policymakers must be sensitisedfirst about the seriousness of these impending issues particularly for a country that does not have the necessary care providing skilled workforce or even the basic elderly-friendly infrastructure in place.
However, not knowing the obvious cannot be an excuse for not making the much-needed preparations.
The elderly may not always be able to contribute to the economy and society like their younger counterpart because of their failing health and deteriorating cognitive ability, but their rich experience, skills, and knowledge can often remain valuable for several more years post-retirement and they can continue to contribute as mentors andtrainers in many industrial sectors and occupations. As an example,the government of Bangladesh has allowed many of its retired officialsto work for a few extra years on contractual service, and this shows these folks do and can contribute to the nation in meaningful ways when given the right opportunity and the government as an employer has gained substantially from this experiment. Supreme Court judges and university professors now retire at 67 and 65 respectively and there are no valid reasons to believe why people in other sectors cannot contribute as well if they are also allowed to remain in gainful employment a little longer. The politicians in Bangladesh never retireand all of them remain actively engaged with full vigour and passiontill their death.
From the government's side, increasing the amount and coverage of old-age allowance, offering functioning health insurance, and takinginitiatives for providing home-based and institute-based nursing and health care services for the elderly would help them maintain good health and wellbeing. Furthermore, today's children should be educatedfrom an early age about their duties and responsibilities for theirolder family members, relatives and in general how to respect and care for elderly members of the society. School teachers, religious scholars, and textbooks can be important sources or media to conveythis important message. The moral aspects of this family and social obligation need to be promoted through mass media, online campaigns,and other social platforms.
The elderly will also have unique needs related to transportation andfinancial transactions. To deal with the banking system-- as most of the operations are being digitised, a better and specialelder-friendly banking service needs to be in place that will make all transactions including withdrawals, deposits, and savings easier for them. Regarding transportationchallenges, it is not easy for the elderly to ride on a crowded bus and the buses or other mass transportvehicles of Bangladesh have no option to accommodate ageing people or those with assisted devices. At one stage of their life, most elderly will not be able to cook their own meals.
All of these cannot be planned or performed by the government alone. All members of society will need to constructively and deliberately contribute to ensure and promote the wellbeing of the senior citizens. This could be done by creating early awareness among the school children by promoting their volunteer activities in thecommunity that focuses on the elderly needs. By initiating programsthrough hospitals and NGOs, a conducive environment can be created to provide special care for the elderly. Giving access to a gym, offeringnutrition and dietary counseling, and establishing geriatric healthcare facilities at all major hospitals to offer them specialized health care will be definitely supportive.
The anticipated growth of the elderly population will create numerous economic and social issues in Bangladesh and these need serious attention from the policymakers and activists now.
Kazi Farzana Sharmin works for Palli
Karma-Sahayak Foundation (PKSF) and Hasnat M Alamgir is a professor of public health