An Aging World

Ensuring enabling and supportive environments

This third priority of the Plan focuses on issues related to housing and living environments of elders and promoting a positive view of aging – enhancing public awareness of the contributions older persons make to society, to care and to services.

The majority of older adults in developing countries live in rural areas while the reverse is true of those in developed regions. While rural living always poses challenges in terms of isolation, lack of services and transportation in all regions of the world, these conditions are much more extreme in developing countries. In the past, the lack of services was partially compensated by traditional reliance on families for care and support. However, in recent years a dramatic increase in migration of the younger generation to urban areas has disrupted social networks leaving the older generation alone and in need.

The recommendations found in the Plan of Action include: ensuring access to affordable housing and transportation; supporting the integration of older persons in their families and communities; developing policies and initiatives that improve seniors' access to goods and services.

Violence and abuse of older persons is also a concern – one that crosses all social, economic, ethnic and geographic boundaries. Recommendations found in the Plan of Action take into account the differing contexts of abuse in the developed and developing world.

The Plan stresses the need to eliminate harmful traditional practices involving older persons; to legislate and strengthen legal efforts to eliminate elder abuse; to sensitize professionals and educate the general public on subject of elder abuse; and to create support services to address elder abuse.

The Plan offered a number of other directives and recommendations, for instance, on the need for action regarding the continuum of care, supporting the caregiving role of older persons and ensuring that a gender perspective is integrated into all policies and programs.

NACA's take on the Assembly

Canada is a signatory to the Madrid International Plan of Action on Aging, and as such, has a moral commitment to Canadians and the rest of the world, to act.

However, we can't assume that the simple existence of the Plan of Action will itself bring about change. We only have to look to the experience of the First World Assembly – which provided some impetus for action but has been of slow and quite uneven application across the world. Certainly, compared to many other regions, Canada has made progress by implementing social and health programs to meet the challenges of its aging population. Nevertheless, problems remain and there's still much work to do.

If Canada doesn't move forward on some of these issues, it will have to bear the cost of inaction to our productivity, quality of life and social programs, including health care. NACA sees the following measures as particularly critical:

• Ensure employment and learning opportunities and incentives for all older persons who want to work. As the Plan of Action points out, unless action is taken, labour shortages are likely to occur and production will slow down as a result of the decline in the pool of young persons entering the labour market and of the barriers and disincentives to employment among older workers. We need to see more flexibility in the workplace, the elimination of mandatory retirement and better training and education for seniors.

• Carry out health promotion activities to forestall disease and decline in seniors. In Canada, as in other developed countries, the major diseases that result in disability and death are chronic conditions that occur in mid to later adult life – most strongly linked to preventable lifestyle risks. These diseases include cancers, heart disease, stroke and diabetes. They have many common risk factors, in particular, smoking, physical inactivity and obesity. Budgets need to be allotted to public education and information campaigns aimed at seniors. But these need to be part of a greater effort that addresses the broader environmental, social and economic conditions that influence the health of Canadians.

• Develop a continuum of health care services to meet the needs of seniors. The Plan directs governments to establish a full and coordinated range of health services to flexibly meet the changing health needs of seniors: disease prevention, primary care, acute care, rehabilitation, long-term and palliative care. It also recommends improving the coordination of health care with social services and other community services, all recommendations endorsed by NACA and many of Canada's thinkers on health care.

• Provide care, and support for caregivers. UN member states recognize that the burden of responsibility for providing support and care to frail seniors is mostly assumed by families – and disproportionately by women. In the future, there will be greater numbers of seniors relying on fewer informal caregivers, as most adults will be in the labour force. In Canada, about one in five adults over the age of 35 currently provide some unpaid care to a senior. We need to develop supports for informal caregivers that include more community services for frail seniors, more services to relieve caregivers, more workplace policies that allow caregivers to balance elder care and work responsibilities and more compensation measures for caregivers' loss of income, pension and career opportunities.

• Provide enabling supportive communities that allow "aging in place". The NACA public consultation in 1989 already showed that inadequate housing, transportation and community services were among the most important barriers to seniors' independence. Action on NACA's more recent recommendations regarding supportive housing and transportation options would go a long way toward increasing seniors' ability to continue to live in and enrich their Canadian communities.

• The Second World Assembly on Aging provided an important opportunity to pinpoint key issues of aging facing the world. Canada is in a privileged position. But population aging will not be without consequences. Our governments need to pursue a course of diligent planning so that Canadians can welcome the new demographics with serenity and share with the world some of the paths that lead to a society for all ages. The Madrid Plan of Action points the way.

1 HelpAge International, Emergencies and Ageing: A Position Paper, 2001.