The will to care for the aged

| Updated on: Feb 02, 2011
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Community-based carer support programmes such as low-cost respite, and day and night in-home help options are a part of a larger array of community-based services that exist to promote the health and social well-being of older adults, write Robbyn R. Wacker and Karen A. Roberto in ‘ Aging Social Policies: An international perspective ' ( ). The policy challenge here is to determine the mix of universal and targeted community-based programmes that serve to keep older adults active and engaged members of society, the authors add.

Urging that the ways in which our social policies are formulated characterise the nation, and also define how we care for one another and for ourselves, the book opens by reminding that the year 2000 marked the first time in human history when the number of older adults reached 600 million; the number is expected to climb well into the middle of this century to a projected 2 billion. And that virtually all countries, with the exception of Africa, have experienced or are on the verge of experiencing a marked growth in their aging population.

If it seems anachronistic that the photo of ‘Arghaben, age 75, India' adorns the start of chapter 1, along with ‘Alta, age 88, United States,' what can be instructive to those closer home is the third place India occupies in the ‘Percentage increase in elderly population – 2000 to 2030,' after Thailand and Brazil, but ahead of China, each with a 150-plus percentage increase, even as European countries are expected to experience a smaller percentage increase in their elderly population over the next 30 years.

Total dependency ratio

Of value is the insight of the authors about dependency ratios, as a characteristic of population aging. The total dependency ratio is the number of people under 15 years of age (i.e., youth dependency ratio) and the number of people aged 65 and older (i.e., old-age dependency ratio) to the number of people between the ages of 15 and 64, explain Wacker and Roberto. For, it is assumed that those under age 15 and over 65 are likely to be dependent on those assumed to be in the working ages of 15 to 64.

Citing studies, the authors reason that it is important to discuss the total dependency ratio rather than present only the old-age dependency ratio, as this ratio provides a more complete picture of the potential social costs of caring for the young as well as elderly adults. Interestingly, as they point out, China and India are expected to experience a decline in total dependency ratio from 1950 to 2025.

What we can afford

A grim fact brought out in the book is the impact of greying on the budget. The authors draw reference to ‘Demography is not destiny, revisited' (Friedland and Summer, 2005) to highlight how the question about how much to spend on aging social policies can be framed. Public policy debates tend to be about what we value, yet most debates eventually narrow to the question of what we can afford, they fret.

A telling example mentioned in the book is of the former US defence Secretary Donald Rumsfeld's appearance before the Senate Committee on Appropriations to testify on the President's emergency supplemental budget request for $87 billion for post-military operations in Afghanistan and Iraq. “In his prepared remarks, Secretary Rumsfeld posed a rhetorical question: ‘Is $87 billion a great deal of money? Yes. But can we afford it? Without question.' His point was that this request was of such high value that the money was not an issue. This request was ‘the price of freedom.' Funding this request would send a clear ‘message to terrorists that we are willing to spend what it takes.'” Alas, such an importance does not usually get accorded to aging social policy issues.

Pension promise

A chapter titled ‘retirement income policies' outlines the complexity in providing for later life income security, an apparently straightforward idea. The authors raise, for example, questions such as – what percentage of one's pre-retirement income should be guaranteed via a pension plan, how much should workers and employers contribute and what eligibility requirements should be considered before one can begin receiving these benefits, how can the income security programme's financial viability be maintained as the population ages and people spend more time in retirement, and what is appropriate mix between public- and private-sector retirement plans.

One way to determine the level of the ‘pension promise' a country makes to its citizens is to compare the level of retirees' income replacement rates once they leave the workforce, the authors inform. Stating that the pension replacement rate gives us some indication of how generous the policies are in ensuring adequate income in later life, they cite the OECD for the two ways to examine how well a country's pension programme provides income security in retirement, viz. the net replacement rate and the relative pension level.

Retirement income security

The net replacement rate tells us to what extent pension systems attempt to maintain a certain standard of living in retirement by preserving a percentage of individual pre-retirement earnings, the book educates. It elaborates that the net replacement rate is the percentage of pre-retirement income replaced by pension schemes (minus personal income taxes and social security contributions paid by workers and pensioners).

For the average-wage earner, Italy and the Netherlands exceed 75 per cent net replacement rate, whereas the UK and the US provide around 50 per cent net replacement rate, one learns. While for low-wage earners, the general percentage is 75 per cent, for high-wage earners who have earnings double the average, Italy and the Netherlands have a replacement rate of more than 75 per cent; Sweden and France have rates more than 50 per cent; and the US, Canada, and the UK have rates lower than 40 per cent, the charts in the book depict. The relative pension level, the second measure, is the pension benefit level in relation to the average-wage earner in a given country. “A retiree may have a high net replacement rate of his or her own pre-retirement income, but the relative pension level gives us a sense of how the pension benefit amount stacks up against a broader measure of the country's economy-wide average earnings.”

Community support

There are many takeaways from the chapter on community support policies, especially the initiatives which can make all the difference in the day-to-day experiences and thus contribute to overall quality of life in the later years. Examples discussed in the book include the Home Delivered Nutrition Services Act in the US, which provides funding for nutritional assessments, counselling, and the delivery of meals to homebound older adults; and the Foster Grandparents Programme, which connects volunteers aged 60 or older with children and young people with exceptional needs for 15 to 40 hours per week in a variety of settings. Enlightening treatment of a critically-relevant subject.

Published on February 02, 2011

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