According to Professor
Shereen Hussein, the Middle East and North Africa [MENA] region family model
of aging no longer meets the needs of shifting demographics. Hussein is a Professor of Health
and Social Care Policy, the London School of Hygiene and Tropical Medicine, UK,
and an authority on aging systems. As she stated in a recent online seminar
presentation for the International Federation on Aging [IFA] on
September 23, 2022, these countries lack formal systems for helping older
adults and caregivers.
According to the World Bank census data for 2021, the MENA
region has 26.4 million older adults, or 5% of the total population.
Collectively, Australia, New Zealand, Europe, and North America have the highest
older population, approximately 17% total, and expected to increase to 25% by
2050 (Abyad, 2021). Global population projections indicate that by 2030, 12%
will be older adults and by 2050, that will increase to 16%. While the MENA
region is comprised mostly of younger people, the population is shifting toward
rapidly growing older people, especially the oldest-old with numerous chronic
conditions. Unfortunately, there are no policies or programs to address these
population shifts (Abyad, 2021).
MENA
populations embrace strong social networks, value and respect older adults, and
expect duties and sacrifices of family members. For centuries, families have
relied on each other for support. Demographic shifts, changing attitudes,
political instability, and climate change have impacted aging outcomes,
resulting in a family system that is breaking down. Older people do not have a
defined role in society beyond caring for grandchildren in their old age. There
are few safety nets for emotional, social, and financial support and long-term
care is not an option…. “not even an idea” (Hussein, 2022). Using the family
system, grown children may be unwilling to provide care, relocate, migrate, or
are displaced. Additionally, younger people are having fewer children due to
contraception and delayed marriage. Relying on the “family model” may not be
possible in the future, with the expanding older population, lack of formal
long-term care, migration, displacement, relocation, and the lack of practical
solutions.
While
private caregiving services have emerged as small businesses, it is scarce. There
is no oversight, no regulations, no standards, and patients must pay out of
pocket. Mistreatment and abuse are common. Affordability and accessibility to
healthcare remain pressing issues, as in the United States where I live. During
Dr. Hussein’s presentation, I thought of home care, assisted living, and
nursing homes in the United States. While we have regulations and standards,
there is little oversight, mistreatment, abuse, and most of the long-term care
is private pay. By default, Americans have also relied on the family systems
approach, and it is far outdated for meeting the needs of our society. Like the
MENA region, we are also plagued by an outdated care model and little
oversight. Like the MENA region, we lack coordinated care and a
wellness/integrated model of care.
Professor
Hussein’s discussions provide a comprehensive and thoughtful overview of the
opportunities and challenges facing not just the MENA region, but society
overall. I have provided resources below including her IFA presentation. Abyad’s
journal article includes helpful population charts for examining and comparing
lifespans and trends by country. AgeDoc
Resources:
Abyad, A. (2021) Aging in
the Middle East and North Africa: Demographic and health trends. International
Journal on Ageing in Developing Countries, 6(2), 112-128.
MENARAH Research on Healthy
Ageing: https://twitter.com/menarah3
Middle East and North Africa Research on Ageing Healthy:
World Bank Population MENA,
2021: https://data.worldbank.org/indicator/SP.POP.65UP.TO?locations=ZQ
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